Drug interactions
Metformin + Ranolazine
Severity: Moderate
Metformin and Ranolazine: 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
Ranolazine increases metformin exposure, raising the risk of gastrointestinal effects and, rarely, lactic acidosis. The effect is dose dependent and more relevant at higher ranolazine doses.
What this interaction means in plain words
Metformin and Ranolazine 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.
Metformin belongs to Endocrine; Ranolazine belongs to Cardiovascular.
Why it happens
Inhibition of renal organic cation transporter OCT2 by ranolazine reduces metformin elimination.
What to do
Limit metformin to no more than 1700 mg daily when ranolazine 1000 mg twice daily is used. Monitor glycemic control and renal function, and watch for signs of metformin toxicity.
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 Ranolazine
- Adagrasib + Ranolazine Contraindicated
- Amobarbital + Ranolazine Contraindicated
- Apalutamide + Ranolazine Contraindicated
- Butabarbital + Ranolazine Contraindicated
- Carbamazepine + Ranolazine Contraindicated
- Clarithromycin + Ranolazine Contraindicated
Other interactions of Metformin
Frequently asked questions
Can I take Metformin with Ranolazine?
MediHelp rates the interaction as moderate. Metformin and Ranolazine 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. Ranolazine increases metformin exposure, raising the risk of gastrointestinal effects and, rarely, lactic acidosis. The effect is dose dependent and more relevant at higher ranolazine doses.
How serious is the interaction between Metformin and Ranolazine?
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 metformin to no more than 1700 mg daily when ranolazine 1000 mg twice daily is used. Monitor glycemic control and renal function, and watch for signs of metformin toxicity.
What other medicines interact with Ranolazine?
MediHelp also lists interactions of Ranolazine with, for example, Adagrasib, Amobarbital, Apalutamide. The full list is on the Ranolazine page.
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