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Drug interactions

Canagliflozin-metformin + Insulin isophane human / insulin regular human

Severity: Moderate

Canagliflozin-metformin and Insulin isophane human / insulin regular human: 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

Combining insulin with canagliflozin and metformin has an additive glucose-lowering effect and raises the risk of hypoglycemia. This is most likely when the oral agents are started or the insulin dose is not reduced.

What this interaction means in plain words

Canagliflozin-metformin and Insulin isophane human / insulin regular human 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.

Evidence level: High

Why it happens

Additive pharmacodynamic glucose lowering through different mechanisms: insulin replacement, increased urinary glucose excretion and reduced hepatic glucose output.

What to do

Monitor blood glucose closely when starting or stopping either agent, and consider lowering the insulin dose when canagliflozin-metformin is added. Teach the patient to recognize and treat hypoglycemia.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Canagliflozin-metformin with Insulin isophane human / insulin regular human?

MediHelp rates the interaction as moderate. Canagliflozin-metformin and Insulin isophane human / insulin regular human 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. Combining insulin with canagliflozin and metformin has an additive glucose-lowering effect and raises the risk of hypoglycemia. This is most likely when the oral agents are started or the insulin dose is not reduced.

How serious is the interaction between Canagliflozin-metformin and Insulin isophane human / insulin regular human?

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 blood glucose closely when starting or stopping either agent, and consider lowering the insulin dose when canagliflozin-metformin is added. Teach the patient to recognize and treat hypoglycemia.

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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