Which medications can cause lactic acidosis? | Rounds Which medications can cause lactic acidosis? | Rounds
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Which medications can cause lactic acidosis?

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Last updated: July 14, 2026 · View editorial policy

Medications Associated With Lactic Acidosis

Lactic acidosis has been reported with several medication classes, most prominently metformin, some HIV nucleoside reverse transcriptase inhibitors (NRTIs), linezolid, and propofol. [1] Lactic acidosis can also occur with beta-adrenergic agonist bronchodilators used for asthma or COPD. [1]

Metformin

Metformin is associated with lactic acidosis and the drug should be discontinued immediately in a patient with lactic acidosis. [2]

HIV Nucleoside Reverse Transcriptase Inhibitors

Some HIV NRTIs are associated with lactic acidosis as a rare but serious adverse effect. [3]

Linezolid

Linezolid has been associated with lactic acidosis. [1] Linezolid-associated lactic acidosis risk may increase with longer duration of therapy. [4]

Propofol

Propofol is associated with lactic acidosis. [1]

Beta-Adrenergic Agonist Bronchodilators

Beta-adrenergic agonist inhalers (such as albuterol) used for asthma or COPD have been associated with lactic acidosis. [1]

Clinical Context and Co-Exposures

Lactic acidosis most often reflects an underlying physiologic process that impairs lactate clearance or increases lactate production. [1] Medication-associated lactic acidosis risk is increased by conditions that reduce tissue perfusion or oxygen delivery. [1]

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