www.ijbcp.com International Journal of Basic & Clinical Pharmacology | February 2017 | Vol 6 | Issue 2 Page 469 IJBCP International Journal of Basic & Clinical Pharmacology Print ISSN: 2319-2003 | Online ISSN: 2279-0780 Case Report Metformin induced yellow nails: a rare entity Tarun Sharma 1 , Aradhna Sharma 2 *, Mukul Bhatnagar 3 INTRODUCTION Metformin, a drug from biguanide class is used orally as a first choice drug in newly diagnosed patients of type 2 diabetes mellitus. 1 Metformin is a drug having pleiotropic effects due to which it is indicated as therapy in insulin resistant states such as PCOD. 2 The most common adverse drug reactions associated with metformin is gastrointestinal symptoms 1 (anorexia, nausea and bloating). Other commonly reported ADRs such as vitamin B12 deficiency, rash, metallic taste, myalgias and tiredness are frequently seen and are non-serious in nature. 3 Serious side effect such as lactic acidosis is very rare and is usually associated with other comorbid conditions. 4 This is a unique case report presenting thickening and yellowish discoloration of all the finger nails on continuous metformin treatment. CASE REPORT A 36 year old married female was diagnosed with type 2 diabetes mellitus two years back. She was put on life style modification and was well controlled without drugs. For last one year her blood sugar levels were uncontrolled and then along with the lifestyle modifications she was treated with metformin 1000 mg in two divided doses. Because of uncontrolled hyperglycaemia, it was further increased to 1500 mg daily in divided doses after which her blood glucose levels became normal. About 6 months after increasing ABSTRACT This article reports an interesting and a rare case of metformin induced nail disorder in a middle aged female with type 2 diabetes. The patient had been receiving metformin one 1500mg daily from the last 6 months and noticed her finger nails gradually thickened and turned yellow. On stopping the metformin, the nails gradually normalized. The patient was treated further with glimepiride and insulin glargine. After 3 months of discontinuation of metformin there was a significant improvement in the nails. Clinicians should be aware of metformin induced yellow discolouration of nails, though a curable and reversible condition if diagnosed well in time. Keywords: Adverse drug reaction, Metformin, Yellow nails DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20170351 1 Department of Medicine, Civil Hospital Kangra, Himachal Pradesh, India 2 Department of Pharmacology, Dr. RPGMC Kangra, Tanda, Himachal Pradesh, India 3 Department of Cardiology, Dr. RPGMC Kangra, Tanda, Himachal Pradesh, India Received: 13 December 2016 Accepted: 03 January 2017 *Correspondence to: Dr. Aradhna Sharma, Email: draradhnasharma@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open- access article distributed under the terms of the Creative Commons Attribution Non- Commercial License, which permits unrestricted non- commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.