https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5788205/
https://www.researchgate.net/publication/322913924_Drug_Interactions_of_Metformin_Involving_Drug_Transporter_Proteins
https://www.researchgate.net/publication/322913924_Drug_Interactions_of_Metformin_Involving_Drug_Transporter_Proteins
§ Metformin is usually a first-line drug to treat Type 2 diabetes
mellitus.
§ Metformin is also found to be useful to treat various conditions
include…
ª Prediabetes
ª Gestational diabetes mellitus (GDM)
ª Polycystic Ovarian Syndrome (PCOS)
ª Obesity
ª Cancer, etc.
§ Interaction between one or more coadministered medications leading
to reduced therapeutic efficacy or enhanced toxicity is termed as “Adverse
drug interaction”.
§
Mechanism
of action of Metformin:
§ Most of the drug interactions of Metformin result in enhanced risk
of “Metformin Associated Lactic Acidosis (MALA)”.
§ The symptoms of MALA include…
ª Nausea
ª Vomiting
ª Fatigue
ª Lethargy
ª Confusion
ª Abdominal pain
ª Thirst
§ Concurrent use of the following drugs along with Metformin, elevate
its plasma concentrations and the risk of MALA…
ª
Iodinated
Contrast Materials (ICMs)
ª
H2 receptor
blockers (Cimetidine, Ranitidine)
ª
Proton
pump inhibitors
ª
Antimicrobials
(Trimethoprim, Cephalexin, Rifampin, Dolutegravir)
ª
Ranolazine
ª
Anticancer
Drugs (Vandetanib, Imatinib, Nilotinib, Gefitinib, and Erlotinib)
ª
Beta
adrenergic blockers (Atenolol, Metoprolol)
§ The risk of adverse effects could be reduced by healthcare
professionals through the screening, education, and follow up on suspected drug
interactions.
§ The diabetic patients should always consult their physician and
pharmacist before taking any new medication.
§ The diabetic patients should bring a list of all of the drugs they
are taking (or simply bring the drugs themselves), including prescription
drugs, over-the-counter drugs, and any supplements, herbal or otherwise, during
their visit to the doctor or pharmacist.
§ They are encouraged to ask their doctor or pharmacist to look over
their list for any potentially dangerous combinations.
§ It is recommended that people fill all their prescriptions at one
pharmacy, if possible.
