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You may dvlop lactic acidosis, a dangous build-up lactic acid in you blood. Call you doctgt mgncy mdical hlp i you hav unusual muscl pain, toubl bathing, stomach pain, dizzinss, ling cold, ling vy wak tid.

Tabl 5: Tatmnt-mgnt Advs vnts Congstiv Hat ailu (CH) Patints Tatd with Pioglitazon PlacbAddd on tMtomin.

Topiamat oth cabonic anhydas inhibitos (.g., zonisamid, actazolamid dichlophnamid) quntly dcas sum bicabonat and induc non-anion gap, hypchlomic mtabolic acidosis. Concomitant us ths dugs may induc mtabolic acidosis. Us ths dugs with caution in patints tatd with mtomin, as th isk lactic acidosis may incas.

Concomitant mdication(s) that may act nal unction sult in signiicant hmodynamic chang may int with th disposition mtomin, such as cationic dugs that a liminatd by nal tubula sction, should b usd with caution [s CLINICAL PHAMACOLOGY ].

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