Metformin and which drugs are incompatible?
Disease description:
Previously, the hospital prescribed metformin for my grandfather who has type 2 diabetes. I would like to ask the doctor, with which medications is metformin incompatible?
Doctor's answer (1)
Dr. Bai Hongmei
Metformin is a commonly used antidiabetic drug for the treatment of type 2 diabetes mellitus, but attention should be paid to potential interactions when used concomitantly with certain medications.
1. Insulin or insulin secretagogues such as sulfonylureas: Concurrent use may increase the risk of hypoglycemia.
2. Nephrotoxic drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) and contrast agents: Combination use may increase the risk of lactic acidosis, as these drugs may impair kidney function and affect the excretion of metformin.
3. Vitamin B12 preparations: Long-term use of metformin may affect the absorption of vitamin B12, leading to deficiency.
4. Cationic drugs: Such as digoxin, morphine, quinine, ranitidine, etc., these drugs compete with metformin for the renal tubular transport system, affecting drug efficacy.
5. H2 receptor antagonists: Such as cimetidine, which can reduce the secretion of metformin by the renal tubules, leading to increased blood concentrations of metformin.
6. Calcium channel blockers: These drugs increase gastrointestinal absorption of metformin and may cause blood glucose fluctuations.
7. Anticoagulant drugs: Such as clopidogrel, which may increase the risk of bleeding.
8. Antiviral drugs: Such as ribavirin, the interaction with metformin is not yet clear, but concurrent use is advised against.
The interactions between metformin and the above medications may increase the risk of adverse drug reactions; therefore, consultation with a physician is recommended to ensure use under professional guidance.
