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If metformin-associated lactic acidosis is suspectedimmediately discontinue Glucovance and institute general supportive measures in a hospital settingPrompt hemodialysis is recommendedsee PRECAUTIONS
There have been post-marketing cases of metformin-associated lactic acidosisincluding fatal casesThese cases had a subtle onset and were accompanied by nonspecific symptoms such as malaisemyalgiasabdominal painrespiratory distressor increased somnolencehoweverhypotension and resistant bradyarrhythmias have occurred with severe acidosisMetformin-associated lactic acidosis was characterized by elevated blood lactate concentrations5 mmol/Lanion gap acidosiswithout evidence of ketonuria or ketonemiaand an increases lactate:pyruvate ratiometformin plasma levels were generally5 mcg/mLMetformin decreases liver uptake of lactate increasing lactate blood levels which may increase the risk of lactic acidosisespecially in patients at risk.
For each of the known and possible risk factors for metformin-associated lactic acidosisrecommendations to reduce the risk of and manage metformin-associated lactic acidosis are provided below:
What is diabetesWhat causes diabetesLearn the signssymptomsdiet for type 1 and type 2 diabetes.
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