When should metformin be held?

When should metformin be held?

• A. It should be continued during NPO status
• B. It should be stopped if the patient is dehydrated
• C. Hold when the patient is NPO
• D. It should be given with meals only

Answer: (C)

Hold metformin when the patient is NPO. Metformin carries a risk of lactic acidosis, especially when there’s reduced renal function, dehydration, or poor intake. During NPO status, these conditions can occur or worsen, so withholding metformin prevents drug accumulation and potential lactic acidosis until the patient resumes eating and fluid intake and kidney function is reassessed. If dehydration or another acute issue is present, holding is also appropriate, but the direct guideline you’ll often see is to hold during NPO. Metformin should not be assumed safe to continue during NPO, nor is it required to be given only with meals.

Hold metformin when the patient is NPO. Metformin carries a risk of lactic acidosis, especially when there’s reduced renal function, dehydration, or poor intake. During NPO status, these conditions can occur or worsen, so withholding metformin prevents drug accumulation and potential lactic acidosis until the patient resumes eating and fluid intake and kidney function is reassessed. If dehydration or another acute issue is present, holding is also appropriate, but the direct guideline you’ll often see is to hold during NPO. Metformin should not be assumed safe to continue during NPO, nor is it required to be given only with meals.