Intended for healthcare professionals

Letters Metformin and lactic acidosis

Metformin: framed again?

BMJ 2009; 339 doi: (Published 23 December 2009) Cite this as: BMJ 2009;339:b5570
  1. David J Preiss, clinical research fellow1,
  2. Naveed Sattar, professor of metabolic medicine1
  1. 1BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow G12 8TA
  1. d.preiss{at}

    Fitzgerald and colleagues show that metformin treatment should be avoided in acute renal failure,1 but their focus on metformin associated lactic acidosis is misplaced.

    Metformin has long been suggested as a cause of lactic acidosis in published case reports, but evidence from large cohorts and meta-analyses of controlled trials remains conspicuously absent.2 Metformin is often …

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