[Prevention of lactic acidosis due to metformin intoxication in contrast media nephropathy].
Use of the oral antidiabetic drug metformin may cause lactic acidosis, a rare but life-threatening complication, especially in patients with renal function loss. Since intravenously administered iodide-containing contrast media may cause renal function disturbances precautions should be taken in metformin-treated patients for whom a radiological study with intravenous contrast media is considered. In diabetic patients who use metformin a serum creatinine concentration should be measured prior to the radiological study. If the serum creatinine is within normal limits (< 130 mumol/l), metformin can be continued and the examination performed. If the serum creatinine concentration is increased (> or = 130 mumol/l), metformin should be discontinued and replaced by another antidiabetic drug if necessary. The radiological procedure with intravenous contrast media should be postponed for 48 hours. If such a procedure cannot be postponed, additional measures to prevent lactic acidosis (hydration, monitoring of the renal function) should be taken.
Landewé-Cleuren
S
S
Academisch Ziekenhuis, AZ Maastricht.
van Zwam
W H
WH
de Bruin
T W
TW
de Haan
M
M
D000140:Acidosis, Lactic / Q000097:blood / Q000139:chemically induced* / Q000517:prevention & control*; D002985:Clinical Protocols; D000075202:Contraindications; D003287:Contrast Media / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy; D004347:Drug Interactions; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D007677:Kidney Function Tests; D008687:Metformin / Q000009:adverse effects*; D051437:Renal Insufficiency / Q000097:blood / Q000139:chemically induced
D003287:Contrast Media; D007004:Hypoglycemic Agents; D008687:Metformin; D003404:Creatinine