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.
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