Refining metformin prescribing in New Zealand.
Metformin is the mainstay of treatment of type 2 diabetes. However, there has been significant concern on prescribing metformin in patients with renal impairment as a result of metformin-associated lactic acidosis (MALA). Recent studies have cast doubt on the existence of MALA purely related to metformin use. Medsafe recently initiated changes to datasheet so lower doses of metformin could be used in patients with GFR down to 15ml/min. In this paper we outline the context and implications of this change.
Department of Medicine, Hutt Valley DHB, Lower Hutt.
Sisira
S
Jayathissa
Department of Medicine, Hutt Valley DHB, Lower Hutt.
Paul
P
Dixon
Department of Medicine, Hutt Valley DHB, Lower Hutt.
Raymond
R
Bruce
Women's and Children's Health, University of Otago, Dunedin.
David
D
Reith
D000140:Acidosis, Lactic / Q000139:chemically induced* / Q000453:epidemiology; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000453:epidemiology; D054796:Drug Dosage Calculations; D005919:Glomerular Filtration Rate; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D008687:Metformin / Q000008:administration & dosage / Q000009:adverse effects*; D009520:New Zealand; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000378:metabolism*
D007004:Hypoglycemic Agents; D008687:Metformin