Metformin is a common diabetes medicine. Drinking in moderation with food is generally tolerated, but alcohol can affect blood sugar control, sometimes causing it to drop, particularly if you drink on an empty stomach or skip meals. Binge drinking and chronic heavy drinking are the main concerns.
Heavy alcohol use combined with metformin increases the small risk of lactic acidosis, a serious build-up of acid in the blood. People with liver or kidney problems are at higher risk and should be especially cautious.
Keep alcohol within recommended limits, eat when you drink, and monitor your blood sugar. Seek urgent care for symptoms of lactic acidosis such as deep rapid breathing, severe muscle pain, extreme tiredness, vomiting, or feeling very cold, and treat severe low blood sugar promptly.