Pharmacophore an International Research Journal
Background: Metformin is the first-line therapy for newly diagnosed type 2 diabetes mellitus. It accomplished glycemic control by gluconeogenesis inhibition in the liver and enhance glucose uptake in the peripheral tissues. Adverse effects commonly include gastrointestinal symptoms, such as nausea, vomiting, and diarrhea. A rare but life-threatening lactic acidosis could develop in the setting of metformin use. Objective: This study aims to understand the mechanism and the reality behind metformin-associated lactic acidosis, particularly in patients with chronic kidney disease. Method: We searched in the PubMed database for relative articles using two Mesh terms, "metformin" and "lactic acidosis." Conclusion: Metformin-associated lactic acidosis is a rare but serious consequence, especially in patients with chronic kidney disease, congestive heart failure, and chronic liver disease. Most of the cases have at least one predisposing factor other than metformin use. The link between metformin and lactic acidosis was previously overestimated, and there are growing data showing that metformin can be used in patients with mild to moderate renal impairment.
