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Inhibitors of carbonic anhydrase may raise the risk of lactic acidosis.
Drugs that decrease metformin clearance, such as cimetidine, ranolazine, vandetanib, and dolutegravir, may cause metformin to accumulate more frequently. Examine the advantages and disadvantages of using medications concurrently.
Metformin's impact on lactate metabolism may be enhanced by alcohol.
Advise patients not to drink too much alcohol.
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