One or two intact local summaries. No averaged regimen, patient-specific dose or automatic source preference.
1 local source card selected. Local card fingerprints checked where supplied. This is not an original-document hash, source-currency guarantee or clinical approval. Record-level cautions below are the current library's cautions, not a frozen prior version.
Independent clinical review is pending. Confirm indication, exact formulation/route, population, renal measure and units, kidney-function stability, dialysis prescription, interacting drugs, monitoring and source revision. An RX mirror and its original label are not independent corroboration. Missing disagreement notes do not certify agreement.
These historical serum-creatinine cutoffs are not a current-label validation. A separately attributed current U.S. eGFR-based label must control current product-label dosing.
The preserved source uses historical serum-creatinine cutoffs. The imported U.S. immediate-release label instead uses indexed eGFR, and contraindicates use below 30 mL/min/1.73 m2. The old rule and current-label summary must not be blended.
The joint ADA/KDIGO 2022 consensus supports selected CKD use with a lower daily dose at eGFR 30-44. The U.S. label separately discourages initiation between eGFR 30 and 45 and requires benefit-risk reassessment for continued therapy below 45.
What to reconcile: Do not interpret a continuation strategy as automatic authorization for a new start. Reconcile label, guideline, acute illness and monitoring; document the plan, including when therapy should be held or reassessed.
Open this note and its source referencesThe consensus supports metformin in selected patients with type 2 diabetes and CKD at eGFR at least 30 mL/min/1.73 m2. Reduce to 1,000 mg daily at eGFR 30-44; consider reduction at 45-59 with high hypoperfusion or hypoxemia risk. Monitor eGFR every 3-6 months once below 60. A sick-day plan that holds metformin during acute illness may reduce lactic-acidosis risk, especially when AKI reduces clearance. The U.S. label separately discourages initiation at eGFR 30-45; distinguish a new start from continuation.
RDM34-professional-metformin-ada-kdigo2022-C1 · Source locator: Metformin subsection and consensus statement.
This reference does not select a regimen. Complete the indication, measured/estimated renal function and trend, dialysis setting, source rationale, monitoring and reassessment plan in your institution's approved documentation system. Confirm the complete current source before adopting its regimen.
Pinned reference: https://globalrph.com/blogCalcs/renal-dosing-master/compare.php?id=metformin&s1=RDM34-professional-metformin-ada-kdigo2022&h1=12c0c6d18a1aa0e7ff67420f3b65101d707291d1505b666ccdc775887647ff1c