Furosemide
A single-dose, metformin-furosemide drug interaction study in healthy subjects
demonstrated that pharmacokinetic parameters of both compounds were affected
by co-administration. Furosemide increased the metformin plasma and blood
Cmax by 22% and blood AUC by 15%, without any significant change in metformin
renal clearance. When administered with metformin, the Cmax and AUC of furosemide
were 31% and 12% smaller, respectively, than when administered alone, and
the terminal half-life was decreased by 32%, without any significant change
in furosemide renal clearance. No information is available about the interaction
of metformin and furosemide when co-administered chronically.
Nifedipine
A single-dose, metformin-nifedipine drug interaction study in normal healthy
volunteers demonstrated that co-administration of nifedipine increased plasma
metformin Cmax and AUC by 20% and 9%, respectively, and increased the amount
excreted in the urine. Tmax and half-life were unaffected. Nifedipine appears
to enhance the absorption of metformin. Metformin had minimal effects on nifedipine.
Cationic drugs
Cationic drugs (e.g., amiloride, digoxin, morphine, procainamide, quinidine,
quinine, ranitidine, triamterene, trimethoprim, or vancomycin) that are eliminated
by renal tubular secretion theoretically have the potential for interaction
with metformin by competing for common renal tubular transport systems. Such
interaction between metformin and oral cimetidine has been observed in normal
healthy volunteers in both single- and multiple-dose, metformin-cimetidine
drug interaction studies, with a 60% increase in peak metformin plasma and
whole blood concentrations and a 40% increase in plasma and whole blood metformin
AUC. There was no change in elimination half-life in the single-dose study.
Metformin had no effect on cimetidine pharmacokinetics. Although such interactions
remain theoretical (except for cimetidine), careful patient monitoring and dose adjustment
of GLUCOVANCE
and/or the interfering drug is recommended in patients who are taking cationic
medications that are excreted via the proximal renal tubular secretory system.
Other
In healthy volunteers, the pharmacokinetics of metformin and propranolol and
metformin and ibuprofen were not affected when coadministered in single-dose interaction
studies.
Glucovance
Pregnancy
Metabolism and elimination
Patients with type 2 diabetes
Hypoglycemia
Mechanism of action
Metformin hydrochloride
Information for patients
Drug interactions
Overdosage
Glipizide (glucotrol)
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