Drug interactions
Dapagliflozin-metformin + Iohexol
Severity: Major
Dapagliflozin-metformin and Iohexol: 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 Iohexol 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.
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?
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Other interactions of Dapagliflozin-metformin
Frequently asked questions
Can I take Dapagliflozin-metformin with Iohexol?
MediHelp rates the interaction as major. Dapagliflozin-metformin and Iohexol 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 Iohexol?
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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