Drug interactions
Bictegravir + Metformin-pioglitazone
Severity: Moderate
Bictegravir and Metformin-pioglitazone: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Bictegravir inhibits the renal transporters OCT2 and MATE1 that eliminate metformin. This raises metformin exposure and may increase the risk of gastrointestinal effects and, rarely, lactic acidosis, especially in patients with reduced renal function.
What this interaction means in plain words
Bictegravir and Metformin-pioglitazone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Inhibition of renal OCT2 and MATE1 transporters reduces tubular secretion of metformin.
What to do
Monitor glycemic control and renal function and consider reducing the metformin dose when starting bictegravir. Watch for signs of lactic acidosis.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Metformin-pioglitazone
Frequently asked questions
Can I take Bictegravir with Metformin-pioglitazone?
MediHelp rates the interaction as moderate. Bictegravir and Metformin-pioglitazone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Bictegravir inhibits the renal transporters OCT2 and MATE1 that eliminate metformin. This raises metformin exposure and may increase the risk of gastrointestinal effects and, rarely, lactic acidosis, especially in patients with reduced renal function.
How serious is the interaction between Bictegravir and Metformin-pioglitazone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor glycemic control and renal function and consider reducing the metformin dose when starting bictegravir. Watch for signs of lactic acidosis.
What other medicines interact with Metformin-pioglitazone?
MediHelp also lists interactions of Metformin-pioglitazone with, for example, Contrast media, Diatrizoate meglumine / diatrizoate, Diatrizoate. The full list is on the Metformin-pioglitazone page.
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