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Generic metformin smells fishy?
If your patients tell you their pills smell like fish, they may be taking generic metformin. A letter to the Annals of Internal Medicine describes two patients who stopped taking generic metformin because of a fishy taste that caused nausea. The fishy smell is a property of metformin and is well known to pharmacists. Apparently the film-coated extended-release formulations have less smell and may be better tolerated (Ann Intern Med 2010;152:267-268).