Metformin Associated Lactic Acidosis

Lactic acidosis is a very rare and serious side effect associated with the use of biguanides. Metformin associated lactic acidosis affects approximately 1 in 30 000 individuals on treatment. The condition is a medical emergency that requires hospitalisation.

 Lactic acidosis is caused by the accumulation of lactate in the blood stream. Lactate is produced by the body as it breaks down carbohydrates from food to produce energy. Lactate gets taken up by the liver and used in the production of glucose. Excess lactate is cleared out of the body by the kidneys.

Metformin is believed to reduces the amount of lactate taken up by the liver, resulting in lactate accumulating in the blood stream.

Signs and symptoms of Lactic acidosis  

•  Feeling very weak or tired
• Trouble breathing
• Unexplained or unusual muscle pain
• Unusual sleepiness
• Slow or irregular heartbeat

Who is at Risk?

Individuals with liver or kidney problems and those over the age of 65 years are at higher risk of developing the condition. Excessive use of alcohol while on metformin increases individuals risk of developing lactic acidosis.

Treatment

Lactic acidosis is a medical emergency, that requires hospitalisation.