Metformin Toxicity in Chronic Kidney Disease: A Case Report of Severe Lactic Acidosis

Metformin is one of the most commonly prescribed oral antihyperglycemic medicine worldwide. Professional diabetes organizations recommend it as the first-line treatment for newly diagnosed type 2 diabetes. Metformin is widely regarded as safe. The most common side effects include nausea, vomiting and diarrhea. Metformin-associated lactic acidosis (MALA) is a rare but serious adverse effect of metformin. Here, we are reporting a case of an elderly patient hospitalized with severe lactic acidosis presented with complaints of hypotension, decreased food intake, multiple episodes vomiting, dyspnoea, related to the treatment of type 2 diabetes with metformin. The patient was treated with emergency dialysis, vasopressor therapy and Inj Sodium bicarbonate.