Don't Use Serum Creatinine Cutoffs Anymore For Metformin

June 2016

Metformin will be used in more diabetes patients with kidney disease...as FDA labeling catches up with the evidence.

We're used to avoiding metformin if serum creatinine is over 1.5 mg/dL for men or over 1.4 mg/dL in women...due to fear of lactic acidosis.

But lactic acidosis is EXTREMELY rare...even in kidney disease.

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Table of Contents

Antimicrobial Stewardship Develop Antimicrobial Order Sets and Protocols Based on YOUR Hospital's Needs
Nutrition Consider Removing Daily Gastric Residual Checks From Tube Feed Orders
Cardiology Start With Beta Blockers to Treat Most Postop Atrial Fib
Cardiology Educate Patients About Their Dual Antiplatelet Therapy Duration
Cardiology Switch Aliskiren to an ACEI or ARB
Pediatrics Expect E. coli Resistance To Common PO Antibiotics in Pediatric UTIs
Rheumatology Watch Methotrexate Doses in Hospitalized Patients
Infectious Diseases Consider Drug Interactions When Evaluating Antibiotic CNS Effects
Neurology & Pain Verify Strength and Application Directions For Lidocaine Patches
New Drugs Avoid Opioids and Anticholinergics in Patients On Eluxadoline
Diabetes Don't Use Serum Creatinine Cutoffs Anymore For Metformin
Diabetes Stop Saxagliptin or Alogliptin in Patients Who Develop Heart Failure
Women's Health Avoid Even One Dose of Fluconazole in Pregnant Women