Drug interactions
Metformin-pioglitazone + Tacrolimus
Severity: Moderate
Metformin-pioglitazone and Tacrolimus: 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
Tacrolimus can impair insulin secretion and cause post-transplant diabetes, which may counteract the effect of metformin and pioglitazone. Glycemic control can worsen after starting or increasing tacrolimus.
What this interaction means in plain words
Metformin-pioglitazone and Tacrolimus 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-pioglitazone belongs to Endocrine; Tacrolimus belongs to Miscellaneous.
Why it happens
Pharmacodynamic antagonism through calcineurin-inhibitor toxicity to pancreatic beta cells and reduced insulin secretion.
What to do
Monitor glucose and HbA1c, particularly after dose changes, and adjust antidiabetic regimen; also monitor renal function because 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-pioglitazone
Other interactions of Tacrolimus
- Adenovirus types 4 and 7 live + Tacrolimus Contraindicated
- Bcg vaccine live + Tacrolimus Contraindicated
- Cidofovir + Tacrolimus Contraindicated
- Cyclosporin + Tacrolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Tacrolimus Contraindicated
- Measles mumps and rubella vaccine live + Tacrolimus Contraindicated
Frequently asked questions
Can I take Metformin-pioglitazone with Tacrolimus?
MediHelp rates the interaction as moderate. Metformin-pioglitazone and Tacrolimus 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. Tacrolimus can impair insulin secretion and cause post-transplant diabetes, which may counteract the effect of metformin and pioglitazone. Glycemic control can worsen after starting or increasing tacrolimus.
How serious is the interaction between Metformin-pioglitazone and Tacrolimus?
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, particularly after dose changes, and adjust antidiabetic regimen; also monitor renal function because of metformin.
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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