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1. www.tsim.org.tw › journal › jour25-1Metformin 治療第2型糖尿病患限制的探討

   www.tsim.org.tw › journal › jour25-1

   列為第2型糖尿病人藥物治療的首選。 然而臨床經常的困境卻是:因病患血清肌酸酐濃度一點超標[男性血清肌酸酐(serum creatinine) ≥1.5 mg/dL、或女性血清肌酸酐≥1.4 mg/dL],醫藥人員寧可不用或隨時停用metformin 以防可能的乳酸中毒(lactic acidosis)發生, �. 而也衍生病人常因而血糖控制惡化。目前各醫療單位均強調醫�. 正確性,意即依醫療行政法規與仿單。 所以,上述困境與臨床醫師作為, 也是目前的必然。鑑於最近一些研究對已往metformin之疑慮漸有澄清, 本文回顧當前學術研究現�. ,希望對形成醫療學術共識有些貢獻。期待日後醫療行政單位與藥廠仿單也有較一致性聲明,俾醫師、 �.

2. www.ktgh.com.tw › Medicament_tbDrug_Look【篤實 關懷 倫理 卓越】光田綜合醫院 Kuang Tien General Hospital

   www.ktgh.com.tw › Medicament_tbDrug_Look

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   當腎功能受損，腎清除率是依肌氨酸酐(creatinine)清除率成比率下降，於是排除半衰期被延長，致使血漿內的 Metformin 濃度值上升。 副作用 噁心、嘔吐、腹瀉、腹痛。

3. 其他人也問了

   Should we look at creatinine as a cut-off for metformin?

   • These guidelines also suggest moving away from just looking at serum creatinine to create a cut-off. Metformin’s costs are lower, and in many underdeveloped countries this is the only medicine available for poor patients. More widespread use of metformin will further help with health care costs, as well as obesity.

   Changes in metformin use in chronic kidney disease - PMC

   www.ncbi.nlm.nih.gov/pmc/articles/PMC5466114/

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   Does metformin kinetics correlate with creatinine clearance?

   • In careful experiments, Tucker et al. (27) studied metformin kinetics in 4 healthy subjects and 12 type 2 diabetic subjects and found that plasma renal clearance of metformin highly correlated with creatinine clearance (CrCl; r = 0.85, P < 0.001).

   Use of Metformin in the Setting of Mild-to-Moderate Renal Insufficiency

   diabetesjournals.org/care/article/34/6/1431/27322/Use-of-Metformin-in-the-Setting-of-Mild-to

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   What is the creatinine cut point for a contraindication to metformin?

   • In the 1980s, the creatinine cut points for contraindication to metformin were considered to be appropriate at 1.4 mg/dL in women and 1.5 mg/dL in men. This was based on the calculated ability to remove 3 g of metformin (an amount slightly beyond the maximum daily U.S. dose) at steady-state levels within 24–48 h.

   Use of Metformin in the Setting of Mild-to-Moderate Renal Insufficiency

   diabetesjournals.org/care/article/34/6/1431/27322/Use-of-Metformin-in-the-Setting-of-Mild-to

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   Are Glucophage (metformin) guidelines too restrictive?

   • Current guidelines are too restrictive, and many patients who could benefit are missing out In January, the electronic Medicines Compendium (eMC) updated the Summary of Product Characteristics for Glucophage (metformin), approved by the UK Medicines and Healthcare Products Regulatory Agency (MHRA).

   Using metformin in the presence of renal disease | The BMJ

   www.bmj.com/content/350/bmj.h1758

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   Do creatinine levels vary inversely with GFR?

   • Creatinine levels, in general, vary inversely with GFR. However, important limitations to the estimation of renal function with creatinine should be considered. First, serum creatinine can only be used reliably in patients with stable kidney function.

   Use of Metformin in the Setting of Mild-to-Moderate Renal Insufficiency

   diabetesjournals.org/care/article/34/6/1431/27322/Use-of-Metformin-in-the-Setting-of-Mild-to

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   Can creatinine be used to measure glomerular filtration rates?

   • Until early 2016, US FDA guidelines contradicted its use with a serum creatinine (Cr) >132.63 µmol/L (1.5 mg/dL) in men and >123.79 µmol/L (1.4 mg/dL) in women. It is well known that serum Cr measurements are not an accurate reflection of the glomerular filtration rates (GFRs) .

   Changes in metformin use in chronic kidney disease - PMC

   www.ncbi.nlm.nih.gov/pmc/articles/PMC5466114/

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4. pmc.ncbi.nlm.nih.gov › articles › PMC5797060Effect of metformin on kidney function in patients with type ...

   pmc.ncbi.nlm.nih.gov › articles › PMC5797060

   Impaired renal function can lead to the accumulation of metformin, and elevated concentrations of metformin have been associated with lactic acidosis. The aim of this study was to evaluate the effect of continuous metformin treatment in patients ...

5. www.kidney-international.org › article › S0085-2538(20)30914-5Does metformin do more benefit or harm in chronic kidney ...

   www.kidney-international.org › article › S0085-2538(20)30914-5

   In a rat model of cyclosporin A (CsA)–induced renal fibrosis, a 4-week treatment of metformin effectively prevented CsA-induced renal dysfunction with (i) increased creatinine clearance rate, (ii) reduced renal fibrosis, and (iii) lower proteinuria compared with the

   • 作者: Marc E. De Broe, François Jouret

   • Publish Year: 2020

6. www.bmj.com › content › 350Using metformin in the presence of renal disease | The BMJ

   www.bmj.com › content › 350

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   2015年4月14日 · Around a quarter of all patients with type 2 diabetes develop diabetic nephropathy, and the condition is the commonest cause of end stage renal failure in most developed countries. The concerns over metformin and renal impairment arise from the perceived risk of lactic acidosis in such patients.

   • 作者: Tahseen A Chowdhury, Roisin Wright, M Magdi Yaqoob

   • Publish Year: 2015

7. www.ncbi.nlm.nih.gov › pmc › articlesChanges in metformin use in chronic kidney disease - PMC

   www.ncbi.nlm.nih.gov › pmc › articles

   2017年3月28日 · Metformin in chronic kidney disease. Abnormal kidney function remains the biggest contraindication for metformin. Until early 2016, US FDA guidelines contradicted its use with a serum creatinine (Cr) >132.63 µmol/L (1.5 mg/dL) in men and >123.79 µmol/L (1.4 mg/dL) in women.

8. diabetesjournals.org › care › articleUse of Metformin in the Setting of Mild-to-Moderate Renal ...

   diabetesjournals.org › care › article

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   2011年5月20日 · Among individuals with eGFR <60 mL/min per 1.73 m 2 and diabetes, 32.2% were treated with metformin and had a normal creatinine level (<1.5 mg/dL), whereas 13.4% were treated with metformin despite a frankly elevated creatinine level (>1.5 mg/dL).