Safe use of radiographic contrast media.

[Argirios Argiriou]

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Metformin

Metformin has been associated with several cases of renal failure and lactic acidosis in patients who have received contrast media. If contrast media causes renal failure, metformin, which is renally excreted, can reach toxic levels resulting in lactic acidosis. It is now recommended that metformin be discontinued at least 12 hours before the contrast investigation and not be resumed for a minimum of 36 hours after the procedure, and longer if the serum creatinine has not returned to baseline. Alternative methods of managing the patient's glucose levels may be required during this interval.
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