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Updated: May 18, 2026

Human Liver Microphysiological System for Assessing Drug-Induced Liver Toxicity In Vitro
Published on: January 31, 2022
Fatal metformin intoxication with markedly elevated blood and liver concentrations
Lee F Cantrell1, Craig L Nelson, Ray D Gary
1California Poison Control System, San Diego Division and Clinical Pharmacy, University of California San Francisco School of Pharmacy, 200 W. Arbor Dr., San Diego, CA 92103, USA. lcantrell@calpoison.org
Abstract:
The highest postmortem metformin concentrations are recorded utilizing a sensitive and specific analytical procedure. The peripheral blood metformin concentration was 240 mg/L, the liver concentration was 240 mg/kg and the gastric concentration was 1,700 mg. Additionally, an antemortem blood sample collected shortly after admission revealed a metformin concentration of 210 mg/L. These data, revealing a liver to peripheral blood ratio of 1.0, provide additional support that metformin is not subject to postmortem redistribution. Intentional self-poisonings with metformin can result in death, despite multiple medical interventions.
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