Drug interactions
Iohexol + Metformin-repaglinide
Severity: Major
Iohexol and Metformin-repaglinide: major interaction.
Last updated Sources: US FDA label
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 an acute fall in renal function. In patients taking metformin, reduced clearance may lead to drug accumulation and lactic acidosis, which is rare but serious.
What this interaction means in plain words
Iohexol and Metformin-repaglinide 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 acute kidney injury reduces renal elimination of metformin, causing accumulation and raising the risk of lactic acidosis.
What to do
Withhold metformin at the time of or before the procedure in patients with eGFR below 30, acute kidney injury, or intra-arterial administration with renal exposure. Recheck 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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References
Other interactions of Metformin-repaglinide
Frequently asked questions
Can I take Iohexol with Metformin-repaglinide?
MediHelp rates the interaction as major. Iohexol and Metformin-repaglinide 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 an acute fall in renal function. In patients taking metformin, reduced clearance may lead to drug accumulation and lactic acidosis, which is rare but serious.
How serious is the interaction between Iohexol and Metformin-repaglinide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Withhold metformin at the time of or before the procedure in patients with eGFR below 30, acute kidney injury, or intra-arterial administration with renal exposure. Recheck renal function about 48 hours afterward and restart metformin only if it is stable.
What other medicines interact with Metformin-repaglinide?
MediHelp also lists interactions of Metformin-repaglinide with, for example, Gemfibrozil, Apalutamide, Clarithromycin. The full list is on the Metformin-repaglinide page.
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