Which biguanide was withdrawn due to association with lactic acidosis?

Which biguanide was withdrawn due to association with lactic acidosis?

• A. Metformin
• B. Phenformin
• C. Buformin
• D. Rosiglitazone

Answer: (B)

Lactic acidosis risk drives the history of biguanide use. Among these drugs, one was withdrawn worldwide because cases of severe lactic acidosis, often fatal, were clearly linked to its use. That drug is phenformin. It penetrates tissues more readily and strongly inhibits mitochondrial respiration, which shifts metabolism toward lactate production and impairs lactate clearance, especially in people with kidney impairment or other stresses. Because of this 큰 safety signal, phenformin was taken off the market. Metformin, while capable of lactic acidosis in rare cases, has a much lower risk and remains widely used with appropriate renal function monitoring. Buformin had its own safety concerns and was withdrawn in many places as well, but the classic teaching focus is phenformin. Rosiglitazone is not a biguanide; it’s a thiazolidinedione with different adverse effects.

Lactic acidosis risk drives the history of biguanide use. Among these drugs, one was withdrawn worldwide because cases of severe lactic acidosis, often fatal, were clearly linked to its use. That drug is phenformin. It penetrates tissues more readily and strongly inhibits mitochondrial respiration, which shifts metabolism toward lactate production and impairs lactate clearance, especially in people with kidney impairment or other stresses. Because of this 큰 safety signal, phenformin was taken off the market.

Metformin, while capable of lactic acidosis in rare cases, has a much lower risk and remains widely used with appropriate renal function monitoring. Buformin had its own safety concerns and was withdrawn in many places as well, but the classic teaching focus is phenformin. Rosiglitazone is not a biguanide; it’s a thiazolidinedione with different adverse effects.