Drug interactions
Dapagliflozin-metformin + Ramipril
Severity: Moderate
Dapagliflozin-metformin and Ramipril: 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
ACE inhibitors may enhance insulin sensitivity and occasionally cause hypoglycaemia in patients on antidiabetic drugs. ACE inhibitors can also reduce renal function in susceptible patients, which could raise metformin accumulation and lactic acidosis risk. Dapagliflozin adds volume depletion risk, increasing the likelihood of acute kidney injury.
What this interaction means in plain words
Dapagliflozin-metformin and Ramipril 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-metformin belongs to Endocrine; Ramipril belongs to Cardiovascular.
Why it happens
ACE inhibition may improve insulin sensitivity, and the combination with an SGLT2 inhibitor can reduce renal perfusion, impairing metformin clearance.
What to do
Monitor blood glucose, renal function and volume status, especially at initiation or dose changes. Hold metformin if acute kidney injury or dehydration develops.
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
Other interactions of Ramipril
- Aliskiren + Ramipril Contraindicated
- Protein a column + Ramipril Contraindicated
- Ramipril + Sacubitril / valsartan Contraindicated
- Ramipril + Sacubitril-valsartan Contraindicated
- Amifostine + Ramipril Major
- Amiloride + Ramipril Major
Frequently asked questions
Can I take Dapagliflozin-metformin with Ramipril?
MediHelp rates the interaction as moderate. Dapagliflozin-metformin and Ramipril 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. ACE inhibitors may enhance insulin sensitivity and occasionally cause hypoglycaemia in patients on antidiabetic drugs. ACE inhibitors can also reduce renal function in susceptible patients, which could raise metformin accumulation and lactic acidosis risk. Dapagliflozin adds volume depletion risk, increasing the likelihood of acute kidney injury.
How serious is the interaction between Dapagliflozin-metformin and Ramipril?
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, renal function and volume status, especially at initiation or dose changes. Hold metformin if acute kidney injury or dehydration develops.
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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