Drug interactions
Gemfibrozil + Metformin-pioglitazone
Severity: Major
Gemfibrozil and Metformin-pioglitazone: 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
Gemfibrozil substantially increases pioglitazone exposure by inhibiting its metabolism. This raises the risk of dose-related adverse effects such as edema, weight gain, heart failure and hypoglycemia.
What this interaction means in plain words
Gemfibrozil and Metformin-pioglitazone 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.
Gemfibrozil belongs to Cardiovascular; Metformin-pioglitazone belongs to Endocrine.
Why it happens
Gemfibrozil inhibits CYP2C8, the main enzyme metabolizing pioglitazone.
What to do
Limit pioglitazone to a maximum of 15 mg daily with gemfibrozil. Monitor glucose and for edema or heart failure signs.
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 Metformin-pioglitazone
Other interactions of Gemfibrozil
- Daprodustat + Gemfibrozil Contraindicated
- Elagolix + Gemfibrozil Contraindicated
- Gemfibrozil + Mavacamten Contraindicated
- Gemfibrozil + Metformin-repaglinide Contraindicated
- Gemfibrozil + Ombitasvir / paritaprevir / ritonavir and dasabuvir Contraindicated
- Gemfibrozil + Repaglinide Contraindicated
Frequently asked questions
Can I take Gemfibrozil with Metformin-pioglitazone?
MediHelp rates the interaction as major. Gemfibrozil and Metformin-pioglitazone 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. Gemfibrozil substantially increases pioglitazone exposure by inhibiting its metabolism. This raises the risk of dose-related adverse effects such as edema, weight gain, heart failure and hypoglycemia.
How serious is the interaction between Gemfibrozil and Metformin-pioglitazone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Limit pioglitazone to a maximum of 15 mg daily with gemfibrozil. Monitor glucose and for edema or heart failure signs.
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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