New recommendation for the use of metformin
The diabetes medication metformin has long been contraindicated in patients with impaired kidney function. But the Committee for Medicines (CHMP) of the European Medicines Agency (EMA) has now spoken in favor of fewer restrictions on use, reports the Federal Institute for Drugs and Medical Devices (BfArM).
Already a year ago, due to the evaluation of new data on the safety of the use of metformin in patients with renal insufficiency, the limit for creatinine clearance, from which metformin is contraindicated, was reduced by a quarter, according to the BfArM. The application has now been extended to patients with impaired kidney function.
The new risk assessment procedure, which October, the EMA has caused “to further limit the creatinine clearance limit from which metformin is contraindicated, namely to <30 ml / min (or eGFR <30 ml / min /1.73m2), lowering, ”reports the BfArM. Accordingly, patients with grade 3b renal impairment can now be treated with metformin. However, the dose has to be adjusted according to kidney function, the kidney function has to be checked regularly and some other precautionary measures have to be taken into account, according to the BfArM. "The contraindication remains for patients with severe renal insufficiency (GFR less than 30 ml / min)," reports the Federal Institute. According to the BfArM, the increased contraindication for metformin in patients with renal insufficiency was the increased risk of lactic acidosis (overacidification of the Blood due to the accumulation of lactic acid) in the event of kidney dysfunction. In the patient group with moderate renal dysfunction, which should also benefit from treatment with metformin in the future, this risk is minimized by clear recommendations. These include, for example, the dose adjustment according to kidney function, the control of kidney function before and regularly during the treatment as well as the special attention required in situations in which kidney function deteriorates acutely the new recommendations will be adapted, ”the BfArM continues. (fp) [W2DC AID = '016351a2cc0b08c03']