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Do not crush, chew, break, or open a delayed-release capsule. Excessive Alcohol Intake: Alcohol potentiates the effect of metformin on lactate metabolism, and this may increase the risk of metformin-associated lactic acidosis. So, these patients often need medications that come in formulations that are chewable, liquid, or are able to be crushed. The therapeutic efficacy of Deoxyspergualin can be decreased when used in combination with Ethinyl Estradiol. What should I avoid while taking clonidine? The therapeutic efficacy of Conjugated estrogens can be decreased when used in combination with Fosphenytoin.