Recemin

Lactic acidosis associated with Recemin treatment is a rare but fatal adverse effect. Lactic acidosis appears to result from biguanide interference causing an increase in production and decrease in clearance of lactate leading to higher cellular lactate levels. A decrease in pyruvate carboxylase activity, the rate-limiting enzyme in the formation of glucose from lactate, can also decrease hepatic metabolism of lactate. leading to increasing lactic acidosis. Signs and symptoms of Recemin induced lactic acidosis are nonspecific and include anorexia, nausea, vomiting, altered level of consciousness, hyperpnoea, abdominal pain, and thirst. 

Yes, Recemin can cause low blood sugar (hypoglycemia). However, this can also occur if you delay or miss a meal, drink alcohol, exercise more than usual, can't eat due to stomach upset, and taking other antidiabetic medicine with metformin. So, regular monitoring of blood glucose level is needed and be cautious of symptoms of hypoglycemia, always keep glucose-rich food with you. 

The long-term use can lead to the deficiency of Vitamin B12, which can further lead to megaloblastic anemia. Furthermore, Long-term Metformin use can also lead to kidney and liver problems. 

Recemin works by decreasing the hepatic glucose production. It also works to lower blood sugar by increasing your sensitivity to insulin and decreasing the amount of glucose that is absorbed from the food you eat.

Recemin can be taken forever, diabetes is a progressive disease it's possible that more medication and/or insulin may eventually need to be added to the regime.