Table 1. Conditions that may increase the risk of lactic acidosis associated with metformin.
Mechanism | Clinical Conditions |
Promote the formation of lactate by the peripheral tissues because of hypoxia | Cardiac failure, Sepsis, Severe dehydration, Respiratory failure |
Impair lactate metabolism through the pathway of gluconeogenesis | Primary or secondary hepatic failure |
Dramatically increase levels of metformin | Renal impairment |