Which oral hypoglycemic agent must be temporarily withheld prior to procedures requiring intravenous iodinated radiocontrast to reduce the risk of lactic acidosis?
Answer and explanation
Correct answer: A. Metformin
Answer: Metformin.
Why not the others: Radiocontrast-induced nephropathy can impair metformin clearance and trigger fatal lactic acidosis; Glipizide stimulates insulin secretion and does not pose a direct contrast-induced lactic acidosis risk; Pioglitazone does not carry a black box warning for contrast-induced lactic acidosis; Sitagliptin is cleared renally but does not induce lactic acidosis.
Why not the others: Radiocontrast-induced nephropathy can impair metformin clearance and trigger fatal lactic acidosis; Glipizide stimulates insulin secretion and does not pose a direct contrast-induced lactic acidosis risk; Pioglitazone does not carry a black box warning for contrast-induced lactic acidosis; Sitagliptin is cleared renally but does not induce lactic acidosis.
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