Summary
Two cases of lactic acidosis are described in which the time sequence of events made it certain that phenformin was the precipitating cause. In one patient the condition arose because of self administration of an overdose; in the other, phenformin had been administered to a patient on maintenance dialysis. After recovery, and in the absence of phenformin therapy the second patient was able to clear an intravenous lactate load at a rate similar to that observed in other patients on chronic dialysis. — A review of the literature re-emphasizes the possible danger of phenformin in the presence of diminished renal or hepatic function, which should be shown to be normal before starting the drug and assessed periodically during therapy.
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Altschuld, R.A., Kruger, F.A.: Inhibition of hepatic gluconeogenesis in guinea pig by Phenformin. Ann. N. Y. Acad. Scienc.148, 612–622 (1968).
Barnett, D., Cohen, R.D., Tassopoulos, C.N., Turtle, J.R., Dmitriadou, A. Fraser, T.R.: A method for estimation of Krebs cycle and related intermediates in animal tissues by gas chromatography. Analyt. Biochem.26, 68–84 (1968).
Bingle, J.P., Storey, G.W., Winter, J.M.: Fatal self-poisoning with Phenformin. Brit. med. J.1970, III, 752.
Davidson, M.B., Bozarth, W.R., Challoner, D.R., Goodner, C.I.: Phenformin, hypoglycaemia and lactic acidosis. New Engl. J. Med.275, 886–888 (1966).
Hall, H., Ramachander, G., Glassman, J.M.: Tissue distribution and excretion of Phenformin in normal and diabetic animals. Ann. N.Y. Acad. Sci.148, 601–611 (1968).
Hohorst, H.J.: In. Methods of Enzymatic Analysis (Ed. by A.U. Bergmeyer) pp. 266–270. New York: Academic Press 1962.
MacGregor, G.A., Poole Wilson, P.A., Jones, N.F.: Phenformin and lactic acidosis. Lancet1972 I, 69–71.
Oliva, P.B.: Lactic acidosis. Amer. J. Med.48, 209–225 (1970).
Sadow, H.S.: This question of lactic acidosis. Postgrad. Med.45, May Suppl., p. 30–35 (1969).
Strauss, F.G. Sullivan, M.A.: Phenformin intoxication resulting in lactic acidosis. J. Hopkins Med. J.128, 278–281 (1970).
Woods, H.F.: Some aspects of lactic acidosis. Brit. J. Hosp. Med.11, 668–676 (1971).
Woods, H. F.: D. Phil. Thesis. University of Oxford (1970).
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Cohen, R.D., Ward, J.D., Brain, A.J.S. et al. The relation between phenformin therapy and lactic acidosis. Diabetologia 9, 43–46 (1973). https://doi.org/10.1007/BF01225999
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DOI: https://doi.org/10.1007/BF01225999