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Phenformin and lactic acidosis: a case report and review



Phenformin and lactic acidosis: a case report and review



Journal of Emergency Medicine 16(6): 881-886



Phenformin was removed from the U.S. market 20 years ago because of a high incidence of lactic acidosis. Unfortunately, this medication is still available from foreign sources. Another biguanide, metformin, was reintroduced to the United States market for the treatment of diabetes. Biguanide-induced lactic acidosis should be included in the differential diagnosis of elevated anion gap metabolic acidosis. We present a case of phenformin-induced lactic acidosis in which we were consulted at the local poison control center. We also review its pathophysiology, presentation, and treatment. A review of the actions of phenformin illustrates the mechanism of pathology that may also occur with metformin. Risk factors for the development of lactic acidosis include renal deficiency, hepatic disease, cardiac disease, and drug interaction such as cimetidine.

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Accession: 046973146

Download citation: RISBibTeXText

PMID: 9848705

DOI: 10.1016/s0736-4679(98)00103-6


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