Drug interactions
Canagliflozin-metformin + Ranolazine
Severity: Moderate
Canagliflozin-metformin and Ranolazine: 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
Ranolazine inhibits renal organic cation transporters involved in metformin elimination, which can raise metformin concentrations. Higher exposure increases the risk of gastrointestinal effects and lactic acidosis, particularly with renal impairment.
What this interaction means in plain words
Canagliflozin-metformin and Ranolazine 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; Ranolazine belongs to Cardiovascular.
Why it happens
Ranolazine inhibits OCT2 and MATE-mediated renal tubular secretion of metformin, decreasing its clearance.
What to do
Keep the daily metformin dose within labeled limits when used with ranolazine 1000 mg twice daily (maximum 1700 mg/day). Monitor glycemic control, renal function and symptoms of lactic acidosis.
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 Ranolazine
- Adagrasib + Ranolazine Contraindicated
- Amobarbital + Ranolazine Contraindicated
- Apalutamide + Ranolazine Contraindicated
- Butabarbital + Ranolazine Contraindicated
- Carbamazepine + Ranolazine Contraindicated
- Clarithromycin + Ranolazine Contraindicated
Frequently asked questions
Can I take Canagliflozin-metformin with Ranolazine?
MediHelp rates the interaction as moderate. Canagliflozin-metformin and Ranolazine 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. Ranolazine inhibits renal organic cation transporters involved in metformin elimination, which can raise metformin concentrations. Higher exposure increases the risk of gastrointestinal effects and lactic acidosis, particularly with renal impairment.
How serious is the interaction between Canagliflozin-metformin and Ranolazine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Keep the daily metformin dose within labeled limits when used with ranolazine 1000 mg twice daily (maximum 1700 mg/day). Monitor glycemic control, renal function and symptoms of lactic acidosis.
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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