Drug interactions
Canagliflozin-metformin + Trimethoprim
Severity: Moderate
Canagliflozin-metformin and Trimethoprim: 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
Trimethoprim reduces renal tubular secretion of metformin, raising metformin exposure and the risk of lactic acidosis, especially in renal impairment. Trimethoprim can also raise serum potassium, which adds to hyperkalemia concern in patients with reduced renal function.
What this interaction means in plain words
Canagliflozin-metformin and Trimethoprim 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; Trimethoprim belongs to Anti Bacterial.
Why it happens
Trimethoprim inhibits OCT2 and MATE1/MATE2-K transporters, decreasing metformin renal elimination, and blocks epithelial sodium channels, causing potassium retention.
What to do
Monitor renal function, potassium and signs of metformin toxicity; consider metformin dose reduction in patients with renal impairment or prolonged trimethoprim courses.
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 Trimethoprim
Frequently asked questions
Can I take Canagliflozin-metformin with Trimethoprim?
MediHelp rates the interaction as moderate. Canagliflozin-metformin and Trimethoprim 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. Trimethoprim reduces renal tubular secretion of metformin, raising metformin exposure and the risk of lactic acidosis, especially in renal impairment. Trimethoprim can also raise serum potassium, which adds to hyperkalemia concern in patients with reduced renal function.
How serious is the interaction between Canagliflozin-metformin and Trimethoprim?
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 renal function, potassium and signs of metformin toxicity; consider metformin dose reduction in patients with renal impairment or prolonged trimethoprim courses.
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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