What side effects can metformin ER and spironolactone cause during PCOS care?

Metformin can cause diarrhea, nausea, gas, and stomach discomfort. Spironolactone can cause more frequent urination, dizziness, breast tenderness, and changes in menstrual bleeding. Tell your prescribing physician if symptoms interfere with eating, drinking, sleep, or daily activities. Do not change the dose yourself to manage side effects.

Spironolactone can raise potassium levels and affect kidney function. High potassium may cause muscle weakness or an irregular heartbeat, but it can also occur without clear symptoms. Your physician may order blood tests. Long-term metformin use can lower vitamin B12 levels, which may also need checking.

Metformin rarely causes lactic acidosis, a dangerous buildup of acid in the blood. Seek urgent medical care for trouble breathing, severe weakness, unusual sleepiness, feeling very cold, or severe illness with vomiting. Call 911 for severe breathing problems, collapse, or signs of a serious allergic reaction. Report heavy or unusual bleeding promptly. Discuss pregnancy plans before treatment, since spironolactone should be avoided during pregnancy.