Drug interactions
Canagliflozin-metformin + Dichlorphenamide
Severity: Major
Canagliflozin-metformin and Dichlorphenamide: major 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
Dichlorphenamide is a carbonic anhydrase inhibitor that causes hyperchloremic metabolic acidosis. Metformin carries a risk of lactic acidosis, and the acidosis from dichlorphenamide may increase this risk. Canagliflozin may also contribute to ketoacidosis in rare cases.
What this interaction means in plain words
Canagliflozin-metformin and Dichlorphenamide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Canagliflozin-metformin belongs to Endocrine; Dichlorphenamide belongs to Miscellaneous.
Why it happens
Additive acidosis from carbonic anhydrase inhibition and impaired lactate clearance or increased lactate with metformin.
What to do
Monitor serum bicarbonate and acid-base status at baseline and periodically, and avoid the combination if renal function is reduced. Stop or reconsider metformin if acidosis develops.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Canagliflozin-metformin
Other interactions of Dichlorphenamide
Frequently asked questions
Can I take Canagliflozin-metformin with Dichlorphenamide?
MediHelp rates the interaction as major. Canagliflozin-metformin and Dichlorphenamide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Dichlorphenamide is a carbonic anhydrase inhibitor that causes hyperchloremic metabolic acidosis. Metformin carries a risk of lactic acidosis, and the acidosis from dichlorphenamide may increase this risk. Canagliflozin may also contribute to ketoacidosis in rare cases.
How serious is the interaction between Canagliflozin-metformin and Dichlorphenamide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum bicarbonate and acid-base status at baseline and periodically, and avoid the combination if renal function is reduced. Stop or reconsider metformin if acidosis develops.
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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