Drug interactions
Metformin-repaglinide + Procainamide
Severity: Moderate
Metformin-repaglinide and Procainamide: 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
Metformin and procainamide are both cationic drugs eliminated by tubular secretion in the kidney. Competition for this pathway may raise procainamide and its active metabolite exposure, increasing the risk of conduction abnormalities and arrhythmia, and may also raise metformin levels.
What this interaction means in plain words
Metformin-repaglinide and Procainamide 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.
Why it happens
Competition for renal tubular secretion via organic cation transporters (OCT2/MATE) reduces clearance of both cationic drugs.
What to do
Monitor ECG, procainamide and NAPA concentrations and renal function when starting or stopping metformin. Reduce procainamide dose if levels or QRS/QT prolongation increase.
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-repaglinide
Frequently asked questions
Can I take Metformin-repaglinide with Procainamide?
MediHelp rates the interaction as moderate. Metformin-repaglinide and Procainamide 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 and procainamide are both cationic drugs eliminated by tubular secretion in the kidney. Competition for this pathway may raise procainamide and its active metabolite exposure, increasing the risk of conduction abnormalities and arrhythmia, and may also raise metformin levels.
How serious is the interaction between Metformin-repaglinide and Procainamide?
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 ECG, procainamide and NAPA concentrations and renal function when starting or stopping metformin. Reduce procainamide dose if levels or QRS/QT prolongation increase.
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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