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Related Experiment Videos

Toxic effects from metformin exposure.

Henry A Spiller1, Debra A Quadrani

  • 1Kentucky Regional Poison Center, Louisville, KY 40232-5070, USA. henry.spiller@nortonhealthcare.org

The Annals of Pharmacotherapy
|March 20, 2004
PubMed
Summary

Metformin overdose rarely causes severe harm, with major adverse events occurring in about 1% of cases. Hypoglycemia is more common than expected, and certain symptoms like acidosis and hypotension may indicate a severe outcome.

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Clinical toxicology (Philadelphia, Pa.)·2024

Area of Science:

  • Clinical Toxicology
  • Pharmacovigilance
  • Drug Safety

Background:

  • Metformin is a widely used antidiabetic medication.
  • Lactic acidosis is a known, though infrequent, risk associated with metformin.
  • Hypoglycemia is generally not considered a primary concern in metformin exposure.

Purpose of the Study:

  • To analyze the demographics, toxic effects, and clinical presentations of metformin exposures.
  • To assess national poison center data for metformin-related adverse events.
  • To clarify the incidence and nature of metformin toxicity.

Main Methods:

  • Utilized the Toxic Exposure Surveillance System (TESS) database.
  • Included metformin-only exposures from January 1, 1996, to December 31, 2000.
  • Analyzed 4072 cases meeting study criteria.

Main Results:

  • Severe adverse events occurred in approximately 1% of cases.
  • Hypoglycemia was observed more frequently than anticipated (2.8%).
  • Acidosis was rare (1.6%), but associated with severe outcomes alongside hypotension, hyperglycemia, and coma.

Conclusions:

  • Severe metformin toxicity is uncommon, aligning with prior research.
  • Hypotension, acidosis, elevated anion gap, hyperglycemia, and coma are potential indicators of severe or fatal metformin exposure.
  • Poison control center data provides valuable insights into metformin-related adverse events.

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