What all of us on MET should know about Lactic Acidosis

christyz · 06-09-2003, 03:22 PM

Whenever our Dr's or Pharmacists mention Metformin, you can count on the term "Lactic Acidosis" to soon follow. It's a scary sounding condition, and it is something we cysters on Met need to be aware of. But knowledge is power when we put LA in proper perspective. So here is what every person on Met should know about lactic acidosis. Speak to your Dr if you have concerns regarding LA or any other complication.

First of all, Lactic acidosis is very rare. Stats vary, but the *highest* stat I have read on the subject is that 3 out of every 100,000 people perscribed Met develops a case of LA. So that's .003% of patients on Metformin...a very low number. And half of those cases are NOT fatal. So only .0015% of people on met for any period of time will die of LA.

LA is SIGNIFICANTLY more common in people with certain risk factors. These include:

1) Pre-existing cardiac disease

2) chronic pulmonary disease

3) severe liver disease

4) acute asthmatic attack

5) Patient over 80 years of age

6) Renal insufficency. *This risk factor is one of the biggest. Ninety percent of metformin is excreted unchanged by the kidneys and lactic acidosis typically occurs in patients with renal (kidney) insufficiency. So if you have had any degree of kidney problems in the past, you need to have liver tests done by your Dr before beginning metformin therapy.

7) patients on extremely high doses (higher than 2550 mg per day)

8) Patients severely dehydrated. Speak to your Dr if you are on a dieuretic.

9) Rapid ascent to high altitude can also be a risk factor.

10) LA is more common after certain surgeries. If you are having surgery involving iodinated contrast media or any other condition in which an acute decline in kidney function might occur (aggressive diuresis, excessive fluid loss from gastroenteritise etc) you can lower your risk significantly by discontinuing the drug a 24 hours to a week before your surgery. Speak with your surgeon about this if you are undergoing any procedures that may require discontinuing the drug.

11) LA is more common in people who drink moderate to heavy amounts of alcohol on Met.

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Symptoms of Lactic Acidosis (which can also be symptoms of other health issues): nausea, vomiting, altered level of consciousness, abdominal pain, severe thirst, and an increase in the depth and rate of your breathing.

Lactic Acidosis is life-threatening, but it is also rare and preventable. Documented cases of a normally healthy person without risk factors developing LA, are very rare. By knowing the risk factors and symptoms mentioned above, you can significantly reduce your risk.

Hope, Health & Happiness to all!

Ange75 · 06-09-2003, 06:15 PM

Good info - thanks!

christyz · 06-09-2003, 06:21 PM

You're welcome, Ange!

DianeJ · 06-09-2003, 07:08 PM

Well, I used to think I didn't have any risk factors. I know differently now (I have asthma).

Thanks for the info. I'll be sure to mention it to my doctor so maybe they'll do testing on me a bit more often than they have been.

Thanks!

christyz · 06-09-2003, 08:54 PM

That was news to me too, Diane. The article I read that mentioned it as a risk didn't give any explanation as to WHY the ACUTE asthma attacks were a risk factor, but I assume it is the risk of pulminary disease with long term acute asthma.

I just wanted to pass this risk factor along so that women could inquire about it to their Dr's. I'm sure they can shed more light on this aspect.

All the best!

MariFlame · 06-19-2003, 04:56 PM

Thanks so much for the information Christy!
It makes lots more sense than ALL the confusing info I had found about it doing my own search.
*hugz* ~Mari

christyz · 06-19-2003, 04:59 PM

Your welcome, Mari!

lorideer · 06-24-2003, 08:50 PM

Thanks. I just started metformin last Thursday in addition to Avandia, so that is good info to know. My pharmacist told me about it and I have been meaning to look it up. It would have been nice if my doctor had mentioned it.

maria vazquez · 06-30-2003, 10:46 PM

Thanks! I saw a new RE today who insisted we run blood work before switching to glucophage xr! My previous RE never ran tests before I starting taking reg Met.

Thanks again!