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May 15, 2002

Frequency of Inappropriate Metformin Prescriptions

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor

JAMA. 2002;287(19):2504-2505. doi:10.1001/jama.287.19.2502

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.

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