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To the Editor: Metformin is commonly used in the management of type 2 diabetes. More than 25 million prescriptions for metformin were written in 2000, making it the most commonly prescribed branded diabetes medication in the United States.¹ Metformin has been associated with the development of lactic acidosis, and since its initial marketing in 1995 the US Food and Drug Administration (FDA) has required a "black box" warning in the package insert.^2-3 Labeled contraindications include renal dysfunction and congestive heart failure (CHF) requiring pharmacologic treatment.⁴ We sought to determine the frequency of metformin use in a sample of patients with these 2 primary contraindications to therapy.

Methods

We performed a retrospective chart review of patients receiving metformin through our outpatient pharmacy at an academic medical center. Institutional review board approval was obtained, and all patients with 2 or more prescriptions for metformin processed between January 1, 2000, and September 30, 2000, . . . [Full Text of this Article]

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