A10BA02 - Metformin |
Not porphyrinogenic |
NP |
Rationale
Metformin is not metabolized in the body. The physiological effects are not porphyrinogenic. Nausea and vomiting may be potentially porphyrinogenic through reduced caloric intake, but can be counteracted by suitable administration regimes. More than 30 observations of safe use by carriers of acute porphyria.
Chemical description
Biguanide antidiabetic.
Therapeutic characteristics
Metformin is indicated for the improvement of glycaemic control in adult patients with type 2 diabetes mellitus. It is administered orally. Common adverse reactions of metformin that can be confused with an acute porphyric attack are nausea, vomiting and abdominal pain.
Metabolism and pharmakokinetics
Eliminated unchanged via glomerular filtration.
Published experience
Kauppinen 1992: uneventfully used by one patient with acute porphyria.
IPNet drug reports
Uneventful use reported in 30 patients with acute porphyria.
References
- Scientific articles
- Kauppinen R, Mustajoki P. Prognosis of acute porphyria: occurrence of acute attacks, precipitating factors, and associated diseases. Medicine (Baltimore). 1992 Jan; 71(1):1-13. PMID 1549056. #1102
- Tornio A, Niemi M, et al. Drug interactions with oral antidiabetic agents: pharmacokinetic mechanisms and clinical implications. Trends Pharmacol Sci. 2012 Jun; 33(6):312-22. PMID 22475684. #4352
- Summary of Product Characteristics
- The electronic Medicines Compendium (emc). Summary of Product Characteristics (SPC). Glucophage. #1104
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