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At the beginning of treatment, the most common adverse reactions are nausea, vomiting, diarrhea, abdominal pain and loss of appetite, which in most cases resolve on their own. In order to avoid the development of these adverse reactions, it is recommended to take the daily dose of Glucovance® in 2 or 3 doses during the day and gradually increase the dose. At the beginning of treatment, transient visual impairment may occur due to a decrease in blood glucose. During treatment with Glucovance®, the following adverse reactions may occur. The frequency of adverse reactions is regarded as follows: very often: ?1/10; often: ?1/100, <1/10; infrequently: ?1/1000, <1/100; rarely: ?1/10000, <1/1000; very rarely: <1/10000. Blood and lymphatic system disorders: These adverse reactions disappear after discontinuation of the drug. Rare: leukopenia, thrombocytopenia. Very rare: agranulocytosis, hemolytic anemia, bone marrow aplasia and pancytopenia. Metabolic and nutritional disorders: Hypoglycemia (see Precautions section). Uncommon: attacks of hepatic porphyria and cutaneous porphyria. Very rare: lactic acidosis (see Precautions section); a decrease in the absorption of vitamin B12, accompanied by a decrease in its concentration in the blood serum with prolonged use of metformin (if megaloblastic anemia is detected, the possibility of such an etiology must be taken into account); disulfiram-like reaction when drinking alcohol. Nervous system disorders: Often: taste disturbance. Visual disturbances: At the beginning of treatment, transient visual impairment may occur due to a decrease in blood glucose. Gastrointestinal disorders: Very common: gastrointestinal disorders such as nausea, vomiting, diarrhoea, abdominal pain and loss of appetite. These symptoms are more common at the beginning of treatment and in most cases go away on their own. To prevent the development of these symptoms, it is recommended to take the drug in 2 or 3 doses; slowly increasing the dose of the drug also improves its tolerability. Skin and subcutaneous tissue disorders: Cross-reactivity to sulfonamides and their derivatives may occur. Rare: skin reactions such as pruritus, urticaria, maculopapular rash. Very rare: cutaneous or visceral allergic vasculitis, erythema multiforme, exfoliative dermatitis, photosensitivity, urticaria up to the development of shock. Liver and biliary tract disorders: Very rare: abnormal liver function tests or hepatitis requiring discontinuation of treatment. Influence on the results of laboratory and instrumental studies: Infrequently: a moderate or moderate increase in serum urea and creatinine concentrations. Very rare: hyponatremia. Reporting Suspected Adverse Reactions It is important to report suspected adverse reactions after drug registration. This will allow continuous monitoring of the benefit-risk ratio of the medicinal product. If an adverse reaction occurs that is indicated in this package leaflet or not mentioned in it, patients are advised to contact their doctor. Medical professionals are encouraged to report any suspected adverse drug reactions to the Republican Unitary Enterprise "Center for Expertise and Testing in Health Care" (see section "Send information about adverse reactions to the address").