Talk to your doctor before taking this medicine If you

• are allergic to SUPERMET AM
• suffer with heart conduction or rhythm problems, heart failure, blocked blood vessels
• suffer from a tight, painful feeling in the chest in periods of rest (Prinzmetals angina)
• are suffering from narrowing of the aortic heart valve (aortic stenosis)
• suffer with untreated phaeochromocytoma (high blood pressure due to a tumor near the kidney)
• suffer from increased acidity of the blood (metabolic acidosis)
• have low blood pressure
• have or have had breathing difficulties or asthma including COPD
• suffer with diabetes associated with frequent episodes of low blood sugar (hypoglycaemia)
• have liver or kidney disease or failure
• have difficulties in passing urine
• have low levels of potassium (hypokalaemia) or sodium (hyponatraemia) in your blood
• have high levels of calcium (hypercalcaemia)
• suffer with gout due to high levels of uric acid
• have or have suffered from psoriasis (severe skin rashes)
• have myasthenia gravis
• are going to have an operation or an anaesthetic, please tell your doctor that you are taking SUPERMET AM tablets, as your heart beat might slow down too much

• If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine

• Do not give this medicine to children

• SUPERMET AM may make you feel tired and dizzy. Make sure you are not affected before you drive or operate machinery, particularly after changing to another medicine or if taken with alcohol

• allergic reaction such as itching, difficulty breathing or swelling of the eyelids, face, lips, throat or tongue
• sudden wheeziness, chest pain, shortness of breath or difficulty in breathing
• severe skin reactions including intense skin rash, hives, reddening of the skin over your whole body, blistering, peeling and swelling of the skin, inflammation of mucous membranes (Stevens johnson syndrome) toxic epidermal necrolysis
• heart attack, abnormal heart beat
• inflamed pancreas which may cause severe abdominal and back pain accompanied with feeling very unwell

• tiredness, dizziness, headache, sleepiness
• a slow heart rates
• feeling faint on standing due to low blood pressure
• shortness of breath with or without strenuous physical activity
• feeling or being sick
• stomach pain or stomach upset
• oedema (fluid retention)
• palpitations (awareness of your heart beat), flushing
• abdominal pain, feeling sick(nausea)
• altered bowel habits, diarrhoea, constipation, indigestion
• visual disturbances, double vision
• muscle cramps
• swollen ankles

• enlarged breasts or discomfort in men
• sleep disorders, irritability, depression, mood changes, anxiety
• pain, feeling unwell, dry mouth, uncontrolled shaking, pins and needles, increased sweating
• problems with your eye-sight (visual disturbances)
• trembling, taste abnormalities
• numbness or tingling sensation in your limbs, loss of pain sensation
• sneezing/running nose caused by inflammation of the lining of the nose (rhinitis)
• disorder in passing urine, increased need to urinate at night, increased number of times of passing urine
• ringing or buzzing in the ears
• fainting, increased heart rate, chest pain, muscle cramps, back pain, muscle and joint pain aggravation of angina may occur at the beginning of the treatment
• low blood pressure, inflammation of the blood vessels
• breathing difficulties, inflammation of the nasal mucosa, cough
• dry mouth, vomiting (being sick), diarrhoea, constipation, swollen gums
• prickling and tingling sensation of the skin, itching, red patches on skin, nettle rash, hair loss, discoloration of the skin
• increase or decrease in weight

• depression, nightmares, inability to think clearly, sleepiness or difficulty in sleeping
• tingling or ‘pins and needles
• difficulty