Metformin pharmacology

Renal disease or renal dysfunction (eg, as suggested by serum creatinine levels greater than or equal to 1.5 mg/dL [males], greater than or equal to 1.4 mg/dL [females], or abnormal Ccr) that may also result from conditions such as cardiovascular collapse (shock), acute myocardial infarction (Ml), and septicemia CHF requiring pharmacologic treatment hypersensitivity to metformin acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma. Treat diabetic ketoacidosis with insulin. 

Hermann LS. Metformin a review of its pharmacological properties and therapeutic use. Diabete Metab 1979 5(3) 233-45. 

Sugiyama, Y. (2002) Involvement of organic cation transporter 1 in hepatic and intestinal distribution of metformin. The Journal of Pharmacology and Experimental Therapeutics, 302, 510-515. 

Patients with renal impairment should not receive metformin. Other contraindications include hepatic disease, a past history of lactic acidosis, cardiac failure requiring pharmacological therapy, or chronic hypoxic lung disease. The drug also should be discontinued temporarily prior to the administration of intravenous contrast media and prior to any surgical procedure. The drug should not be readministered any sooner than 48 hours after such procedures, and should be withheld until renal function is determined to be normal. These conditions all predispose to increased lactate production and hence to the potentially fatal complication of lactic acidosis. The reported incidence of lactic acidosis during metformin treatment is less than 0.1 cases per 1000 patient-years, and the mortality risk is even lower. 

There are three pharmacological agents often referred to as insulin sensitizers two thiazoli-denedione (TZD) compounds (rosiglitazone and pioglitazone) and metformin. Despite the frequency... 

The study [44] was initiated with two pharmacological treatment arms (metformin and trogUtazone) however, the hepatic toxicity of troglitazone resulted in a premature closure of that portion of the study. As discussed above, although metformin is unlikely to act by increasing insulin-stimulated glucose disposal, it is ofteu considered to be an insulin sensitizer, Be that as it may, the report of... 

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