The Editorial Executive Committee welcomes letters, which should be less than 250 words. Before a decision to publish is made, letters which refer to a published article may be sent to the author for a response. When letters are published, they are usually accompanied in the same issue by their responses or comments. The Committee screens out discourteous, inaccurate or libellous statements. Authors are required to declare any conflicts of interest. Editor, – I write regarding the article dealing with radiographic contrast media (Aust Prescr 2010;-22). I have recently authored a systematic review relating to the safety of iodinated contrast in patients receiving metformin. The review found no evidence to substantiate beliefs about the need to cease metformin in individuals with stable, normal renal function who were to have a 'normal' amount of intravenous iodinated contrast for an examination such as a CT scan. Despite a number of international guidelines having disparate recommendations about cessation of metformin, the Royal Australian and New Zealand College of Radiologists (RANZCR), the Royal College of Radiologists (RCR) and the European Society of Urogenital Radiology guidelines recommend that there is no need to stop metformin in these patients. The RANZCR recommendations are based on the extremely low risk of precipitation of contrast-induced nephropathy in this group. The effects of metformin may increase and cause a serious condition called lactic acidosis, especially if you have kidney problems. Symptoms of lactic acidosis are: feeling very weak, tired, or uncomfortable, unusual muscle pain, trouble breathing, unusual or unexpected stomach discomfort, feeling cold, dizziness or lightheadedness, suddenly developing a slow or irregular heartbeat. Contact your doctor about taking these two medicines together before you have any tests done that use an iodine dye. Your doctor may want to check to make sure your kidneys are working properly before and after the imaging test. In some cases, your doctor may instruct you to stop taking your metformin before the exam and not to begin using it again until 48 hours after your test. doctor or pharmacist) may already be aware of this drug interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first. Selected from data included with permission and copyrighted by First Databank, Inc. Metformin in diabetes type 2 Metoprolol 100 mg Sildenafil teva 100 Metformin is a biguanide used to treat type LI diabetes mellitus. States there has been considerable interest in metformin associated lactic acidosis MALA following intravenous contrast media. Metformin, marketed under the trade name Glucophage among others, is the first-line medication for the treatment of type 2 diabetes, particularly in people who are overweight. Metformin and intravenous contrast. Mark Otto Baerlocher, Murray Asch and Andy Myers. Metformin in isolation is not considered a risk factor for contrast-induced nephropathy,2 but. Metformin is a biguanide used to treat type II diabetes mellitus. Since the recent introduction of this drug into the United States there has been considerable interest in metformin associated lactic acidosis (MALA) following intravenous contrast media. The Royal College of Radiologists published advice in November, 1996 (Advice to Members and Fellows with regard to metformin-induced lactic acidosis and X-ray contrast medium agents, RCR Publication) supporting the manufacturers' advice that metformin should not be used in the 48 h before or after intravenous (i.v.) contrast medium. We performed a systematic review of the literature and this has shown that almost all reported cases of MALA following i.v. contrast medium occurred where there was either pre-existing poor renal function or another contraindication to metformin usage. There has been only one reported case of lactic acidosis following the use of intravenous contrast medium in a patient with normal renal function. We suggest that the Royal College of Radiologists' advice should be modified and that it is safe to give i.v. Metformin is an oral drug which lowers blood sugar levels by decreasing the amount of sugar produced in the liver and increasing the sensitivity of muscle cells to insulin. However, metformin use had been thought in the past to predispose patients with Type 2 diabetes, especially those with underlying kidney problems, to increased risk of kidney failure or serious cases of lactic acidosis. Because of this potential risk, the ACR and the Food and Drug Administration (FDA) issued strict guidelines in 2013 about the use of metformin when contrast is used in medical imaging. These guidelines came about because such contrast can damage the kidneys in some cases, a condition called contrast-induced nephropathy. The 2013 guidelines recommended that metformin be stopped 48 hours post-procedure, and that it should not be taken again until doctors see the kidney is not injured. In 2015, these restrictions were removed from the guidelines, according to a article. This is partly because most radiologists simply weren’t following the 2013 guidelines, and partly because the rate of contrast-induced nephropathy in metformin users has been found to be incredibly low. Also, researchers now believe that metformin is not the source for most of the kidney problems. Metformin and contrast Metformin/Iodinated Contrast Materials - WebMD, Metformin - Wikipedia Diflucan childrenPrednisolone onset of actionSertraline children Intravascular administration of iodinated contrast media to patients who are receiving metformin, an oral antidiabetic agent, can result in lactic acidosis. Metformin and contrast media where is the conflict?. Metformin and intravenous contrast CMAJ. Why hold the metformin? Nursing2019. Jun 1, 2010. Radiographic contrast media and metformin. Stacy Goergen, Kenneth R Thomson, and Dinesh K Varma; 3 min read; Aust Prescr 2010. Metformin in isolation is not considered a risk factor for contrast-induced nephropathy, but particular attention must be paid to patients taking metformin who are. Protocol for Management of Patients taking Metformin scheduled for CT Studies with IV Radiographic Contrast Media. 1. Metformin medications are generally.