Drug interactions
Canagliflozin-metformin + Tolbutamide
Severity: Moderate
Canagliflozin-metformin and Tolbutamide: 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 canagliflozin and metformin with tolbutamide increases the risk of hypoglycemia through additive glucose lowering. Dose reduction of the sulfonylurea may be needed.
What this interaction means in plain words
Canagliflozin-metformin and Tolbutamide 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; Tolbutamide belongs to Endocrine.
Why it happens
Additive glucose-lowering effects, with the sulfonylurea causing glucose-independent insulin release.
What to do
Consider lowering the tolbutamide dose when starting canagliflozin-metformin and monitor blood glucose. Counsel the patient on hypoglycemia symptoms.
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 Tolbutamide
- Glyburide-metformin + Tolbutamide Major
- Insulin degludec-liraglutide + Tolbutamide Major
- Aceclofenac + Tolbutamide Moderate
- Acemetacin + Tolbutamide Moderate
- Acetylsalicylic acid + Tolbutamide Moderate
- Albiglutide + Tolbutamide Moderate
Frequently asked questions
Can I take Canagliflozin-metformin with Tolbutamide?
MediHelp rates the interaction as moderate. Canagliflozin-metformin and Tolbutamide 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 canagliflozin and metformin with tolbutamide increases the risk of hypoglycemia through additive glucose lowering. Dose reduction of the sulfonylurea may be needed.
How serious is the interaction between Canagliflozin-metformin and Tolbutamide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider lowering the tolbutamide dose when starting canagliflozin-metformin and monitor blood glucose. Counsel the patient on hypoglycemia symptoms.
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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