Metformin IV contast

Specialties Radiology

Published

What is the current practice and/or recommendations for IV contrast and metformin? I believe my teacher was teaching old information and I'm trying to clarify. I don't really know, but maybe what is done in practice is not necessarily what is recommended?

Specializes in Cath lab, acute, community.

We advise patients to cease metformin 48 hours prior to the scheduled contrast injection. This is because we have seen (and also done our own studies) of higher creat if we didn't, indicating kidney damage. Some kidney damage is temporary, some is not. Diabetics often have compromised kidneys to begin with!

I do not know if it is dose dependent. Some of these cases we used a lot of contrast (100+mls of 320 omnipaque etc), and some was a small amount of diluted contrast (say 50/50 300 omnipaque just 20mls in total).

We also pre-hydrate with normal saline in patients with a high risk of kidney injury, regardless of metformin usage or not. We post-hydrate with at least 500mls of normal saline for everyone.

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Nice discussion, Our facility just tells our patients to cease taking metformin products 48 hour post injection. It is what our doctors have agreed upon.

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