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Internal and Emergency Medicine

, Volume 3, Issue 4, pp 401–403 | Cite as

Older age and phenformin therapy: a dangerous association

  • Filippo Luca Fimognari
  • Andrea Corsonello
  • Ruggero Pastorelli
  • Raffaele Antonelli Incalzi
CE - Letter to the Editor

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 [1]. 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 [1]. 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” [3].

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 [6].

Age is an absolute contraindication to...

Keywords

Metformin Glomerular Filtration Rate Lactic Acidosis Chinese Herbal Medicine Public Health System 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

The GIFA study is partially supported by a grant 94000402 from the Italian National Research Council, Roma, Italy.

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Copyright information

© SIMI 2008

Authors and Affiliations

  • Filippo Luca Fimognari
    • 1
    • 2
  • Andrea Corsonello
    • 3
    • 4
  • Ruggero Pastorelli
    • 1
  • Raffaele Antonelli Incalzi
    • 2
    • 4
  1. 1.Unità Operativa di Medicina Interna, ASL Roma G, Ospedale Leopoldo Parodi-Delfino, Colleferro (Rome)RomeItaly
  2. 2.Cattedra di GeriatriaUniversità Campus BiomedicoRomeItaly
  3. 3.Unità Operativa di Medicina Geriatrica, Istituto Nazionale di Ricovero e Cura per Anziani (INRCA)CosenzaItaly
  4. 4.Fondazione San Raffaele-Cittadella della CaritàTarantoItaly

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