Summary
Twenty-four patients with biguanide-induced lactic acidosis were reported to the Adverse Drug Reaction Register of the Finnish National Board of Health from 1974–1977. Of them, 23 had been treated with phenformin and one with metformin. The mean age of the patients was 71 years, and all but one were more than 65 years of age. The mortality rate was 63%. One patient had cirrhosis of the liver and one was already known to have had impaired renal function. Fourteen of the patients had a normal serum creatinine concentration either before or after the development of lactic acidosis. Thus, in most patients it had not been possible to prevent development of lactic acidosis by observing the contraindications to biguanide therapy. Most patients had some form of co-existing cardiovascular disease. Tetracycline therapy was a probable precipitating factor in three cases. Based on the statistics of biguanide consumption in Finland, the annual incidence of biguanide-induced lactic acidosis in 1976 and 1977 was between 1/2000 and 1/3000 and that of fatal lactic acidosis was 1/4000.
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References
Alberti, K. G. M. M., Nattrass, M.: Lactic acidosis. Lancet1977/II, 25–29
Aro, A., Korhonen, T., Halinen, M.: Phenformin-induced lactic acidosis precipitated by tetracycline. Lancet1978/I, 673–674
Berger, W., Amrein, R.: Laktatazidosen unter der Behandlung mit den drei Biguanidpräparaten Phenformin, Buformin und Metformin — Resultate einer gesamtschweizerischen Umfrage 1977 Schweiz. Rundschau Med.67, 661–667 (1978)
Bergman, U., Boman, G., Wiholm, B.-E.: Epidemiology of adverse drug reactions to phenformin and metformin. Br. Med. J.1978/II, 464–466
Bergman, U., Elmes, P., Halse, M., Halvorsen, T., Hood, H., Lund P. K. M., Sjöqvist, F., Wade, O. L., Westerholm, B.: The measurement of drug consumption. Drugs for diabetes in Northern Ireland, Norway and Sweden. Europ. J. Clin. Pharmacol.8, 83–89 (1975)
Böttiger, L. E., Nordlander, M., Strandberg, I., Westerholm, B.: Deaths from drugs: An analysis of drug-induced deaths reported to the Swedish adverse drug reaction committee during a five year period (1966–1970). J. Clin. Pharmacol.14, 401–407 (1974)
Cohen, R., Woods, H.: Clinical and biochemical aspects of lactic acidosis. Oxford: Blackwell 1976
Gale, E. A. M., Tattersall, R. B.: Can phenformin-induced lactic acidosis be prevented? Br. Med. J.1976/II, 972–975
Lepper, M. H.: Effect of large doses of aureomycin on human liver. Arch. Intern. Med.88, 271–283 (1951)
Luft, D., Schmülling, R. M., Eggstein, M.: Lactic acidosis in biguanide-treated patients. A review of 330 cases. Diabetologia14, 75–87 (1978)
Misbin, R. I.: Phenformin-associated lactic acidosis: Pathogenesis and treatment. Ann. Intern. Med.87, 591–595 (1977)
Shils, M. E.: Renal disease and the metabolic effects of tetracycline. Ann. Intern. Med.58, 389–408 (1963)
Tashima, C. K.: Phenformin, tetracycline and lactic acidosis. Br. Med. J.1971/IV, 557–558
Walker, R. S., Linton, A. L.: Phenylethylbiguanide: Dangerous side-effect. Br. Med. J.1959/II, 1005–1006
Wise, P. H., Chapman, M., Thomas, D. W., Clarkson, A. R., Harding, P. E., Edwards, J. B.: Phenformin and lactic acidosis. Br. Med. J.1976/I, 70–72
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Korhonen, T., Idänpään-Heikkilä, J. & Aro, A. Biguanide-induced lactic acidosis in Finland. Eur J Clin Pharmacol 15, 407–410 (1979). https://doi.org/10.1007/BF00561739
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DOI: https://doi.org/10.1007/BF00561739