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Can Metformin Cause Lactic Acidosis?

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Posted on Fri, 20 Nov 2015
Question: I got a prescription for Gluco-phage 500 mg . after reading paper workfrom the drug store about the side
effects and especially a condition called lactic acidsosis I amconsidering to ask my doctor for an alternative.
What is your opin0n? XXXXXXX 74 yrs. old YYYY@YYYY
doctor
Answered by Dr. Panagiotis Zografakis (26 minutes later)
Brief Answer:
metformin is the best first choice for treatment

Detailed Answer:
Hello,

metformin has worldwide recognition as the best first choice of drug against type 2 diabetes. It's a drug which helps from diagnosis to the very late stages. The side effect you've mentioned (lactic acidosis) is an extremely rare one. I've never seen it despite the fact that I've managed thousands of patients with diabetes. Lactic acidosis seems to be more common when the drug is not used according to its indications. For example, using it when the patient has "insufficiencies" like severe chronic kidney disease, heart failure, etc.

Your HbA1c is low. You could try with diet and physical activity if you'd like. But if I had to pick a drug for your case I would have chosen metformin.

I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.

Kind Regards!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Panagiotis Zografakis (2 hours later)
Since I have tried Lipitor some years back for my cholesterol do you think I should
try another statin. I have read a lot of articles that suggest not to take a statin
when you are in your seventies since a lot of the elderly have memory problems after taking statins.
My cholesterol is 250 and my LDL is 175. which was a VAP test. My doctor has been trying to get me on them. My cholesterol has always been on the high side
and I didn't feel well when I tried Lipitor, but my doctor keeps telling me I should
be on some kind of statin. I am a very active person and I walk for 45 minutes per
day. What are your thoughts on this. Thank you for clarifying the metformin issue.
doctor
Answered by Dr. Panagiotis Zografakis (12 minutes later)
Brief Answer:
LDL lowering is indicated

Detailed Answer:
Current guidelines suggest that diabetic patients with LDL levels above 100mg/dL should receive treatment (a statin that is). If you were a 40 years old individual, I would insist on the statin. For a 74 years old patient though, despite the fact that I agree with your doctor, I wouldn't be very eager to persuade the patient.

Kind Regards!
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3816 Questions

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Can Metformin Cause Lactic Acidosis?

Brief Answer: metformin is the best first choice for treatment Detailed Answer: Hello, metformin has worldwide recognition as the best first choice of drug against type 2 diabetes. It's a drug which helps from diagnosis to the very late stages. The side effect you've mentioned (lactic acidosis) is an extremely rare one. I've never seen it despite the fact that I've managed thousands of patients with diabetes. Lactic acidosis seems to be more common when the drug is not used according to its indications. For example, using it when the patient has "insufficiencies" like severe chronic kidney disease, heart failure, etc. Your HbA1c is low. You could try with diet and physical activity if you'd like. But if I had to pick a drug for your case I would have chosen metformin. I hope you find my comments helpful! You can contact me again, if you'd like any clarification or further information. Kind Regards!