Table 1 Dosing by adverse reaction (AR) CTCAE criteria
CTCAE grade (G) | Metformin dosing decision | 2-week review |
|---|---|---|
≤G1 | Increase dose as per dose-titration plan, review in 2 weeks | Increase dose as per dose-titration plan |
G2 | Dosing decision to be made following review by Principal Investigator | If resolved to ≤G1, increase the dose as per the dose titration plan. If G2 ongoing, continue metformin at the current level and do not follow the titration plan |
G3 | Temporarily stop metformin Review in 2 weeks | If resolved to ≤G1 /G2, restart the metformin titration plan at lower dose of metformin. If on the lowest dose (500 mg od) metformin when experiencing toxicity, stop metformin permanently |
G4 | Discontinue metformin and repeat symptom check/institute medical management as appropriate | |