n CME : Your SA Journal of CPD - Metformin and lactic acidosis : clinical pharmacology




  • Metformin-associated lactic acidosis is extremely rare.
  • Prospective studies have so far failed to demonstrate that the traditional contraindications increase the risk of this life-threatening complication.
  • Case reports have suggested that renal dysfunction may be the strongest association with this disorder.
  • A creatinine level greater than 130 mmol/ l in men and 120 mmol/ l in women has been suggested as a contraindication, but an estimation of the creatinine clearance is more meaningful.


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