Drug interactions
Dapagliflozin-metformin + Insulin degludec / insulin aspart
Severity: Moderate
Dapagliflozin-metformin and Insulin degludec / insulin aspart: 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
Adding insulin to dapagliflozin and metformin increases the glucose-lowering effect and the risk of hypoglycemia. SGLT2 inhibitors with insulin also carry a risk of ketoacidosis if insulin doses are reduced too much.
What this interaction means in plain words
Dapagliflozin-metformin and Insulin degludec / insulin aspart 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.
Why it happens
Additive glucose lowering through insulin action, reduced hepatic glucose output and increased urinary glucose excretion.
What to do
Monitor blood glucose and consider lowering the insulin dose when starting dapagliflozin-metformin. Avoid excessive insulin reduction and watch for ketoacidosis.
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 Dapagliflozin-metformin
Frequently asked questions
Can I take Dapagliflozin-metformin with Insulin degludec / insulin aspart?
MediHelp rates the interaction as moderate. Dapagliflozin-metformin and Insulin degludec / insulin aspart 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. Adding insulin to dapagliflozin and metformin increases the glucose-lowering effect and the risk of hypoglycemia. SGLT2 inhibitors with insulin also carry a risk of ketoacidosis if insulin doses are reduced too much.
How serious is the interaction between Dapagliflozin-metformin and Insulin degludec / insulin aspart?
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 blood glucose and consider lowering the insulin dose when starting dapagliflozin-metformin. Avoid excessive insulin reduction and watch for ketoacidosis.
What other medicines interact with Dapagliflozin-metformin?
MediHelp also lists interactions of Dapagliflozin-metformin with, for example, Contrast media, Diatrizoate, Diatrizoate meglumine / diatrizoate. The full list is on the Dapagliflozin-metformin page.
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