Phenformin

Oral
Type 2 diabetes mellitus

Insulin-dependent diabetes, diabetic coma, ketoacidosis, trauma, severe infection, heart failure, recent MI; dehydration. Renal or hepatic impairment.

Monitor vitamin B₁₂ concentrations annually during long-term treatment. Pregnancy.

Anorexia, nausea, vomiting, diarrhoea, metallic taste, wt loss, skin reactions, acute pancreatitis.
Potentially Fatal: Lactic acidosis, CV adverse effects.

Symptoms: Lactic acidosis. Treatment: Intensive supportive therapy. Glucose or glucagon may be given if hypoglycaemia is present.

May impair vitamin B₁₂ absorption.
Potentially Fatal: Cimetidine may reduce renal clearance of phenformin. Increased risk of lactic acidosis with alcohol, nephrotoxic drugs.

Description: Phenformin is a biguanide antidiabetic. It does not stimulate insulin release but requires the presence of insulin to exhibit its hypoglycaemic effect. It delays glucose absorption from the GI tract, increases insulin sensitivity and glucose uptake, and inhibits gluconeogenesis in the liver.
Pharmacokinetics:
Metabolism: Hepatic.

Antidiabetic Agents