I'm Dr. Joshua Schwimmer, a nephrologist and internal medicine physician in New York City. • Kidney Notes was the first active nephrology blog. (Trivia: Kidney Notes is so old that the National Library of Medicine still uses it as an example of how to formally cite blogs.) • Professionally, you can find me at Kidney.nyc. • Kidney Notes is for educational purposes only, not medical advice. Consult qualified health care professionals. See disclaimer.

Tuesday, October 18, 2005

Are the Contraindications of Glucophage (Metformin) Contraindicated?

Glucophage (metformin) is a frequently used and effective medication for type 2 diabetes. Unfortunately, it is often stopped in patients with kidney disease because of concerns about lactic acidosis, a feared complication. (Currently, the guidelines are to stop metformin when the creatinine is greater than 1.4 - 1.5.)

However, lactic acidosis is rare, and doctors may be stopping metformin in many diabetic patients with kidney disease even though the risk of this complication is very low.

The Canadian Medical Association Journal has an excellent review of the debate for and against relaxing the guidelines for the use of metformin in patients with kidney disease.

(Thanks to Dr. RW.)

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