Metformin-associated lactic acidosis reported to the United Kingdom National Poisons Information Service (NPIS) between 2010 and 2019: a ten-year retrospective analysis

Metformin toxicity following therapeutic use or overdose may result in metabolic acidosis with hyperlactatemia. This study aims to assess the relationship between serum lactate concentration, arterial pH, and ingested dose with severity of poisoning, and to identify if serum lactate concentration is...

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Published in:Clinical toxicology (Philadelphia, Pa.) Pa.), 2023-06, Vol.61 (6), p.445-452
Main Authors: Hughes, Bethan W., Gray, Laurence A., Bradberry, Sally M., Sandilands, Euan A., Thanacoody, Ruben H., Coulson, James M.
Format: Article
Language:English
Subjects:
Acidosis, Lactic - chemically induced
Acidosis, Lactic - diagnosis
Acidosis, Lactic - epidemiology
Drug Overdose - diagnosis
Drug Overdose - epidemiology
Humans
Hypoglycemic Agents
Lactic Acid
lactic acidosis
Metformin
poisoning
poisoning severity score
Poisons
Retrospective Studies
serum lactate concentration
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Summary:Metformin toxicity following therapeutic use or overdose may result in metabolic acidosis with hyperlactatemia. This study aims to assess the relationship between serum lactate concentration, arterial pH, and ingested dose with severity of poisoning, and to identify if serum lactate concentration is a useful marker of severity in metformin toxicity. A retrospective study of telephone enquiries relating to metformin exposures to the National Poisons Information Service between 2010 and 2019 from hospitals in the United Kingdom. Six-hundred and thirty-seven cases were identified; 117 involved metformin only and 520 involved metformin with other drugs. The majority of cases involved acute (87%) and intentional (69%) exposures. There was a statistically significant difference in doses between the Poisoning Severity Scores, as well as between intentional and unintentional or therapeutic error doses (P 
ISSN:1556-3650
1556-9519
DOI:10.1080/15563650.2023.2198667