Patient name: _______________________________________________
Social Security Number: _______________________________________
Contrast Medium: ____________________________________________
Batch Number: ______________________________________________
Mililiter: ___________________________________________________
Date: _____________________________________________________
Time: _____________________________________________________
The patient attended an examination today and intravenous contrast medium was administered.
Metformin treatment must not re-commence for 48 hours and then only if GFR remains unchanged.
For this reason, the patient’s P-creatinine must be checked and GFR calculated.