Drug interactions
Canagliflozin-metformin + Insulin lispro protamine / insulin lispro
Severity: Moderate
Canagliflozin-metformin and Insulin lispro protamine / insulin lispro: 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 lispro protamine / insulin lispro 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
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?
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Other interactions of Canagliflozin-metformin
Frequently asked questions
Can I take Canagliflozin-metformin with Insulin lispro protamine / insulin lispro?
MediHelp rates the interaction as moderate. Canagliflozin-metformin and Insulin lispro protamine / insulin lispro 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 lispro protamine / insulin lispro?
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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