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Cardiovascular Disease

What are the signs and symptoms of biguanide-induced lactic acidosis?

Signs and symptoms of biguanide-induced lactic acidosis are nonspecific and include:

-anorexia
-nausea, vomiting, abdominal pain
-altered level of consciousness
-hyperpnoea
-thirst

Doctors should suspect lactic acidosis in patients presenting with acidosis, but without evidence of hypoperfusion or hypoxia.

Treatment involves biguanide withdrawal, adequate hydration/circulatory support and correction of the acidosis. Haemodialysis may be useful for both acid/base control and drug clearance.

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