Is Metformin Contraindicated In Chronic Kidney Disease?

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Using Metformin In The Presence Of Renal Disease

In January, the electronic Medicines Compendium (eMC) updated the Summary of Product Characteristics for Glucophage (metformin), approved by the UK Medicines and Healthcare Products Regulatory Agency (MHRA). The summary states that “Metformin may be used in patients with moderate renal impairment, stage 3a (creatinine clearance [CrCl] 45-59 mL/min or estimated glomerular filtration rate [eGFR] 45-59 mL/min/1.73 m2) only in the absence of other conditions that may increase the risk of lactic acidosis . . . If CrCl or eGFR fall <45 mL/min or <45 mL/min/1.73 m2 respectively, metformin must be discontinued immediately.”1 This is reiterated in the patient information leaflet. Interestingly, the summary for generic metformin states that “Renal failure or renal dysfunction (creatinine clearance <60 ml/min)” is a contraindication to use. In the face of burgeoning levels of type 2 diabetes and associated renal disease, we believe that this restriction is too conservative and will deny an important drug to many thousands of people with diabetes who … Continue reading >>

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Popular Questions

  1. Buttons11

    I've just been prescribed metformin reading the leaflet it says not to drink any alcohol. It's not that I'm an alcoholic or anything but does this mean I can't even have the occasional drink and what will happen if I do?

  2. Resurgam

    It means what it says - no alcohol.
    The consequences can be lactic acidosis, which is a serious matter and requires urgent treatment.

  3. SueNSW

    I'm the naughty one on here I think - I still drink - not excessively (normally) but certainly a glass of wine (or even 2 - shock - horror) with dinner some evenings and a Baileys and milk during the evening too sometimes - doesn't seem to be causing me any problems.
    Also over indulged a little on cocktails (including creamy ones!) while on holiday in Bali in December, as well as drinking light beer - again no problem for me whatsoever - but of course everyone is different.
    Interestingly here in Australia we don't seem to get the info sheet in with meds anymore - or not the ones I'm taking anyway - and only once had a pharmacist print off a copy as I had some specific questions - looking up the consumer medicine information leaflet for the one I take (Metex XR) it says:
    Drinking excessive amounts of alcohol while you are being treated with the medicine may also lead to serious side effects
    Let's face it though, drinking excessive amounts of alcohol is always likely to cause some problem or other!!

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