Based on NIH | Is it safe to eat cheese while taking metformin, or are there any interaction risks I should know about?

You can safely eat cheese while taking metformin, and there is no known direct drug–food interaction between metformin and dairy products like cheese. The main dietary caution with metformin is to avoid excessive alcohol because it can raise the risk of lactic acidosis, a rare but serious side effect. ^{[1] [2]}

What official guidance says

• Metformin’s labeling advises against heavy alcohol intake (binge drinking or regular large amounts), because alcohol can potentiate metformin’s effect on lactate metabolism and increase lactic acidosis risk. ^{[1] [3]}
• Food in general can lower and slow metformin absorption somewhat, which is why the medicine is commonly taken with meals to reduce stomach upset; this is not a harmful interaction, and it applies to meals broadly rather than specifically to cheese or dairy. ^{[4] [5]}

Cheese, dairy, and metformin

• There is no specific warning or restriction on cheese or other dairy products with metformin in official prescribing information. ^{[4] [5]}
• Eating metformin with food is often recommended to lessen common gastrointestinal side effects like nausea or diarrhea; including a modest portion of cheese as part of a meal is acceptable. ^[6]

Practical tips for taking metformin with meals

• Taking metformin with breakfast and/or dinner can help reduce stomach upset; including protein or fat (such as cheese, yogurt, or nuts) may make the dose easier on the stomach for some people. ^[6]
• If you notice persistent gastrointestinal symptoms, using smaller, more frequent meals or switching to an extended‑release formulation (with your clinician’s guidance) are common strategies. ^[6]

Alcohol is the key dietary caution

• Limit alcohol; avoid binge drinking and regular heavy intake, because alcohol can raise the chance of metformin‑associated lactic acidosis. ^{[1] [7]}
• This caution applies regardless of what you eat, including cheese. ^[1]

Vitamin B12 considerations

• Longer‑term metformin use can reduce vitamin B12 absorption, which over time may lead to low B12 levels and contribute to neuropathy symptoms in some people; this is unrelated to cheese intake but is worth monitoring periodically. ^[8]
• Discuss periodic B12 testing with your clinician, especially after several years on metformin or if you have symptoms like numbness, tingling, or unexplained fatigue. ^[8]

Bottom line

• Cheese and other dairy products do not have a known harmful interaction with metformin, and it’s fine to include them in your meals. ^{[4] [5]}
• Focus on taking metformin with food to reduce stomach upset, avoid excessive alcohol, and consider periodic vitamin B12 checks during long‑term therapy. ^{[4] [1] [8]}

Would you like suggestions for metformin‑friendly meal ideas that include dairy while keeping blood sugar in mind?