Metformin-associated lactic acidosis (MALA) in ICUs often follow acute dehydration or infection, and these high-risk situations must be signals to prevent this serious ADR.

Specific education programs for physicians and patients could also reduce this risk.

Metformin-associated lactic acidosis (MALA) is a rare but serious adverse drug reaction (ADR).

The aim of the study was to identify clinical situations associated with the onset of MALA in patients hospitalized in the Nord Pas de Calais regional intensive care units (ICUs), and to assess its preventability.

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