优化新西兰二甲双胍的处方开具

Refining metformin prescribing in New Zealand.

作者信息

Jayathissa Sisira, Dixon Paul, Bruce Raymond, Reith David

机构信息

Department of Medicine, Hutt Valley DHB, Lower Hutt.

Women's and Children's Health, University of Otago, Dunedin.

出版信息

N Z Med J. 2017 Mar 24;130(1452):49-53.

PMID:28337040

Abstract

Metformin is the mainstay of treatment of type 2 diabetes. However, there has been significant concern on prescribing metformin in patients with renal impairment as a result of metformin-associated lactic acidosis (MALA). Recent studies have cast doubt on the existence of MALA purely related to metformin use. Medsafe recently initiated changes to datasheet so lower doses of metformin could be used in patients with GFR down to 15ml/min. In this paper we outline the context and implications of this change.

摘要

二甲双胍是2型糖尿病治疗的主要药物。然而，由于二甲双胍相关乳酸酸中毒（MALA），在肾功能损害患者中使用二甲双胍一直存在重大担忧。最近的研究对单纯因使用二甲双胍而导致MALA的存在提出了质疑。药品安全监测部门（Medsafe）最近对药品说明书进行了修改，以便在估算肾小球滤过率（eGFR）低至15ml/min的患者中可以使用较低剂量的二甲双胍。在本文中，我们概述了这一变化的背景和影响。