Metformin is a commonly prescribed medication for the treatment of type 2 diabetes, which helps to lower blood sugar levels. It is known to be excreted by the kidneys, and there is a risk of a rare but serious condition called lactic acidosis when metformin is used in patients with impaired kidney function.
When a patient is undergoing an angiogram with injectable contrast, they are given a contrast dye that is eliminated by the kidneys. The dye can temporarily impair kidney function, especially in patients with pre-existing kidney disease. This impairment can increase the risk of lactic acidosis in patients who are taking metformin.
To prevent this risk, the American College of Cardiology (ACC) and the American Heart Association (AHA) recommend that metformin should be stopped before an angiogram with injectable contrast, and not restarted until at least 48 hours after the procedure, provided kidney function has been confirmed to be normal. This recommendation is intended to reduce the risk of lactic acidosis and to ensure the safety of the patient undergoing the angiogram.
It is important to note that this recommendation applies only to patients with normal kidney function, and those with impaired kidney function should consult their healthcare provider for individualized guidance regarding the use of metformin before an angiogram.
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