quick question..

[DocInProgress]

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how does metformin cause lactic acidosis?

if it doesn't, how does renal insufficiency or myocardial infarction contribute to it?

 

[bydotte]

it does according to goodman and gilman's, but i don't think the mechanism is known. some gibberish in there about cation transporters in the liver. MI might contribute by hypoxemia, and renal insufficiency might prevent the excretion of excess acid or production of bicarb