Metformin Toxicity in Chronic Kidney Disease: A Case Report of Severe Lactic Acidosis
Aalia P.S
Department of Pharmacy Practice, St. Joseph’s College of Pharmacy, Cherthala, Kerala, 688524, India.
Farisa T.A
Department of Pharmacy Practice, St. Joseph’s College of Pharmacy, Cherthala, Kerala, 688524, India.
Lakshmi R *
Department of Pharmacy Practice, St. Joseph’s College of Pharmacy, Cherthala, Kerala, 688524, India.
Binu Upendran
Department of Nephrology, Lourdes Hospital, Post Graduate Institute of Medical Science & Research, Kochi, Kerala-682012, India.
Punnose Thomas
Department of Nephrology, Lourdes Hospital, Post Graduate Institute of Medical Science & Research, Kochi, Kerala-682012, India.
*Author to whom correspondence should be addressed.
Abstract
Metformin is one of the most commonly prescribed oral antihyperglycemic medicine worldwide. Professional diabetes organizations recommend it as the first-line treatment for newly diagnosed type 2 diabetes. Metformin is widely regarded as safe. The most common side effects include nausea, vomiting and diarrhea. Metformin-associated lactic acidosis (MALA) is a rare but serious adverse effect of metformin. Here, we are reporting a case of an elderly patient hospitalized with severe lactic acidosis presented with complaints of hypotension, decreased food intake, multiple episodes vomiting, dyspnoea, related to the treatment of type 2 diabetes with metformin. The patient was treated with emergency dialysis, vasopressor therapy and Inj Sodium bicarbonate.
Keywords: MALA, type 2 diabetes mellitus, metformin, lactic acidosis, chronic kidney disease, renal dialysis