Drug interactions
Metformin + Sirolimus
Severity: Moderate
Metformin and Sirolimus: 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
Sirolimus commonly causes hyperglycemia and insulin resistance through mTOR inhibition. This can worsen glycemic control and reduce the effect of metformin in transplant recipients.
What this interaction means in plain words
Metformin and Sirolimus 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; Sirolimus belongs to Miscellaneous.
Why it happens
Pharmacodynamic antagonism: mTOR inhibition leads to insulin resistance and impaired beta-cell function.
What to do
Monitor glucose and HbA1c regularly in patients on sirolimus and intensify antidiabetic therapy as needed. Review renal function, since transplant patients may have reduced clearance of metformin.
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
Other interactions of Sirolimus
- Adenovirus types 4 and 7 live + Sirolimus Contraindicated
- Bcg vaccine live + Sirolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Sirolimus Contraindicated
- Ketoconazole + Sirolimus Contraindicated
- Levoketoconazole + Sirolimus Contraindicated
- Measles mumps and rubella vaccine live + Sirolimus Contraindicated
Frequently asked questions
Can I take Metformin with Sirolimus?
MediHelp rates the interaction as moderate. Metformin and Sirolimus 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. Sirolimus commonly causes hyperglycemia and insulin resistance through mTOR inhibition. This can worsen glycemic control and reduce the effect of metformin in transplant recipients.
How serious is the interaction between Metformin and Sirolimus?
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 glucose and HbA1c regularly in patients on sirolimus and intensify antidiabetic therapy as needed. Review renal function, since transplant patients may have reduced clearance of metformin.
What other medicines interact with Metformin?
MediHelp also lists interactions of Metformin with, for example, Contrast media, Diatrizoate meglumine / diatrizoate, Diatrizoate. The full list is on the Metformin page.
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