Iodinated contrast use during metformin therapy

Concomitant use of iodinated contrast and metformin in patients at risk of acute kidney injury. ACR 2021 and EMA recommend temporary metformin withdrawal for 48 hours before and after contrast in patients with eGFR < 30 mL/min/1.73 m² or signs of acute kidney injury.

1 drug

Also known as: Metformin contrast

Marketing claims without evidence base

The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.

FIopromideNot recommended · X-ray contrast media. Watersoluble nephrotropic low-osmolar iodinated agentsACR 2021 and EMA recommend temporary metformin withdrawal for 48 hours before and after contrast in patients with eGFR < 30 mL/min/1.73 m² or signs of acute kidney injury. In patients with stable eGFR ≥ 30 mL/min/1.73 m², withdrawal is not required. Contrast administration during metformin therapy in renally impaired patients without withdrawal raises the risk of lactic acidosis.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit