Drug interactions
Cimetidine + Saxagliptin-metformin
Severity: Moderate
Cimetidine and Saxagliptin-metformin: 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 concentrations by reducing its renal elimination, increasing the risk of adverse effects including lactic acidosis. It may also modestly increase saxagliptin exposure through CYP3A4 inhibition, which is rarely clinically significant.
What this interaction means in plain words
Cimetidine and Saxagliptin-metformin 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; Saxagliptin-metformin belongs to Endocrine.
Why it happens
Inhibition of renal tubular cation transporters (OCT2/MATE) reduces metformin clearance; weak CYP3A4 inhibition affects saxagliptin.
What to do
Monitor glucose and renal function and consider lowering the metformin dose. Use an alternative acid suppressant such as a proton pump inhibitor if appropriate.
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 Saxagliptin-metformin
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 Saxagliptin-metformin?
MediHelp rates the interaction as moderate. Cimetidine and Saxagliptin-metformin 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 concentrations by reducing its renal elimination, increasing the risk of adverse effects including lactic acidosis. It may also modestly increase saxagliptin exposure through CYP3A4 inhibition, which is rarely clinically significant.
How serious is the interaction between Cimetidine and Saxagliptin-metformin?
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 glucose and renal function and consider lowering the metformin dose. Use an alternative acid suppressant such as a proton pump inhibitor if appropriate.
What other medicines interact with Saxagliptin-metformin?
MediHelp also lists interactions of Saxagliptin-metformin with, for example, Atazanavir, Clozapine, Contrast media. The full list is on the Saxagliptin-metformin page.
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