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Phenformin-associated lactic acidosis; a review.
American Journal of Hospital Pharmacy
|May 1, 1975
Summary
Phenformin therapy for diabetes can cause lactic acidosis. Predisposing factors include renal impairment, infections, liver issues, alcohol, and heart failure. Early symptoms like anorexia and nausea signal impending danger.
Area of Science:
- Endocrinology
- Pharmacology
- Nephrology
Background:
- Phenformin was a widely used oral antihyperglycemic agent for type 2 diabetes mellitus.
- Lactic acidosis is a rare but serious adverse effect associated with phenformin therapy.
- Identifying predisposing factors is crucial for patient safety.
Purpose of the Study:
- To report a case of phenformin-associated lactic acidosis.
- To review previously reported cases to identify predisposing factors.
- To characterize the syndrome of impending lactic acidosis.
Main Methods:
- Case report of lactic acidosis during phenformin therapy.
- Systematic review of 34 previously reported cases.
- Analysis of patient demographics, medical history, drug dosage, and clinical presentation.
Main Results:
- Renal impairment, urinary tract infections, hepatic impairment, ethanol ingestion, and poorly controlled congestive heart failure were identified as predisposing factors.
- The onset of impending lactic acidosis was characterized by anorexia, nausea, vomiting, abdominal pain, or lethargy.
- Phenformin therapy, particularly in patients with predisposing conditions, poses a significant risk of lactic acidosis.
Conclusions:
- Phenformin therapy is associated with lactic acidosis, especially in patients with specific comorbidities.
- Awareness of predisposing factors and early recognition of symptoms are vital for preventing severe outcomes.
- The findings underscore the importance of careful patient selection and monitoring during phenformin treatment.