Drug interactions
Cholic acid + Metformin-pioglitazone
Severity: Moderate
Cholic acid and Metformin-pioglitazone: 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
Pioglitazone may inhibit the bile salt export pump, which cholic acid depends on for biliary elimination of bile salts. This can lead to accumulation of conjugated bile salts in hepatocytes and liver injury.
What this interaction means in plain words
Cholic acid and Metformin-pioglitazone 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.
Cholic acid belongs to Gastrointestinal Tract; Metformin-pioglitazone belongs to Endocrine.
Why it happens
Inhibition of the hepatic bile salt export pump (BSEP) reduces bile acid elimination.
What to do
Avoid the combination if possible. If used together, monitor serum transaminases and bilirubin regularly.
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 Metformin-pioglitazone
Other interactions of Cholic acid
Frequently asked questions
Can I take Cholic acid with Metformin-pioglitazone?
MediHelp rates the interaction as moderate. Cholic acid and Metformin-pioglitazone 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. Pioglitazone may inhibit the bile salt export pump, which cholic acid depends on for biliary elimination of bile salts. This can lead to accumulation of conjugated bile salts in hepatocytes and liver injury.
How serious is the interaction between Cholic acid and Metformin-pioglitazone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination if possible. If used together, monitor serum transaminases and bilirubin regularly.
What other medicines interact with Metformin-pioglitazone?
MediHelp also lists interactions of Metformin-pioglitazone with, for example, Contrast media, Diatrizoate meglumine / diatrizoate, Diatrizoate. The full list is on the Metformin-pioglitazone page.
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