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Published:
Journal of Analytical Toxicology,
ISSN 0146-4760,
Volume 27, Number 8, November/December,
pp.592-594
CASE REPORT: Analysis of Metformin in Antemortem Serum
and Postmortem Specimens by a Novel HPLC Method and Application to an Intoxication
Case
Karla A. Moore, Barry Levine, Jack M. Titus, and David R. Fowler
Office of the Chief Medical Examiner, State of Maryland, 111 Penn Street, Baltimore,
Maryland 21201
A case of intoxication from the oral hypoglycemic drug metformin
is presented. A number of published liquid chromatographic methods were combined
to enable a simplified analysis of metformin in both antemortem and postmortem
specimens. The method involved direct injection of a protein-free filtrate
into the liquid chromatograph. The method was sufficiently sensitive to detect
therapeutic use of metformin; no common therapeutic or abused drugs interfered
with the assay. In the presented case, the hospital admission serum metformin
concentration was 141 mg/L, or approximately two orders of magnitude above
therapeutic concentrations. The medical examiner concluded that the cause of
death in this case was metformin intoxication, and the manner of death was
suicide. Reproduction
of editorial content of this journal is prohibited without publisher’s
permission.
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