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Rare but serious side effects may include severe abdominal pain, persistent vomiting, allergic reactions, or signs of gallbladder or pancreatic inflammation

Tuesta et al

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doi: 10.1016/j.cmet.2012.04.019

By pre-treating rats with the non-specific cholinergic receptor antagonist atropine as well as the specific M3 cholinergic receptor antagonist 4-DAMP and performing vagotomy, the researchers found that atropine and 4-DAMP significantly reduced metformin-induced GLP-1 secretion, whereas vagotomy had no effect on metformin-induced GLP-1 secretion