Drug interactions
Dapagliflozin-metformin + Insulin nph
Severity: Moderate
Dapagliflozin-metformin and Insulin nph: 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
Dapagliflozin and metformin together with NPH insulin produce additive blood glucose lowering and increase the chance of hypoglycemia. Labeling for dapagliflozin advises considering a lower insulin dose.
What this interaction means in plain words
Dapagliflozin-metformin and Insulin nph 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 pharmacodynamic glucose lowering from insulin, SGLT2 inhibition and reduced hepatic glucose output.
What to do
Reduce the NPH insulin dose when initiating the combination and monitor glucose frequently, especially overnight. Readjust insulin if the oral agents are discontinued.
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 nph?
MediHelp rates the interaction as moderate. Dapagliflozin-metformin and Insulin nph 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. Dapagliflozin and metformin together with NPH insulin produce additive blood glucose lowering and increase the chance of hypoglycemia. Labeling for dapagliflozin advises considering a lower insulin dose.
How serious is the interaction between Dapagliflozin-metformin and Insulin nph?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the NPH insulin dose when initiating the combination and monitor glucose frequently, especially overnight. Readjust insulin if the oral agents are discontinued.
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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