Intended for healthcare professionals

Rapid response to:

Endgames Case Report

Life threatening lactic acidosis

BMJ 2010; 340 doi: (Published 25 March 2010) Cite this as: BMJ 2010;340:c857

Rapid Response:

Medical Mythology

Once again the legend of metformin induced Lactic Acidosis is
resurrected.I refer all readers to the most recent Cochrane Database Syst
Rev 2010 Jan 20;(1) : CD002967 (Review) by SR Salpeter,

The authors conclusions after reviewing 347 comparative trials and
cohort studies including 70,490 patient years of metformin use and 55,451
patient years in the non-metformin group were:"There is no evidence from
prospective comparative trials or from observational cohort studies that
metformin is associated with an increased risk of lactic acidosis,or
withincreased levels of lactate, compared to other anti-hyperglycemic

It is time for this piece of medical mythology to RIP.

Competing interests:
None declared

Competing interests: No competing interests

30 March 2010
Robert Matz
Professor of Medicine
Mount Sinai School of Medicine, NYC, NY 10029