What Are The Signs Of Lactic Acidosis With Metformin?

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Metformin-associated Lactic Acidosis

OVERVIEW metformin use is associated with lactic acidosis, but it remians controversial as a disease entity MECHANISM the mechanism of lactic acidosis is uncertain Metabolic effects of metformin include: decreased gluconeogenesis increased peripheral glucose uptake decreased fatty acid oxidation CLINICAL FEATURES presence of risk factors abdominal pain nausea and vomiting fatigue myalgias altered mental status myocardial insufficiency multi-organ failure RISK FACTORS advanced age high dose renal failure (metformin is excreted unchanged in the urine) hypoxia active alcohol intake sepsis dehydration shock acidosis INVESTIGATIONS high anion gap metabolic acidosis (HAGMA) high lactate MANAGEMENT rule out other causes of lactic acidosis (sepsis, cardiogenic shock, hypoperfusion, ischaemic bowel) withdrawal of metformin RRT RRT remove metformin and correct acidosis best performed early due to large volume of distribution of metformin use hemodialysis use HCO3 buffer CONTROVERSY Some argue that metformin itself does not cause lactic acidosis, that it is actually due to the underlying conditions such as renal failure and diabetes mellitus. However, there are definite cases of lactic acidos Continue reading >>

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Popular Questions

  1. MAYS

    Metformin Induced Lactic Acidosis! ... It can happen to anyone!

    How many questions do you ask your doctor, pharmacist or medical team concerning your nedications?
    How much in the way of research do you do on your own pertaining to medications and treatment that has been prescribed, or administered unto you?
    Let's talk about the diabetes medication, "Metformin" and a serious complication that it can cause called " Lactic Acidosis" in some people.
    What is Metformin induced Lactic Acidosis?
    Diabetic Connect family member "granniesophie" sent me this message, which I am sharing with everyone here (with her permission) concerning "Metformin and Lactic Acidosis" from a very personal perspective, her very own words!
    " I have to sit on my hands everytime a Metformin discussion comes up! I have just been diagnosed, after 4 months of tests and pain and losing 20 pounds for no reason and 2 different doctors not having a clue until just a few days ago, with Lactic Acidosis, caused by Metformin. This is a very rare side effect wihich only affects 5% of users. I'd been on it for over 6 years now, and it just came up in June. It can be fatal if not caught in time. It has also done damage to my kidneys, which the doctors hope can be reversed.
    The FDA says this is not a side effect, and studies are out on it, but there is a black box warning on it that it can cause Lactic Acidosis in some people. I have to report it to the FDA.
    This is a dangerous drug, and I may never be 100 percent-
    I have just begun taking Lantus, since the doctor no longer wants me on any oral meds until we can assess the damage that the Met may have caused long term.
    I am one sick human and I have other meds that have been causing issues now as well, related or not. So I am being juggled on all my meds in hopes that there is no long term damage.
    Whether this gets mentioned in discussions or not (and I am not going to) people should be aware that the Gold Standard of Diabetes treatment has some darn nasty thorns."
    If you have any questions, or concerns about Metformin and Lactic Acidosis talk to your doctor or pharmacist, if you have any questions that you would like to ask "Sonya" personally concerning this you can contact her here:

  2. Mamawiggles

    Metformin can aggravate breathing. Stupid D.O. Put my dad on it! Endocrinologist took him off immediately. You see. He has copd. Put him on Lantus.

  3. Jimbo6217

    I've only been taking the drug for a week but I've already developed hives head to toe and painfully swelled hands and feet. The only kidney proems I've had are stones .

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