Curated insights • How it Works • Practical Pearls • Evidence Base
| eGFR (mL/min/1.73m²) | Metformin Recommendation |
|---|---|
| ≥ 60 | No renal dose adjustment. Monitor annually. |
| 45 – 59 | Safe to continue. Monitor every 3–6 months. |
| 30 – 44 | Reduce dose by 50%. Do not initiate new treatment. |
| < 30 | Contraindicated. Discontinue immediately. |
9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2024
Metformin-containing drugs: revised recommendations for use in patients with reduced kidney function
For eGFR between 30–60, Metformin should be withheld before IV contrast procedures and for 48 hours afterward, resuming only if renal function remains stable.