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Drug interactions

Dapagliflozin-metformin + Iodixanol

Severity: Major

Dapagliflozin-metformin and Iodixanol: major 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

Intravascular iodinated contrast can cause acute kidney injury, and metformin accumulation in that setting raises the risk of lactic acidosis. This is rare but potentially serious, particularly in patients with impaired renal function.

What this interaction means in plain words

Dapagliflozin-metformin and Iodixanol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.

Evidence level: Moderate

Why it happens

Contrast-induced decline in renal function reduces metformin elimination, leading to accumulation and lactic acidosis.

What to do

Hold metformin at the time of or before the procedure in patients with eGFR below 30, in acute kidney injury, or with intra-arterial contrast. Re-check renal function about 48 hours afterward and restart metformin only if it is stable.

What to ask your pharmacist

  • Does the benefit of taking both outweigh the risk in my case?
  • Do I need any blood test, ECG or other check while on both?
  • What early warning signs should I watch for, and what should I do if they appear?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Dapagliflozin-metformin with Iodixanol?

MediHelp rates the interaction as major. Dapagliflozin-metformin and Iodixanol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Intravascular iodinated contrast can cause acute kidney injury, and metformin accumulation in that setting raises the risk of lactic acidosis. This is rare but potentially serious, particularly in patients with impaired renal function.

How serious is the interaction between Dapagliflozin-metformin and Iodixanol?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Hold metformin at the time of or before the procedure in patients with eGFR below 30, in acute kidney injury, or with intra-arterial contrast. Re-check renal function about 48 hours afterward and restart metformin only if it is stable.

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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