Older age and phenformin therapy: a dangerous association
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The anti-diabetic drug phenformin was banned in many countries because of the high risk of lactic acidosis (LA), mostly arising in elderly with predisposing conditions . To our knowledge, phenformin is still legal in Italy, Brazil, Uruguay, China, Poland, Greece and Portugal, and cases of LA are continuously reported worldwide [2, 3, 4, 5].
Phenformin-induced LA is an unpredictable complication that may occur even in people without predisposing diseases, causing death in 50% of cases . In addition, LA is often misdiagnosed, and many cases may go unrecognized, particularly in older persons affected by various chronically symptomatic illnesses. As recently emphasized, the reported cases of phenformin-induced LA may thus represent only “the tip of an iceberg” .
Phenformin can always be replaced by metformin, a safe and useful drug. A recent meta-analysis showed that metformin does not cause LA more frequently than diabetes per se .
Age is an absolute contraindication to...
KeywordsMetformin Glomerular Filtration Rate Lactic Acidosis Chinese Herbal Medicine Public Health System
The GIFA study is partially supported by a grant 94000402 from the Italian National Research Council, Roma, Italy.
- 5.Chen ZS, Liy FF (2005) Observation of treatment effectiveness in ten cases of diabetic lactic acidosis [in Chinese]. Chin J Misdiagn 5:686–687Google Scholar
- 6.Salpeter S, Greyber E, Pasternak G, Salpeter E (2006) Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes mellitus. Cochrane Database Syst Rev 25:CD002967Google Scholar
- 11.Sino American Health Products, Inc., Issues National Recall of herbal products due to the presence of the undeclared drugs glyburide and phenformin. US Food and Drug Administration website. http://www.fda.gov/oc/po/firmrecalls/Zhenqi.htlm. Accessed 19 Feb 2000
- 12.Health Canada warns consumers not to take the Chinese medicine Shortclean due to potential health risk (article online) (2005). Available at: http://www.medicalnewstoday.com/medicalnews.php?newsid=34038#. Accessed 23 Nov 2005