Reported Reactions

Drugs › Biguanide

Generic name

Metformin: adverse event reports filed with FDA

66,495 reports list it as a suspect or interacting product, 2004–2026. Class: Biguanide. Also reported as Metformin 500mg, Metformin 850mg, Metformin 1000mg.

66,495
reports as suspect product
0.3% of all reports · about 2,978 a year
5,178
reports, 12 months to June 2026
4,883 in the 12 months before
87.1%
marked serious by the reporter
81.3% across the class
14.9%
record death among outcomes, as reported
9,910 reports · not verified by FDA

66,495 adverse event reports received by FDA list metformin, a generic name as a suspect or interacting product, from March 2004 to June 2026. A further 237,665 reports list it only as a concomitant medication, and those are not counted in the figures on this page.

In the 12 months to June 2026, 5,178 reports listed it, close to the 4,883 of the 12 months before. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases. Over its reporting history that is about 2,978 reports a year and 0.3% of the 20,646,523 reports in the database, and 57% of the reports for the biguanide class. How many people take it is not in the data, so a count is not a rate of occurrence.

The reactions recorded most often are lactic acidosis (19.3%), acute kidney injury (12.5%) and diarrhoea (8.4%). A report can list several reactions, so shares add to more than 100%; 3,646 different terms appear across these reports. Lactic acidosis is recorded in 19.3% of these reports, a larger share than in the median biguanide drug (4.7%).

87.1% of the reports are marked serious by the reporter (81.3% across the class); 14.9% record death among the outcomes and 46.6% record hospitalisation, as reported. 32.8% of the reports came from other health professionals, and the largest patient age group is 45 to 64 (26.3%). FDA states that "a causal relationship cannot be established between product and reactions listed in a report" and that for any given report "there is no certainty that a suspected drug caused the event."

Reports by month, five years

0336672Jul 2021: 557Aug 2021: 379Sep 2021: 385Oct 2021: 358Nov 2021: 420Dec 2021: 5242022Jan 2022: 358Feb 2022: 384Mar 2022: 440Apr 2022: 438May 2022: 383Jun 2022: 379Jul 2022: 294Aug 2022: 360Sep 2022: 614Oct 2022: 505Nov 2022: 406Dec 2022: 4642023Jan 2023: 609Feb 2023: 672Mar 2023: 434Apr 2023: 471May 2023: 445Jun 2023: 446Jul 2023: 409Aug 2023: 551Sep 2023: 327Oct 2023: 438Nov 2023: 454Dec 2023: 5542024Jan 2024: 555Feb 2024: 515Mar 2024: 463Apr 2024: 411May 2024: 446Jun 2024: 359Jul 2024: 449Aug 2024: 424Sep 2024: 380Oct 2024: 458Nov 2024: 319Dec 2024: 5022025Jan 2025: 539Feb 2025: 354Mar 2025: 400Apr 2025: 384May 2025: 303Jun 2025: 371Jul 2025: 482Aug 2025: 354Sep 2025: 418Oct 2025: 325Nov 2025: 333Dec 2025: 5702026Jan 2026: 502Feb 2026: 424Mar 2026: 409Apr 2026: 495May 2026: 410Jun 2026: 456

Reports by the month FDA received them. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases.

By year received

03,6367,2722004: 2720042005: 2032006: 4112007: 6620072008: 572009: 1442010: 26520102011: 2802012: 5772013: 2,05620132014: 2,4092015: 2,7422016: 4,12620162017: 4,1232018: 6,0392019: 6,54120192020: 7,2722021: 5,5122022: 5,02520222023: 5,8102024: 5,2812025: 4,83320252026: 2,696

2026 covers reports received through June 2026 only.

