The safety and pharmacokinetics of metformin in patients with chronic liver disease
| Autor: | Jerry R. Greenfield, Sophie L. Stocker, Kenneth M. Williams, Garry G. Graham, Felicity C. Smith, Shaun S. Kumar, Hannah E. Braithwaite, Richard O. Day, Jane E. Carland, Tim S. Cheng, Zhixin Liu, Mark Danta |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Cirrhosis endocrine system diseases Renal function Comorbidity Chronic liver disease Gastroenterology Severity of Illness Index 03 medical and health sciences Liver disease 0302 clinical medicine Pharmacokinetics Internal medicine Diabetes mellitus medicine Humans Hypoglycemic Agents Pharmacology (medical) 030212 general & internal medicine Lactic Acid Prospective Studies Aged Aged 80 and over Hepatology business.industry Liver Diseases nutritional and metabolic diseases Middle Aged medicine.disease Metformin Cross-Sectional Studies Diabetes Mellitus Type 2 Lactic acidosis Chronic Disease 030211 gastroenterology & hepatology Acidosis Lactic Female business medicine.drug |
| Zdroj: | Alimentary pharmacologytherapeuticsREFERENCES. 51(5) |
| ISSN: | 1365-2036 |
| Popis: | BACKGROUND The FDA approved 'label' for metformin lists hepatic insufficiency as a risk for lactic acidosis. Little evidence supports this warning. AIMS To investigate the safety and pharmacokinetics of metformin in patients with chronic liver disease (CLD). METHODS Chronic liver disease patients with and without type 2 diabetes mellitus (T2DM) were studied by a cross-sectional survey of patients already prescribed metformin (n = 34), and by a prospective study where metformin (500 mg, immediate release, twice daily) for up to 6 weeks was prescribed (n = 24). Plasma metformin and lactate concentrations were monitored. Individual pharmacokinetics were obtained and compared to previously published values from healthy and T2DM populations without CLD. RESULTS All plasma metformin and lactate concentrations remained below the putative safety thresholds (metformin, 5 mg/L; lactate, 5 mmol/L). Lactate concentrations were unrelated to average steady-state metformin concentrations. In patients with CLD, T2DM was associated with higher plasma lactate concentrations (48% higher than those without T2DM, P |
| Databáze: | OpenAIRE |
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