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We present the case of a 42‐year‐old female patient who attempted suicide by taking approximately 100 tablets of metformin (500 mg). Laboratory tests revealed severe lactic acidosis with lactate levels of 24 mmol/L and  pH  of 7.09. The patient was treated with high‐volume continuous venovenous hemodiafiltration ( CVVH ) and resin‐sorbent hemoperfusion. Metformin concentrations were measured by high‐performance liquid chromatography during  CVVH  and hemoperfusion treatment. Before extracorporeal treatment, the plasma metformin concentration was 208.5 mg/L. After  CVVH  treatment for 24 h, the plasma metformin concentration had decreased to 13.9 mg/L. Resin‐based sorbent hemoperfusion plus  CVVH  treatment had reduced the metformin plasma concentration by 61.8% after 3 h. After 7 days, the patient's laboratory tests and clinical syndrome were improved, and she was discharged from hospital. We provide evidence that  CVVH  plus hemoperfusion is effective in eliminating metformins and metabolic products.

High‐volume continuous venovenous hemodiafiltration plus resin hemoperfusion improves severe metformin‐associated toxicity