Metformin lactic acidosis, acute renal failure and rofecoxib.
A patient with acute renal failure associated with lactic acidosis as a result of concurrent treatment with metformin is described. Rofecoxib may have been a precipitating factor. The risk of renal failure with the use of traditional NSAIDs is well known. However, what is less well appreciated is the role that the COX 2 inhibitors may play in the development of renal failure which, when it occurs in a patient on metformin, can lead to a potentially disastrous outcome.
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Department of Anaesthesia, Victoria Hospital, Kirkcaldy, Fife, Scotland, UK. grantprice@hotmail.com
D000140:Acidosis, Lactic / Q000139:chemically induced*; D058186:Acute Kidney Injury / Q000139:chemically induced*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects*; D004347:Drug Interactions; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D007783:Lactones / Q000009:adverse effects*; D008687:Metformin / Q000009:adverse effects*; D008875:Middle Aged; D013450:Sulfones
D000894:Anti-Inflammatory Agents, Non-Steroidal; D016861:Cyclooxygenase Inhibitors; D007004:Hypoglycemic Agents; D007783:Lactones; D013450:Sulfones; C116926:rofecoxib; D008687:Metformin