see also: [[Sulfonylureas]], [[Insulin Overdose]] - acute metformin OD is usually asymptomatic - lactic acidosis, if develpps, usually a few hours later, non-specific sx like nausea, diarrhea - can produce life threatening lactic acidosis, may occur in patients on therapeutic doses who develop renal failure - rare acute overdose (>10g), but can have high mortality - hypoglycaemia rare, and usually minor and easily tx with dextrose  - treat with haemodialysis in children, accidental ingestion up to 1700mg benign, doesn't require hospital tx