Table 4.

Recommended dose adjustments for metformin based on eGFR

eGFR (mL/min/1.73 m2)	Proposed action
≥60	No contraindication to metformin
	Monitor kidney function annually
<60 and ≥45	Continue use
	Increase monitoring of renal function (every 3–6 months)
<45 and ≥30	Prescribe metformin with caution
	Use lower dose (e.g., 50%, or half-maximal dose)
	Closely monitor renal function (every 3 months)
	Do not start new patients on metformin
<30	Stop metformin

Adapted with permission from ADA (83).