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| Interactions: | AmilorideAdverse Effect an increased risk of lactic acidosisClinical Management In patients receiving metformin and Amiloride , closely monitor blood glucose concentrations. Metformin doses may need to be reduced.
Atenolol Adverse Effect hypoglycemia, hyperglycemia, or hypertensionClinical Management If the use of a beta blocker is required in a diabetic, watch for decreased diabetic control by monitoring the patients glucose carefully. Cardioselective beta blockers (atenolol, metoprolol) cause less disturbance of glucose metabolism and less masking of hypoglycemic effects. Propranolol accounts for the majority of positive reports of an interaction and should clearly be avoided.
BisoprololAdverse Effect hypoglycemia, hyperglycemia, or hypertension . Clinical Management: If the use of a beta blocker is required in a diabetic, watch for decreased diabetic control by monitoring the patients glucose carefully. Cardioselective beta blockers (atenolol, metoprolol) cause less disturbance of glucose metabolism and less masking of hypoglycemic effects. Propranolol accounts for the majority of positive reports of an interaction and should clearly be avoided.
CarvedilolAdverse Effect Hypoglycemia, hyperglycemia, or hypertensionClinical Management If the use of a beta blocker is required in a diabetic, watch for decreased diabetic control by monitoring the patients glucose carefully. Cardioselective beta blockers (atenolol, metoprolol) cause less disturbance of glucose metabolism and less masking of hypoglycemic effects. Propranolol accounts for the majority of positive reports of an interaction and should clearly be avoided.
CeliprololAdverse Effect hypoglycemia, hyperglycemia, or hypertension . Clinical Management: If the use of a beta blocker is required in a diabetic, watch for decreased diabetic control by monitoring the patients glucose carefully. Cardioselective beta blockers (atenolol, metoprolol) cause less disturbance of glucose metabolism and less masking of hypoglycemic effects. Propranolol accounts for the majority of positive reports of an interaction and should clearly be avoided.
CimetidineAdverse Effect increased metformin plasma concentrations, which increases the risk of metformin-induced lactic acidosisClinical Management Metformin doses may need be reduced when given concurrently with cimetidine. An alternative to cimetidine could also be prescribed.
Cotrimoxazole Adverse Effect an increased risk of lactic acidosisClinical Management In patients receiving metformin and Cotrimoxazole , closely monitor serum glucose levels and metformin plasma concentrations. Metformin dose may need to be reduced.
Digoxin Adverse Effect an increased risk of lactic acidosisClinical Management In patients receiving metformin and Digoxin, closely monitor blood glucose concentrations. Metformin doses may need to be reduced.
EnalaprilAdverse Effect Hyperkalemic lactic acidosisClinical Management Avoid metformin and enalapril in patients with renal insufficiency.
Fentanyl Adverse Effect An increased risk of lactic acidosisClinical Management In patients receiving metformin and Fentanyl, closely monitor serum glucose levels and metformin plasma concentrations. Metformin doses may need to be reduced.
Frusemide Adverse Effect An increased risk of hypoglycemiaClinical Management During concomitant therapy, carefully monitor blood glucose and watch for signs and symptoms of hypoglycemia (irritability, tremulousness, diaphoresis, tachycardia, confusion).
LabetalolAdverse Effect Hypoglycemia, hyperglycemia, or hypertensionClinical Management If the use of a beta blocker is required in a diabetic, watch for decreased diabetic control by monitoring the patients glucose carefully. Cardioselective beta blockers (atenolol, metoprolol) cause less disturbance of glucose metabolism and less masking of hypoglycemic effects. Propranolol accounts for the majority of positive reports of an interaction and should clearly be avoided.
Metoprolol Adverse Effect hypoglycemia, hyperglycemia, or hypertension . Clinical Management: If the use of a beta blocker is required in a diabetic, watch for decreased diabetic control by monitoring the patients glucose carefully. Cardioselective beta blockers (atenolol, metoprolol) cause less disturbance of glucose metabolism and less masking of hypoglycemic effects. Propranolol accounts for the majority of positive reports of an interaction and should clearly be avoided.
Morphine Adverse Effect an increased risk of lactic acidosisClinical Management In patients receiving metformin and Morphine, closely monitor serum glucose levels and metformin plasma concentrations. Metformin doses may need to be reduced.
Nifedipine Adverse Effect An increased risk of hypoglycemiaClinical Management Closely monitor blood glucose concentrations in patients receiving metformin and nifedipine.
OxprenololAdverse Effect hypoglycemia, hyperglycemia, or hypertension . Clinical Management: If the use of a beta blocker is required in a diabetic, watch for decreased diabetic control by monitoring the patients glucose carefully. Cardioselective beta blockers (atenolol, metoprolol) cause less disturbance of glucose metabolism and less masking of hypoglycemic effects. Propranolol accounts for the majority of positive reports of an interaction and should clearly be avoided.
PindololAdverse Effect hypoglycemia, hyperglycemia, or hypertension . Clinical Management: If the use of a beta blocker is required in a diabetic, watch for decreased diabetic control by monitoring the patients glucose carefully. Cardioselective beta blockers (atenolol, metoprolol) cause less disturbance of glucose metabolism and less masking of hypoglycemic effects. Propranolol accounts for the majority of positive reports of an interaction and should clearly be avoided.
Procainamide Adverse Effect An increased risk of lactic acidosisClinical Management In patients receiving metformin and Procainamide, closely monitor serum glucose levels and metformin plasma concentrations. Metformin doses may need to be reduced.
PropranololAdverse Effect hypoglycemia, hyperglycemia, or hypertension . Clinical Management: If the use of a beta blocker is required in a diabetic, watch for decreased diabetic control by monitoring the patients glucose carefully. Cardioselective beta blockers (atenolol, metoprolol) cause less disturbance of glucose metabolism and less masking of hypoglycemic effects. Propranolol accounts for the majority of positive reports of an interaction and should clearly be avoided.
Quinidine Adverse Effect An increased risk of lactic acidosisClinical Management In patients receiving metformin and Quinidine, closely monitor serum glucose levels and metformin plasma concentrations. Metformin doses may need to be reduced.
QuinineAdverse Effect An increased risk of lactic acidosisClinical Management In patients receiving metformin and Quinine , closely monitor serum glucose levels and metformin plasma concentrations. Metformin doses may need to be reduced.
Ranitidine Adverse Effect an increased risk of lactic acidosisClinical Management In patients receiving metformin and Ranitidine , closely monitor serum glucose levels. Metformin doses may need to be reduced.
SelegilineAdverse Effect excessive hypoglycemia, CNS depression, and seizuresClinical Management Blood glucose levels should be closely monitored when Selegiline is added or discontinued in a patient receiving Metformin . Lower doses of hypoglycemic drugs may be required with concomitant therapy
VancomycinAdverse Effect an increased risk of lactic acidosis |
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