Drug interactions
Enalapril + Metformin-pioglitazone
Severity: Moderate
Enalapril and Metformin-pioglitazone: 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 can improve insulin sensitivity and occasionally enhance glucose lowering, with hypoglycemia reported in patients on antidiabetic drugs. They may also reduce renal function in susceptible patients, which could raise metformin exposure and the risk of lactic acidosis.
What this interaction means in plain words
Enalapril and Metformin-pioglitazone 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.
Enalapril belongs to Cardiovascular; Metformin-pioglitazone belongs to Endocrine.
Why it happens
Enhanced insulin sensitivity by ACE inhibition and possible renal function decline reducing metformin clearance.
What to do
Monitor blood glucose and renal function, particularly after initiation or dose increases. Reduce antidiabetic doses if hypoglycemia occurs and review metformin if eGFR falls.
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 Metformin-pioglitazone
Other interactions of Enalapril
- Aliskiren + Enalapril Contraindicated
- Enalapril + Protein a column Contraindicated
- Enalapril + Sacubitril / valsartan Contraindicated
- Enalapril + Sacubitril-valsartan Contraindicated
- Amifostine + Enalapril Major
- Amiloride + Enalapril Major
Frequently asked questions
Can I take Enalapril with Metformin-pioglitazone?
MediHelp rates the interaction as moderate. Enalapril and Metformin-pioglitazone 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 can improve insulin sensitivity and occasionally enhance glucose lowering, with hypoglycemia reported in patients on antidiabetic drugs. They may also reduce renal function in susceptible patients, which could raise metformin exposure and the risk of lactic acidosis.
How serious is the interaction between Enalapril and Metformin-pioglitazone?
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 and renal function, particularly after initiation or dose increases. Reduce antidiabetic doses if hypoglycemia occurs and review metformin if eGFR falls.
What other medicines interact with Metformin-pioglitazone?
MediHelp also lists interactions of Metformin-pioglitazone with, for example, Contrast media, Diatrizoate meglumine / diatrizoate, Diatrizoate. The full list is on the Metformin-pioglitazone page.
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