Drug interactions
Canagliflozin-metformin + Cimetidine
Severity: Moderate
Canagliflozin-metformin and Cimetidine: 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
Cimetidine reduces the renal tubular secretion of metformin, leading to higher metformin plasma concentrations and a longer half-life. This raises the risk of metformin accumulation and lactic acidosis, especially in patients with reduced kidney function.
What this interaction means in plain words
Canagliflozin-metformin and Cimetidine 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.
Canagliflozin-metformin belongs to Endocrine; Cimetidine belongs to Gastrointestinal Tract.
Why it happens
Cimetidine inhibits renal tubular transporters (OCT2 and MATE1/MATE2-K) that eliminate metformin, reducing its renal clearance.
What to do
Monitor glycemic control and renal function, and watch for signs of lactic acidosis. Reduce the metformin dose if needed, or use an alternative H2 blocker such as famotidine.
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 Canagliflozin-metformin
Other interactions of Cimetidine
- Cimetidine + Dofetilide Contraindicated
- Cimetidine + Fezolinetant Contraindicated
- Alfentanil + Cimetidine Major
- Atazanavir + Cimetidine Major
- Carmustine + Cimetidine Major
- Cimetidine + Citalopram Major
Frequently asked questions
Can I take Canagliflozin-metformin with Cimetidine?
MediHelp rates the interaction as moderate. Canagliflozin-metformin and Cimetidine 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. Cimetidine reduces the renal tubular secretion of metformin, leading to higher metformin plasma concentrations and a longer half-life. This raises the risk of metformin accumulation and lactic acidosis, especially in patients with reduced kidney function.
How serious is the interaction between Canagliflozin-metformin and Cimetidine?
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 watch for signs of lactic acidosis. Reduce the metformin dose if needed, or use an alternative H2 blocker such as famotidine.
What other medicines interact with Canagliflozin-metformin?
MediHelp also lists interactions of Canagliflozin-metformin with, for example, Contrast media, Diatrizoate, Diatrizoate meglumine / diatrizoate. The full list is on the Canagliflozin-metformin page.
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