Suspension of Metformin in Patients Receiving IV or IA Radiographic Contrast Material

Medical Directive ID: 
DIA-2017-001
Lead Contact Person: 
Karen Kennedy, Coordinator MR/CT, University Hospital
Physician/Nurse Lead: 
Dr. Keng Yeow Tay, Site Chief, Medical Imaging
Dr. Aashish Goela, Site Chief, Medical Imaging
Program: 
Medical Imaging
Approval By: 
Medical Advisory Committee
Original Effective Date: 
Wednesday, February 12, 2014
Revised Date: 
Wednesday, November 8, 2017
To Be Reviewed Date: 
Sunday, November 8, 2020
This Medical Directive Applies to the following sites: 
All LHSC sites
This Medical Directive Applies to the following patient population: 
In-Patients
Adults
Order: 

The Registered Nurse/Medical Radiation Technologist will suspend Metformin/or oral diabetic medications containing metformin at the time of the Radiographic iodinated contrast administration (not before) in patients with renal disease stage IV or V (estimated glomerular filtration rate (eGFR) less than 30 mL/min/1.73m2). Metformin will remain suspended for at least 48 hours following the administration of iodinated radiographic contrast material. The Registered Nurse/Medical Radiation Technologist will place an order for serum creatinine bloodwork to be completed two days (minimum 48 hours) following the procedure. Metformin must not be restarted until directed by the Most Responsible Professional (MRP).

Suspension of Metformin is also referenced in medical directive MED-2014-034 “Cardiac Catheterization Referrals by Regional Cardiac Care Coordinator”.

Note: The terms metformin and metformin HCl are used interchangeably.

Click the link to view the entire medical directive in detail: 

Signatures

SurnameKnown ByDate Signed
AkinciogluCigdemFeb 6 2018 10:59:38:530AM
BachDavidJan 20 2018 03:15:03:920PM
BagurRodrigoJan 17 2018 09:48:19:197AM
BerginLynnFeb 26 2018 02:57:12:310PM
BhaduriMousumiMar 12 2018 01:50:09:967PM
BoughnerDerekJan 30 2018 03:42:35:763PM
BrahmGaryJan 17 2018 08:38:58:137AM
CalvinJamesJan 21 2018 12:16:47:543PM
CarstensenHeinrichApr 2 2018 10:00:06:630AM
ChanIanJan 19 2018 12:38:13:220AM
ChungJonathanJan 18 2018 03:08:08:847PM
CoolDerekJan 28 2018 09:35:42:910PM
DaveyRyanJan 17 2018 09:00:12:567AM
DeSabeMar 30 2020 11:40:01:290AM
DiamantourosPantelisFeb 27 2018 03:37:13:653PM
DiasBryanMar 10 2018 10:50:38:750PM
Etemad-RezaiRoyaFeb 20 2018 04:36:57:900PM
GargPallavMar 19 2018 09:25:08:997AM
GoelaAashishFeb 15 2018 01:46:22:287PM
GulaLorneJan 17 2018 10:15:18:827AM
GulkaIreneMar 20 2018 07:50:32:577PM
HaddadRichardJan 28 2018 06:34:25:677PM
HoDerekMar 27 2020 11:07:47:200PM
JablonskyGeorgeJan 17 2018 10:47:55:360AM
JollyUmjeetFeb 21 2018 01:06:29:503PM
KleinGeorgeMar 12 2018 10:54:24:320PM
KribsStewartFeb 8 2018 01:20:04:450PM
LaviShaharJan 22 2018 04:41:41:260PM
LeeDonaldFeb 26 2018 01:06:37:010PM
Leong-SitPeterJan 22 2018 10:37:06:143AM
LeungAndrewJan 17 2018 08:24:33:347AM
LeungStephanieJan 29 2018 07:47:46:750AM
LumAndreaFeb 5 2018 08:26:43:987AM
ManlucuJaimieJan 17 2018 11:08:33:323AM
MathewAndrewMar 31 2018 10:13:01:173PM
MayichMichaelApr 9 2018 04:17:28:167PM
McCartyDavidMar 19 2018 09:21:16:610PM
McKillopScottMar 27 2018 07:12:33:990PM
McPhersonTerrenceJan 17 2018 08:50:31:260AM
MujoomdarAmolJan 17 2018 07:45:24:257AM
O'RiordanA.Feb 20 2018 09:37:25:840AM
PandeySachinFeb 15 2018 10:44:01:577AM
PapoffWayneJan 29 2018 09:27:32:513AM
PaulNarinderMar 27 2018 11:14:58:043AM
PeckDavidJan 17 2018 09:42:07:920AM
PelzDavidFeb 28 2018 12:21:41:453PM
PickeringJ.GeoffreyJan 18 2018 09:34:35:617PM
PritchettStephanyJan 19 2018 09:58:42:017AM
RachinskyIrinaFeb 22 2018 02:21:32:510PM
RamsewakDarrylMar 8 2018 07:12:46:573AM
ReidRobertMar 22 2018 01:58:05:637PM
RobertsJasonJan 29 2018 06:32:07:733PM
RomsaJonathanFeb 23 2018 11:20:40:693AM
RossIanMar 1 2018 07:23:58:567PM
SharmaManasJan 19 2018 04:54:11:817PM
ShoemakerGerardFeb 15 2018 03:23:40:237PM
SiuSamMar 13 2018 06:39:09:660PM
SkanesAllanMay 7 2018 09:34:11:843PM
SmithStuartFeb 17 2018 04:43:11:317PM
SpougeAlisonFeb 14 2018 09:05:45:353AM
SridharKumarMar 6 2018 10:12:05:230AM
TangAnthonyApr 9 2018 09:59:51:123AM
TayKengJan 17 2018 11:25:58:353AM
TeefyPatrickFeb 28 2018 10:03:24:200AM
ThainAndrewFeb 25 2018 02:03:29:350PM
TzemosNikolaosApr 23 2018 10:33:24:730AM
VezinaWilliamMar 26 2018 12:00:00:000AM
WarringtonJamesMar 20 2018 12:01:11:230PM
WeingertMichaelFeb 8 2018 02:32:28:690PM
WisemanDanieleJan 17 2018 12:15:11:493PM
WisenbergGeraldJan 28 2018 06:47:40:063AM
YacobMarina SandraHave Not Signed
YeeRaymondJan 17 2018 01:36:01:597PM
YoshyCatherineJan 17 2018 10:03:16:400AM
ZaleskiWitekJan 25 2018 01:17:42:700PM