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Instruct patients to inform their doctor that they are taking Glucovance prior to any surgical or radiological procedureas temporary discontinuation of Glucovance may be required until renal function has been confirmed to be normalsee PRECAUTIONS

Initial and periodic monitoring of hematologic parameterse.ghemoglobin/hematocrit and red blood cell indicesand renal functionserum creatinineshould be performedat least on an annual basisWhile megaloblastic anemia has rarely been seen with metformin therapyif this is suspectedvitamin B 12 deficiency should be excluded.

You may develop lactic acidosisa dangerous build-up of lactic acid in your bloodCall your doctor or get emergency medical help if you have unusual muscle paintrouble breathingstomach paindizzinessfeeling coldor feeling very weak or tired.

Before having surgery or any X-ray/scanning procedure using iodinated contrasttell your doctor or dentist about all the products you useincluding prescription drugsnonprescription drugsand herbal productsYou may need to stop this medication for a short time for the surgery/procedureAsk your doctor or dentist for instructions before your surgery/procedure.

Patients suspected of having signs or symptoms of lactic acidosis must seek emergency medical help.

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