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British Journal of Anaesthesia, 2003, Vol. 91, No. 6 909-910
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia

Case Reports

Metformin lactic acidosis, acute renal failure and rofecoxib

G. Price*,

Department of Anaesthesia, Victoria Hospital, Kirkcaldy, Fife, Scotland, UK

*Present address: Department of Intensive Care The St George Hospital, Kogarah, Sydney, Australia. E-mail: grantcprice@hotmail.com

A patient with acute renal failure associated with lactic acidosis as a result of concurrent treatment with metformin is described. Rofecoxib may have been a precipitating factor. The risk of renal failure with the use of traditional NSAIDs is well known. However, what is less well appreciated is the role that the COX 2 inhibitors may play in the development of renal failure which, when it occurs in a patient on metformin, can lead to a potentially disastrous outcome.

Br J Anaesth 2003; 91: 909–10


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