Drug interactions
Cimetidine + Metformin-pioglitazone
Severity: Moderate
Cimetidine 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
Cimetidine raises metformin plasma levels and reduces its renal clearance, which may increase the risk of adverse effects including lactic acidosis. Its effect on pioglitazone is minor.
What this interaction means in plain words
Cimetidine 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.
Cimetidine belongs to Gastrointestinal Tract; Metformin-pioglitazone belongs to Endocrine.
Why it happens
Cimetidine inhibits renal tubular cation transporters (OCT2/MATE) that secrete metformin.
What to do
Monitor glycemic control and renal function, and reduce the metformin dose if needed; consider an alternative acid suppressant such as a proton pump inhibitor.
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 Cimetidine
- Cimetidine + Dofetilide Contraindicated
- Cimetidine + Fezolinetant Contraindicated
- Alfentanil + Cimetidine Major
- Atazanavir + Cimetidine Major
- Carmustine + Cimetidine Major
- Cimetidine + Citalopram Major
Frequently asked questions
Can I take Cimetidine with Metformin-pioglitazone?
MediHelp rates the interaction as moderate. Cimetidine 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. Cimetidine raises metformin plasma levels and reduces its renal clearance, which may increase the risk of adverse effects including lactic acidosis. Its effect on pioglitazone is minor.
How serious is the interaction between Cimetidine 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: Monitor glycemic control and renal function, and reduce the metformin dose if needed; consider an alternative acid suppressant such as a proton pump inhibitor.
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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