New guidelines for the use of metformin in various degree of kidney disease
What is the new guideline for the appropriate use of metformin in patients with various degree of kidney disease?
Historically, metformin was contraindicated in patients with CKD.
The U.S. Food and Drug Administration (FDA) required a labeling change for metformin. Dosing is now based off of eGFR rather than the previous serum creatinine.
The eGFR should be calculated before patients begin treatment with metformin and at least annually thereafter. In patients with an eGFR ≥60 mL/min, no dose adjustments are required for the use of metformin with annual monitoring.
However, patients with an eGFR between 30 and 60 mL/min require more frequent kidney function monitoring every 3 to 6 months and dosage to be adjusted to no more than 1000 mg per day. In patients with an eGFR less than 30 mL/min, metformin should be discontinued to avoid the risk of lactic acidosis.
