Table 4

Recommended dose adjustments for metformin based on eGFR

eGFR (mL/min/1.73 m2)Proposed action
≥60No contraindication to metformin
Monitor kidney function annually
<60 and ≥45Continue use
Increase monitoring of renal function (every 3–6 months)
<45 and ≥30Prescribe metformin with caution
Use lower dose (e.g., 50%, or half-maximal dose)
Closely monitor renal function (every 3 months)
Do not start new patients on metformin
<30Stop metformin
  • Adapted with permission from ADA (83).