Drug interactions
Dolutegravir + Metformin
Severity: Moderate
Dolutegravir and Metformin: 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
Dolutegravir raises metformin concentrations, which increases the risk of excessive glucose lowering and metformin-related adverse effects, including lactic acidosis in susceptible patients. The effect is greatest in patients with renal impairment.
What this interaction means in plain words
Dolutegravir and Metformin 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.
Dolutegravir belongs to Anti Virals; Metformin belongs to Endocrine.
Why it happens
Dolutegravir inhibits renal OCT2 and MATE1 transporters, reducing tubular secretion and clearance of metformin.
What to do
Limit the total daily metformin dose to about 1,000 mg when starting either drug together, and monitor blood glucose and renal function. Reassess the metformin dose when dolutegravir is stopped.
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 Dolutegravir
Other interactions of Metformin
Frequently asked questions
Can I take Dolutegravir with Metformin?
MediHelp rates the interaction as moderate. Dolutegravir and Metformin 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. Dolutegravir raises metformin concentrations, which increases the risk of excessive glucose lowering and metformin-related adverse effects, including lactic acidosis in susceptible patients. The effect is greatest in patients with renal impairment.
How serious is the interaction between Dolutegravir and Metformin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Limit the total daily metformin dose to about 1,000 mg when starting either drug together, and monitor blood glucose and renal function. Reassess the metformin dose when dolutegravir is stopped.
What other medicines interact with Dolutegravir?
MediHelp also lists interactions of Dolutegravir with, for example, Dofetilide, Aluminum hydroxide, Atidarsagene autotemcel. The full list is on the Dolutegravir page.
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