Contrast media and metformin: guidelines to diminish the risk of lactic acidosis in non-insulin-dependent diabetics after administration of contrast media. ESUR Contrast Media Safety Committee

Eur Radiol. 1999;9(4):738-40. doi: 10.1007/s003300050746.


The purpose of this study was to establish guidelines on how to avoid metformin-induced lactic acidosis following intravascular use of contrast media. We reviewed articles published in international journals. No conclusive evidence was found to indicate that the intravascular use of contrast media precipitated the development of metformin-induced lactic acidosis in patients with normal S-creatinine (< 130 mumol/l). The complication was almost always observed in non-insulin-dependent diabetic patients with decreased renal function before injection of contrast media. Guidelines for the use of contrast media in this group of patients are proposed.

Publication types

  • Guideline
  • Practice Guideline

MeSH terms

  • Acidosis, Lactic / blood
  • Acidosis, Lactic / chemically induced
  • Acidosis, Lactic / prevention & control*
  • Angiography / methods
  • Contrast Media / administration & dosage*
  • Contrast Media / adverse effects
  • Creatinine / blood
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications*
  • Humans
  • Hypoglycemic Agents / administration & dosage*
  • Hypoglycemic Agents / adverse effects
  • Metformin / administration & dosage*
  • Metformin / adverse effects
  • Practice Guidelines as Topic
  • Risk Factors


  • Contrast Media
  • Hypoglycemic Agents
  • Metformin
  • Creatinine