Patient was educated on contraindications for taking Metformin as follows:
- Metformin should be avoided in individuals with history of serious allergic reactions to metformin use.
- Metformin is usually not metabolized in the body and for the significant part is excreted unchanged by the kidneys. Individuals with renal disease cannot excrete Metformin normally. In such patients with compromised renal function, Metformin can stay active in circulation for longer time and can be toxic. In such individuals, metformin use could be avoided for a safer alternative or be used exercising caution with labs for periodical evaluation of kidney function.
- Individuals with history of liver failure poorly process the glucose and contribute to excess production of lactic acid in the body. Also, lactic acid produced in the body is normally cleared from the body by metabolism in the liver. In individuals with liver failure, metabolism of lactic acid could suffer, which could lead to build-up of excess lactic acid in the body. Excess lactic acid in the body can be dangerous, as it can lead to a state of increased acid ions and metabolic acidosis. Individuals can present with symptoms of metabolic acidosis, such as, rapid shallow breath, increased heart rate, fatigue, headache, confusion, and stomach upset with nausea and vomiting. Metformin use, by itself, carries risk of metabolic acidosis and can complicate the outcome for patients in liver failure. In such individuals, metformin use could be avoided for a safer alternative or be used exercising caution with labs for periodical evaluation of liver function.
- Individuals with history of cardiac failure present with reduced blood and oxygen supply to the tissues. This can result in poor glucose processing in the tissues and contribute to excess production of lactic acid in the body. Excess lactic acid in the body can be dangerous, as it can lead to a state of increased acid ions and metabolic acidosis. Individuals can present with symptoms of metabolic acidosis, such as, rapid shallow breath, increased heart rate, fatigue, headache, confusion, and stomach upset with nausea and vomiting. Metformin use, by itself, carries risk of metabolic acidosis and can complicate the outcome for patients in heart failure. In such individuals, metformin use could be avoided for a safer alternative or be used exercising extreme caution with periodical labs drawn for evaluation of body metabolism and various other parameters.
- Avoid using Metformin in patients with history of acute or chronic metabolic acidosis, secondary to various other health conditions. Metformin use, by itself, carries risk of metabolic acidosis and can complicate the outcome for such individuals.
