Phenformin combination

The combination of sulphonylureas and acarbose (3 x 100 mg) versus sulphonylureas and phenformin (75 mg) was tested for 3 months by Pagano and Cavallo-Perin (1990), who could not find any significant difference between the two treatments as far as blood glucose, plasma insulin and HbA] were concerned. However, there was a 20% increase in plasma lactate in the biguanide group and no variation in the acarbose patients. 

Metformin (Glucophage, others) and phenformin were introduced in 1957, and buformin was introduced in 1958. The latter was of limited use, but metformin and phenformin were used widely. Phenformin was withdrawn in many countries during the 1970s because of an association with lactic acidosis. Metformin has been associated only rarely with that complication, and has been used widely in Europe and Canada it became available in the United States in 1995. Metformin given alone or in combination with a sulfonylurea improves glycemic control and lipid concentrations in patients who respond poorly to diet or to a sulfonylurea alone. 

The use of ethylestrenol combined with phenformin to reduce platelet stickiness in 9 arteriopathic patients was reported.The epoxide 42, although devoid of anabolic-androgenic activity, possessed hypolipemic activity in the rat. ... 

The objections against the use of phenformin are important. The risk of lactic acidosis, a state which is often not immediately recognized and which is often fatal, combined with the higher frequency of cardiovascular accidents, seems to lead to the conclusion that prescription of phenformin is accompanied with so many risks that the use of this drug should be discouraged. 

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