We aimed to perform a meta-analysis to determine whether the risks of contrast-induced acute kidney injury (CI-AKI) and lactic acidosis increase with metformin use in diabetic patients receiving a contrast medium. There have been few studies published on the use of contrast media (CM) in metformin-treated patients. In this study, we conducted a systematic review and meta-analysis to investigate the relationship between metformin and contrast-induced acute kidney injury (CI-AKI). For most patients, metformin should be stopped at the time of contrast administration Should you stop metformin before a CT scan or MRI with contrast? Learn exactly when to hold the drug, why lactic acidosis risk matters, and what current… Learn why you must stop metformin before CT scans with contrast dye. Expert guide covers the 48-hour rule, risks, and safety tips. See the updated ACR metformin contrast guidelines with the 2026 protocol explained. Learn safe practices, key updates, and recommendations for patient care. What are current best practices on holding metformin prior to and post contrast administration? For patients with normal renal function (eGFR ≥60 mL/min/1.73 m²), metformin does NOT need to be held before the CT scan with contrast—discontinue it at the. This topic provides recommendations for the prevention of CI-AKI in patients expected to receive intravenous iodinated contrast material with computed tomography (CT) [13]. Most people taking metformin do not need to stop it before an MRI with contrast. The worry about metformin and contrast agents stems primarily from iodinated contrast dyes used in CT scans, not from the gadolinium-based agents used in MRI.