Reactions recorded in the reports

share of Metformin reports recording the termmedian drug in biguanide

  1. Lactic acidosisa build-up of lactic acid in the blood19.3%12,812
  2. Acute kidney injurysudden loss of kidney function12.5%8,344
  3. Diarrhoealoose or frequent stools8.4%5,559
  4. Toxicity to various agentspoisoning or toxic effect of one or more substances7.5%4,957
  5. Metabolic acidosistoo much acid in the body fluids6.3%4,199
  6. Hypoglycaemialow blood sugar5.9%3,927
  7. Drug ineffectivethe medicine did not work as expected5.5%3,665
  8. Nauseafeeling sick5.4%3,603
  9. Vomitingbeing sick5.3%3,529
  10. Blood glucose increasedraised blood sugar reading4.3%2,846
  11. Completed suicidedeath by suicide4%2,685
  12. Hypotensionlow blood pressure3.9%2,590
  13. Fatiguetiredness3.5%2,336
  14. Dyspnoeashortness of breath3.3%2,202
  15. Drug interactionan interaction between medicines3.2%2,145
  16. Malaisegeneral feeling of being unwell3%2,026
  17. Weight decreasedweight loss3%2,003
  18. Hyperkalaemiahigh blood potassium3%1,972
  19. Astheniaweakness or lack of energy2.8%1,862
  20. Renal failurekidney failure2.8%1,834
  21. Off label useused for a purpose or in a way not on the label2.7%1,804
  22. Headachehead pain2.7%1,776
  23. Overdosea dose above the recommended amount2.6%1,743
  24. Dizzinesslight-headedness or unsteadiness2.6%1,696
  25. Intentional overdosea deliberate overdose2.4%1,582
  26. Abdominal painstomach or belly pain2.3%1,547
  27. Painpain, site not specified2.3%1,517
  28. Condition aggravatedthe condition being treated got worse2.2%1,495
  29. Confusional stateconfusion2.1%1,416
  30. Arthralgiajoint pain2.1%1,375

Top 30 of 3,646 MedDRA preferred terms recorded across these reports, with a plain-language gloss where one is available. One report can record several terms. The hollow bar is the median share across the 7 drugs in the biguanide class; it describes the reports, not the patients. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic."

Outcomes recorded

Death14.9%9,910
Life-threatening13.2%8,775
Hospitalisation (initial or prolonged)46.6%31,015
Disability2.4%1,581
Congenital anomaly1.3%849
Other serious52.6%34,991
Not serious12.9%8,602

Outcome flags as the reporter set them; a report can carry several, and "other serious" is FDA's own category for serious reports outside the named outcomes. Grey bar: all 116,598 reports in the class. FDA has not verified any outcome and states that the reports "cannot be used to estimate the incidence of these events."

Patients and reporters

Patient age

Under 20.4%254
2 to 110.2%118
12 to 171.2%824
18 to 448.8%5,884
45 to 6426.3%17,480
65 to 7419.8%13,143
75 and over17%11,297
Age not given26.3%17,495

Patient sex

Female46.5%30,901
Male40%26,629
Not given13.5%8,965

Who reported

Physician32%21,249
Pharmacist9.7%6,438
Other health professional32.8%21,786
Lawyer0.1%59
Consumer or non-health professional21.6%14,396
Not given3.9%2,567

Age and sex as stated in the report; the reporter's qualification is the primary source recorded by FDA. 34.7% of reports give the United States as the country of the event or reporter.

Reason for use recorded

Indication as recorded (MedDRA)ReportsShare
Type 2 diabetes mellitus17,76026.7%
Diabetes mellitus11,62517.5%
Suicide attempt3570.5%
Polycystic ovaries2760.4%
Gestational diabetes2490.4%
Glucose tolerance impaired1990.3%

The indication field is filled in by the reporter and is often blank; shares are of all 66,495 reports.

Drugs most often listed in the same reports

Drug (any role in the report)ReportsShare of Metformin reports
Atorvastatin5,2807.9%
Amlodipine4,5416.8%
Aspirin4,2166.3%
Ramipril4,0136%
Furosemide3,9956%
Gliclazide3,4235.1%
Bisoprolol3,1274.7%
Simvastatin3,0574.6%
Omeprazole2,7474.1%
Lisinopril2,6754%

Other products listed in reports where Metformin is a suspect product, whatever their own role. Co-listing means the two were recorded together; it says nothing about either product's part in the event. Only the 2,500 most-reported names are counted here.

