UCLA Department of Radiology

METFORMIN Rx PROTOCOL for RADIOGRAPHIC STUDIES USING INTRAVASCULAR CONTRAST MEDIA

The following Type 2 Diabetes medications contain METFORMIN:

Avandamet - rosiglitazone/METFORMIN

Glucophage - METFORMIN

Glucophage XR - METFORMIN extended-release

Glucovance - glyburide/METFORMIN

Metaglip - glipizide/METFORMIN

Riomet - METFORMIN

METFORMIN Medications should be stopped at the time of or prior to the procedure.

METFORMIN Medications should then be withheld for 48 hours after the procedure. Patients should be advised to contact their physician as to when METFORMIN Medication therapy can be started again.

Schedulers should ask if a patient has diabetes. If the answer is yes, then one of the questions to ask is "are you taking glucophage (Metformin) or any other medication for your diabetes?"

If the answer is yes for Metformin medication, the patient should be told that the Metformin medication must be discontinued at the time of or prior to the procedure and that the Metformin medication should be withheld for 48 hours after the contrast study. The patient should be told to contact their physician regarding stopping and re-starting this drug (their doctor may want to place them on another drug during that time).

If the patient is taking insulin and not a Metformin medication, a serum creatinine is necessary (there is increased risk of contrast nephrotoxicity if the baseline serum creatinine is > 1.5 mg/dl).

As an additional safety measure, schedulers should note on the schedule that the patient takes a Metformin medication.

As usual, technologists and radiology nursing staff should ask all patients prior to contrast administration if they take a Metformin medication. If yes, they should ask when the patient took his / her last dose and to make certain the patient knows they should remain off the medication for 48 hours after their study. In addition, it is important to verify that the patient has contacted his/her referring physician regarding this protocol.

With Metformin medications, serious adverse events are primarily limited to lactic acidosis (serious and potentially life-threatening condition) due to excess drug accumulation.