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. 1983 Jan 1;128(1):24–26.

The status of metformin in Canada.

O J Lucis
PMCID: PMC1874707  PMID: 6847752

Abstract

During the 1970s two biguanide drugs, phenformin and metformin, were used to control hyperglycemia. Phenformin was phased out of the Canadian market because it carried an unacceptable risk of causing lactic acidosis, but metformin remains available. All documented cases of lactic acidosis associated with metformin administration, which are rare, have occurred abroad in patients who were taking the drug in spite of having contraindications to its use. The two drugs are metabolized differently, phenformin being deactivated and concentrated in the liver, and metformin being excreted rapidly, unchanged, by the kidneys. In properly selected diabetic patients therapeutic doses of metformin do not raise the blood levels of intermediary metabolites enough to induce ketoacidosis or lactic acidosis. The safety of the drug is supported by the clinical experience over about 56,000 patient-years in Canada.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Biron P. Metformin monitoring. Can Med Assoc J. 1978 Jan 7;118(1):15–18. [PMC free article] [PubMed] [Google Scholar]
  2. Bolzano K. Biguanide: Gründe für die Rücknahme von Präparaten und verbleibende Indikationen. Acta Med Austriaca. 1978;5(3):85–88. [PubMed] [Google Scholar]
  3. Dubas T. C., Johnson W. J. Metformin-induced lactic acidosis: potentiation by ethanol. Res Commun Chem Pathol Pharmacol. 1981 Jul;33(1):21–31. [PubMed] [Google Scholar]
  4. Hermann L. S. Metformin: a review of its pharmacological properties and therapeutic use. Diabete Metab. 1979 Sep;5(3):233–245. [PubMed] [Google Scholar]
  5. Holle A., Mangels W., Dreyer M., Kühnau J., Rüdiger H. W. Biguanide treatment increases the number of insulin-receptor sites on human erythrocytes. N Engl J Med. 1981 Sep 3;305(10):563–566. doi: 10.1056/NEJM198109033051007. [DOI] [PubMed] [Google Scholar]
  6. Hunt J. A., Catellier C., Dupre J., Gardiner R. J., McKendry J. B., Toews C. J., Yip C. C. The use of phenformin and metformin. Can Med Assoc J. 1977 Sep 3;117(5):429–430. [PMC free article] [PubMed] [Google Scholar]
  7. Joncas F. Quatre années d'étude clinique de la metformine chez 47 patients diabétiques. Union Med Can. 1972 Jan;101(1):65–70. [PubMed] [Google Scholar]
  8. Korhonen T., Idänpän-Heikkilä J., Aro A. Biguanide-induced lactic acidosis in Finland. Eur J Clin Pharmacol. 1979 Jul;15(6):407–410. doi: 10.1007/BF00561739. [DOI] [PubMed] [Google Scholar]
  9. Nattrass M., Hinks L., Smythe P., Todd P. G., Alberti K. G. Metabolic effects of combined sulphonylurea and metformin therapy in maturity-onset diabetice. Horm Metab Res. 1979 May;11(5):332–337. doi: 10.1055/s-0028-1092733. [DOI] [PubMed] [Google Scholar]
  10. Pentikäinen P. J., Neuvonen P. J., Penttilä A. Pharmacokinetics of metformin after intravenous and oral administration to man. Eur J Clin Pharmacol. 1979 Sep;16(3):195–202. doi: 10.1007/BF00562061. [DOI] [PubMed] [Google Scholar]
  11. Phillips P. J., Scicchitano R., Clarkson A. R., Gilmore H. R. Metformin associated lactic acidosis. Aust N Z J Med. 1978 Jun;8(3):281–284. doi: 10.1111/j.1445-5994.1978.tb04524.x. [DOI] [PubMed] [Google Scholar]
  12. Sargent E. N. Renal function following double dose infusion intravenous cholangiography. West J Med. 1974 Feb;120(2):145–145. [PMC free article] [PubMed] [Google Scholar]
  13. Shenfield G. M., Bhalla I. P., Steel J. M., Duncan L. J. Metformin in the treatment of obese diabetics. Practitioner. 1977 Nov;219(1313):745–749. [PubMed] [Google Scholar]
  14. Shenfield G. M., Campbell C. J., Duncan L. J. Hyperlipidaemia and treatment of diabetes. Practitioner. 1979 Jan;222(1327):111–113. [PubMed] [Google Scholar]
  15. Sirtori C. R., Franceschini G., Galli-Kienle M., Cighetti G., Galli G., Bondioli A., Conti F. Disposition of metformin (N,N-dimethylbiguanide) in man. Clin Pharmacol Ther. 1978 Dec;24(6):683–693. doi: 10.1002/cpt1978246683. [DOI] [PubMed] [Google Scholar]
  16. Tucker G. T., Casey C., Phillips P. J., Connor H., Ward J. D., Woods H. F. Metformin kinetics in healthy subjects and in patients with diabetes mellitus. Br J Clin Pharmacol. 1981 Aug;12(2):235–246. doi: 10.1111/j.1365-2125.1981.tb01206.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Waters A. K., Morgan D. B., Wales J. K. Blood lactate and pyruvate levels in diabetic patients treated with biguanides with and without sulphonylureas. Diabetologia. 1978 Feb;14(2):95–98. doi: 10.1007/BF01263446. [DOI] [PubMed] [Google Scholar]

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