Biguanides adverse effects

Metformin, a biguanide derivative, can lower excessive blood glucose levels, provided that insulin is present Metformin does not stimulate insulin release. Glucose release from the liver is decreased, while peripheral uptake is enhanced. The danger of hypoglycemia apparently is not increased. Frequent adverse effects include anorexia, nausea, and diarrhea Overproduction of lactic acid (lactate acidosis, lethality 50%) is a rare, potentially fatal reactioa Metformin is used in combination with sulfony-lureas or by itself. It is contraindicated in renal insufficiency and should therefore be avoided in elderly patients. 

Biguanides (1) and metformin (2-4) have been reviewed. Metformin (rINN) is the only biguanide commonly used buformin (rINN) and phenformin (rINN) have been withdrawn in many countries (SEDA-4, 306) because of dangerous adverse effects. However, they are still available in a few countries, and with increasing travel, adverse effects of drugs no longer available in one country can occur if the drug is obtained elsewhere. 

Adverse effect Lactic acidosis due to biguanides Dose-relation toxic effect Time-course time-independent Susceptibility factors genetic (slow phenformin metabolizers) age disease (impaired liver, kidney, or cardiac function, alcoholism)... 

The early symptoms of lactic acidosis are nausea, vomiting, and diarrhea since these are common adverse effects of biguanides, a careful watch should be kept for their sudden onset or aggravation, which might point to lactic acidosis (78). 

Biguanides This class of antidiabetics may cause acute poisoning with adverse effects such as acidosis and may be treated by supportive therapy. These drugs have therapeutic interactions with other antidiabetic drugs, alcohol, drugs that affect kidney function, and cimetidine. 

Adverse effect Lactic acidosis due to biguanides Dose-relation toxic effect Time-course time-independent... 

Biguanides. Metformin acts peripherally to increase glucose uptake by an unknown mechanism.. As it does not increase insulin release, it rarely cau-scs hypoglycaemia. Adverse effects include nausea, vomiting, diarrhoea and. very (Kcasionally, fatal lactic acidosis. 

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