Drug interactions
Canagliflozin-metformin + Ombitasvir / paritaprevir / ritonavir and dasabuvir
Severity: Moderate
Canagliflozin-metformin and Ombitasvir / paritaprevir / ritonavir and dasabuvir: 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
This direct-acting antiviral regimen contains ritonavir, which induces UGT enzymes and can reduce canagliflozin exposure. Paritaprevir and ritonavir may also affect transporters involved in metformin handling. The clinical significance is uncertain, but changes in glycemic control are possible, and metformin accumulation raises concern for lactic acidosis in patients with renal or hepatic impairment. Glucose can also fall as hepatitis C is cleared.
What this interaction means in plain words
Canagliflozin-metformin and Ombitasvir / paritaprevir / ritonavir and dasabuvir 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
Ritonavir may induce UGT-mediated canagliflozin metabolism, and the regimen may modestly alter transporter-mediated metformin disposition; the mechanism is not fully established.
What to do
Monitor blood glucose and renal function, and watch for symptoms of lactic acidosis. Avoid the combination in patients with significant renal or hepatic impairment and adjust antidiabetic therapy as hepatitis C is treated.
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 Ombitasvir / paritaprevir / ritonavir and dasabuvir?
MediHelp rates the interaction as moderate. Canagliflozin-metformin and Ombitasvir / paritaprevir / ritonavir and dasabuvir 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. This direct-acting antiviral regimen contains ritonavir, which induces UGT enzymes and can reduce canagliflozin exposure. Paritaprevir and ritonavir may also affect transporters involved in metformin handling. The clinical significance is uncertain, but changes in glycemic control are possible, and metformin accumulation raises concern for lactic acidosis in patients with renal or hepatic impairment. Glucose can also fall as hepatitis C is cleared.
How serious is the interaction between Canagliflozin-metformin and Ombitasvir / paritaprevir / ritonavir and dasabuvir?
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 and renal function, and watch for symptoms of lactic acidosis. Avoid the combination in patients with significant renal or hepatic impairment and adjust antidiabetic therapy as hepatitis C is treated.
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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