Unsaffe. Avoid alcohol completely. Mixing alcohol with Metformin drastically increases the risk of Lactic Acidosis—a rare but life-threatening metabolic complication. It can also cause unpredictable blood sugar crashes (hypoglycemia).

Unsafe. It is generally not recommended during pregnancy. Insulin is typically the preferred and safest choice for controlling blood sugar during gestational or pre-existing diabetes. Consult your doctor immediately if you plan to conceive.

Safe. On its own, this medicine does not cause drowsiness or hypoglycemia. However, if taken alongside other anti-diabetic drugs (like sulfonylureas or insulin), your blood sugar could drop, causing dizziness. Keep a fast-acting sugar source handy.

Caution. It should be used with extreme caution or avoided in patients with severe, active liver disease, as hepatic impairment compromises the body's ability to clear lactate, further increasing the risk of lactic acidosis.

Caution. Metformin can pass into breast milk in small amounts, and data on Sitagliptin during lactation is limited. Consult your physician, who will weigh the benefits against potential risks to the infant.

Caution. Metformin is cleared exclusively by the kidneys. If you have severe kidney impairment (low eGFR levels), this drug is contraindicated due to the high risk of lactic acidosis. Regular kidney function tests (eGFR/Serum Creatinine) are mandatory.