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.