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Drug interactions

Metformin-repaglinide + Ranolazine

Severity: Moderate

Metformin-repaglinide 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 inhibits renal and hepatic transporters involved in metformin clearance, which raises metformin plasma concentrations. Higher exposure increases the risk of gastrointestinal intolerance and, in susceptible patients, lactic acidosis.

What this interaction means in plain words

Metformin-repaglinide 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-repaglinide belongs to Endocrine; Ranolazine belongs to Cardiovascular.

Evidence level: High

Why it happens

Ranolazine inhibits OCT2 and MATE1 transporters, reducing renal tubular secretion of metformin.

What to do

Limit the metformin dose to 1700 mg/day when given with ranolazine 1000 mg twice daily. Monitor glycemic control, renal function and symptoms of lactic acidosis.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Metformin-repaglinide with Ranolazine?

MediHelp rates the interaction as moderate. Metformin-repaglinide 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 inhibits renal and hepatic transporters involved in metformin clearance, which raises metformin plasma concentrations. Higher exposure increases the risk of gastrointestinal intolerance and, in susceptible patients, lactic acidosis.

How serious is the interaction between Metformin-repaglinide 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 the metformin dose to 1700 mg/day when given with ranolazine 1000 mg twice daily. Monitor glycemic control, renal function and symptoms of lactic acidosis.

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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