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. 2019 May 23;11(5):e4739. doi: 10.7759/cureus.4739

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
HHS Vulnerability Disclosure