Metformin, heart failure, and lactic acidosis: is metformin absolutely contraindicated?
Open accessAbstract
Many patients with type 2 diabetes are denied treatment with metformin because of “contraindications” such as cardiac failure, which may not be absolute contraindications
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Despite the use of metformin in cases where it is contraindicated, the incidence of lactic acidosis has not increased.
“Despite the use of metformin in cases where it is contraindicated, the incidence of lactic acidosis has not increased.”
From Metformin: An Old But Still the Best Treatment for Type 2 Diabetes (2013) · cites this paper as [161]
Most patients with case reports relating metformin to lactic acidosis had at least one or more predisposing conditions for lactic acidosis.
“Most patients with case reports relating metformin to lactic acidosis had at least one or more predisposing conditions for lactic acidosis [161].”
From Metformin: An Old But Still the Best Treatment for Type 2 Diabetes (2013) · cites this paper as [161]
Structural and pharmacokinetic differences in metformin may account for differences in lactic acidosis risk between metformin and phenformin.
“Structural and pharmacokinetic differences in metformin such as poor adherence to the mitochondrial membrane, lack of interference with lactate turnover, unchanged excretion, and inhibition of electron transport and glucose oxidation may account for such differences [161].”
From Metformin: An Old But Still the Best Treatment for Type 2 Diabetes (2013) · cites this paper as [161]
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Cites
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AMPK is associated with the beneficial effects of antidiabetic agents on cardiovascular diseases
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- Authors
- Tahrani, A. A., Varughese, G. I., Scarpello, J. H., & Hanna, F. W. F.
- Affiliations
- University Hospitals of North Midlands NHS Trust (GB)
- Corresponding author
- Tahrani, A A
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2007-09-06
- Volume
- 335
- Issue
- 7618
- Pages
- 508-512
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC1971167
- OpenAlex
- W2027275601
- Cited by
- 138
- References
- 24
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 7 · 2023: 5 · 2022: 3 · 2021: 6 · 2020: 7 · 2019: 5 · 2018: 5 · 2017: 2 · 2016: 9 · 2015: 8 · 2014: 10 · 2013: 12 · 2012: 13
- FWCI
- 8.04
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- University of Birmingham Research Portal (University of Birmingham) (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- metformin, heart failure, lactic acidosis, type 2 diabetes, contraindications, drug safety
- MeSH terms
- Contraindications, Acidosis, Lactic, Diabetes Mellitus, Type 2, Heart Failure, Humans, Hypoglycemic Agents, Metformin, Risk Factors
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