Which condition is NOT a contraindication for metformin?

Metformin is generally considered safe for use in patients with peptic ulcer disease, making it a condition that is not a contraindication. This is because the mechanism of action for metformin primarily involves the liver, where it decreases glucose production, and the gut, where it improves insulin sensitivity and glucose uptake. There is no direct physiological interaction between metformin and the pathophysiology of peptic ulcer disease that would preclude its use.

On the other hand, liver cirrhosis, severe kidney impairment, and alcohol use disorder are more concerning due to the increased risk of lactic acidosis, a rare but serious side effect associated with metformin. In patients with liver dysfunction, the metabolism and clearance of the drug can be significantly altered. Similarly, with severe kidney impairment, the clearance of metformin is reduced, leading to higher serum levels and an increased risk of adverse effects. Alcohol use disorder is another risk factor for lactic acidosis due to its effects on liver metabolism and potential for hypoglycemia, which could further complicate a patient's condition.

Therefore, peptic ulcer disease does not pose the same level of risk for patients taking metformin as the other listed conditions.