Ruggiero Nicole A, Kish Troy D, Lee Mikyung L
1Pharmacy Department, James J. Peters VA Medical Center, Bronx, NY; and 2Arnold and Marie Schwartz College of Pharmacy and Health Sciences, Long Island University, Brooklyn, NY.
Am J Ther. 2016 Mar-Apr;23(2):e575-8. doi: 10.1097/MJT.0000000000000194.
Metformin, an oral antidiabetic agent, is considered the preferred first-line therapy for patients with type II diabetes. Between 2010 and 2012, it has been estimated that 14 million Americans were administered an oral antidiabetic agent, suggesting the extensive use of metformin among the diabetic population. There have been few case reports implicating metformin in causing hemolytic anemia. We present a case of a 53-year-old white male who developed hemolytic anemia after the initiation of treatment with metformin 500 mg twice daily. The patient experienced a 1.5 g/dL decrease in hemoglobin from baseline and a 2.8 mg/dL increase in total bilirubin within 1 day of treatment. Laboratory results confirmed that the patient was also glucose-6-phosphate dehydrogenase deficient. The hemolytic anemia resolved on discontinuation of metformin. Although this adverse effect seems to be rare, it is important to consider its seriousness. Clinicians should be advised to closely monitor patients newly started on metformin.
二甲双胍是一种口服抗糖尿病药物，被认为是II型糖尿病患者首选的一线治疗药物。据估计，在2010年至2012年期间，有1400万美国人服用了口服抗糖尿病药物，这表明二甲双胍在糖尿病患者中被广泛使用。很少有病例报告表明二甲双胍会导致溶血性贫血。我们报告一例53岁白人男性病例，该患者在开始每日两次服用500毫克二甲双胍治疗后发生了溶血性贫血。在治疗的1天内，患者血红蛋白较基线水平下降了1.5 g/dL，总胆红素增加了2.8 mg/dL。实验室结果证实该患者还缺乏葡萄糖-6-磷酸脱氢酶。停用二甲双胍后，溶血性贫血得到缓解。尽管这种不良反应似乎很少见，但考虑到其严重性很重要。应建议临床医生密切监测新开始服用二甲双胍的患者。