In context

MeasureMetforminBiguanideAll reports
Reports as suspect product66,495116,59820,646,523
Share of that pool—57%0.3%
Reports, latest 12 months5,178—1,332,454
Marked serious87.1%81.3%57.4%
Death recorded among outcomes, per 1,000 reports14913991
Hospitalisation recorded, per 1,000 reports466431213
Consumer-filed share21.6%28.4%45.8%
Top term, share of reportsLactic acidosis 19.3%median 4.7%0.2%

Shares are of reports, not of patients treated. The number of people taking a product is not in the data, so none of these figures is a rate, and differences between columns reflect who takes a product, who reports and how long it has been sold. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic."

Other drugs in the biguanide class

DrugName typeReportsLatest 12 monthsMarked serious
Metformin hydrochloridegeneric24,1871,85180.6%
Metformin hclgeneric11,314067.2%
Janumetbrand10,50913364.9%
Xigduobrand2,19917776.5%
Invokametbrand1,336160%
Actoplus Metbrand558089.1%

Ordered by report count for navigation only. FDA states that adverse event reports "represent a small percentage of total usage numbers of a product", that "common products may have a higher number of adverse events due to the higher total number of people using the product", and that the data "by themselves are not an indicator of the safety profile of the drug or biologic." A brand and its generic are separate rows because reporters name them separately.

Questions about Metformin reports

How many adverse event reports has FDA received for Metformin?

66,495 reports list Metformin as a suspect or interacting product in the openFDA FAERS release of 28 Sep 2026, covering reports received through June 2026. 5,178 of them arrived in the latest 12 months. Another 237,665 list it only as a concomitant medication.

What reactions are recorded in Metformin reports?

lactic acidosis (19.3%), acute kidney injury (12.5%), diarrhoea (8.4%), toxicity to various agents (7.5%) and metabolic acidosis (6.3%). These are MedDRA preferred terms coded from what the reporter described; a report can list several, and a term's presence is not a finding that Metformin was responsible.

How serious are the reports?

87.1% are marked serious by the reporter. Among the outcomes recorded, 14.9% of reports include death and 46.6% include hospitalisation. FDA has not verified these outcomes and states that the reports "cannot be used to estimate the incidence" of the events.

Who files these reports?

other health professional (32.8%), physician (32%) and consumer or non-health professional (21.6%). Most reports reach FDA through the manufacturer, which must forward reports it receives.

Are reports for Metformin rising?

5,178 reports in the 12 months to June 2026, close to the 4,883 of the 12 months before. FDA releases FAERS data quarterly, so the newest months are incomplete and grow in later releases. Counts also move with how many people take a product, its time on the market and publicity.

Do these reports show that Metformin was responsible for these reactions?

No. FDA states that "a causal relationship cannot be established between product and reactions listed in a report" and that for any given report "there is no certainty that a suspected drug caused the event." The reaction may relate to the condition being treated, to other medicines, or to something else.

Is this a list of the side effects of Metformin?

No. It is a count of what was reported to FDA. The adverse reactions observed in clinical studies are printed on the FDA-approved label, which a pharmacist or clinician can go through with you.

How do I report an adverse event?

Consumers and health professionals can report to FDA through MedWatch (Form FDA 3500 online, or 1-800-FDA-1088), or to the manufacturer, which must pass reports on. See the guide on how to report.

Where this comes from. Counts are built from the openFDA Drug Adverse Event (FAERS) bulk export released 28 Sep 2026, which holds reports FDA received through 30 Jun 2026. Drug names are as reported, resolved to the brand or generic name on the FDA label where openFDA's harmonisation matched them; classes are the pharmacologic class (EPC) from the label and the National Drug Code Directory of 17 Sep 2026. A report counts here when it lists Metformin as a suspect or interacting product; reports listing it only as a concomitant medication (237,665) are excluded. No report narrative, lot number, patient detail or reporter identity is published. See the methodology and sources; FDA's record is authoritative, and corrections are handled within five working days.

Drug data (FAERS) through 30 Jun 2026; device data (MAUDE) through 31 Aug 2026. Not medical advice.