Metformin Contraindications in Alcohol Abuse

Primary Contraindications

• The American Diabetes Association recommends that metformin is contraindicated in active alcohol abuse or chronic alcoholism, as it increases the risk of lactic acidosis 1
• Conditions causing tissue hypoxia or impaired lactate clearance, such as acute congestive heart failure with hypoperfusion, require metformin discontinuation, as stated by the American College of Cardiology 2

Clinical Considerations

• Any acute illness causing dehydration or hypoxemia necessitates metformin discontinuation, according to the American Association of Clinical Endocrinologists 1