Metformin Use Reduction in Mild to Moderate Renal Impairment: Possible Inappropriate Curbing of Use Based on Food and Drug Administration Contraindications -

Metformin Use Reduction in Mild to Moderate Renal Impairment: Possible Inappropriate Curbing of Use Based on Food and Drug Administration Contraindications
Information type: Other primary research
Source: JAMA Internal Medicine
Specialities: Diabetes
Summary
The results of this research indicate that exaggerated concerns about the safety of metformin use in renal impairment may unnecessarily prevent its use in many patients in the US; the inconsistency between professional society guidelines and the FDA label is a contributing factor
UKMi comment
The UK SPC for Glucophage® has recently been updated to include detailed advice on the use of metformin in patients with/at risk of renal impairment. The max dose in moderate impairment is 1000 mg daily, given as 2 divided doses, and it is contra-indicated in patients with in moderate (stage 3b) and severe renal failure or renal dysfunction (CrCl < 45 ml/min or eGFR < 45 ml/min/1.73m2). The SPCs for Glucophage SR and generic formulations of metformin have not been updated; these currently state that use is contraindicated in patients with CrCl < 60 ml/min.
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