A patient reports taking his metformin 500 mg twice daily but has persistent GI side effects (nausea, diarrhea) after 6 weeks. What is the best recommendation?
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A
Discontinue metformin and switch to a DPP-4 inhibitor
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B
Switch to metformin extended-release (XR) formulation
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C
Add a proton pump inhibitor to reduce GI symptoms
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D
Reduce the dose to 250 mg twice daily permanently