Metformin Hepatotoxicity
Authors: M. Deutsch, D. Kountouras, S. P. Dourakis
Journal: Annals of Internal Medicine (2004)

Letters2 March 2004Metformin HepatotoxicityM. Deutsch, MD, D. Kountouras, MD, and S. P. DourakisM. Deutsch, MDFrom Hippocration General Hospital, 11523 Athens, Greece.Search for more papers by this author, D. Kountouras, MDFrom Hippocration General Hospital, 11523 Athens, Greece.Search for more papers by this author, and S. P. DourakisFrom Hippocration General Hospital, 11523 Athens, Greece.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-5-200403020-00026-w1 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Background: Approximately 5% of patients with type 2 diabetes mellitus may have mildly elevated serum alanine aminotransferase (ALT) values. In 83% of these patients, ALT levels usually decrease during antidiabetic therapy (1).Metformin is an oral biguanide with a potent insulin-sensitizing effect and is an effective treatment for many patients with type 2 diabetes mellitus. Because of metformin's interference with mitochondrial oxidative processes, the most important, but rare, side effect is lactic acidosis. Other oral antidiabetic agents, such as acarbose (2), gliclazide (3), and some of the thiazolidinediones (mainly troglitazone), have been implicated in liver toxicity (4). ...References1. Lebovitz HE, Kreider M, Freed MI. Evaluation of liver function in type 2 diabetic patients during clinical trials: evidence that rosiglitazone does not cause hepatic dysfunction. Diabetes Care. 2002;25:815-21. [PMID: 11978674] CrossrefMedlineGoogle Scholar2. Carrascosa M, Pascual F, Aresti S. Acarbose-induced acute severe hepatotoxicity [Letter]. Lancet. 1997;349:698-9. [PMID: 9078205] CrossrefMedlineGoogle Scholar3. Dourakis SP, Tzemanakis E, Sinani C, Kafiri G, Hadziyannis SJ. Gliclazide-induced acute hepatitis. Eur J Gastroenterol Hepatol. 2000;12:119-21. [PMID: 10656221] CrossrefMedlineGoogle Scholar4. Chitturi S, George J. Hepatotoxicity of commonly used drugs: nonsteroidal anti-inflammatory drugs, antihypertensives, antidiabetic agents, anticonvulsants, lipid-lowering agents, psychotropic drugs. Semin Liver Dis. 2002;22:169-83. [PMID: 12016548] CrossrefMedlineGoogle Scholar5. Babich MM, Pike I, Shiffman ML. Metformin-induced acute hepatitis. Am J Med. 1998;104:490-2. [PMID: 9626034] CrossrefMedlineGoogle Scholar6. Desilets DJ, Shorr AF, Moran KA, Holtzmuller KC. Cholestatic jaundice associated with the use of metformin. Am J Gastroenterol. 2001;96:2257-8. [PMID: 11467664] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: M. Deutsch, MD; D. Kountouras, MD; S. P. DourakisAffiliations: From Hippocration General Hospital, 11523 Athens, Greece. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byFatal Fulminant Hepatitis E in a Diabetic Patient on MetforminLiterature review of the clinical characteristics of metformin-induced hepatotoxicityMachine learning liver-injuring drug interactions with non-steroidal anti-inflammatory drugs (NSAIDs) from a retrospective electronic health record (EHR) cohortMetabolic Comorbidities and Risk of Development and Severity of Drug-Induced Liver InjuryPhytochemical screening and preliminary clinical trials of the aqueous extract mixture of Andrographis paniculata (Burm. f.) Wall. ex Nees and Syzygium polyanthum (Wight.) Walp leaves in metformin treated patients with type 2 diabetesDrug-Induced Liver InjuryDrugs and ToxinsMetformin as a Rare Cause of Drug-Induced Liver Injury, a Case Report and Literature ReviewHepatotoxicity of Cardiovascular and Antidiabetic DrugsHepatic injury due to drugs, herbal compounds, chemicals and toxinsDrug-Induced Liver InjuryHepatotoxicidad por metforminaHepatotoxicity Associated with Metformin Therapy in Treatment of Type 2 Diabetes Mellitus with Nonalcoholic Fatty Liver DiseaseClarifying metformin's role and risks in liver dysfunctionSíndrome constitucional asociado a hepatotoxicidad por metforminaHepatotoxicidad secundaria a fármacos de uso comúnHepatitis colestásica inducida por metformina 2 March 2004Volume 140, Issue 5 Page: W-25 Keywords Alanine aminotransferase Autoimmune hepatitis Bilirubin Hepatitis Hypoglycemics Inflammation Insulin Liver Patients Type 2 diabetes ePublished: 2 March 2004 Issue Published: 2 March 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...