Table 3.

2016 Revised recommendations for metformin use in patients with impaired renal function³⁷

eGFR, ml/min per 1.73 m2	FDA Recommendations for Metformin Use
>45	No contraindications
	Obtain eGFR at least annually
30–45	Starting metformin is not recommended
	Assess the benefits and risks of continuing treatment for patients currently receiving metformin
<30	Contraindicated
Metformin should be discontinued in patients with	History of liver disease, alcoholism, or heart failure
	Upcoming iodinated contrast imaging procedure and eGFR between 30 and 60 ml/min per 1.73 m2 (may restart 48 h after procedure if kidney function stabilizes)
	Upcoming administration of intra-arterial iodinated contrast (may restart 48 h after procedure if kidney function stabilizes)

Obtain an eGFR before initiating metformin therapy.