Drug interactions
Metformin-repaglinide + Zonisamide
Severity: Moderate
Metformin-repaglinide and Zonisamide: 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
Zonisamide can cause metabolic acidosis, which may add to the risk of metformin-associated lactic acidosis, particularly in patients with renal impairment or acute illness.
What this interaction means in plain words
Metformin-repaglinide and Zonisamide 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; Zonisamide belongs to Central Nervous System.
Why it happens
Zonisamide inhibits carbonic anhydrase, lowering serum bicarbonate and causing hyperchloremic acidosis, which compounds the acidosis risk with metformin.
What to do
Check serum bicarbonate at baseline and periodically, and reassess the combination if acidosis develops or renal function declines.
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
Other interactions of Zonisamide
- Zonisamide + Zuranolone Major
- Acetazolamide + Zonisamide Moderate
- Amisulpride + Zonisamide Moderate
- Amobarbital + Zonisamide Moderate
- Apalutamide + Zonisamide Moderate
- Asenapine transdermal + Zonisamide Moderate
Frequently asked questions
Can I take Metformin-repaglinide with Zonisamide?
MediHelp rates the interaction as moderate. Metformin-repaglinide and Zonisamide 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. Zonisamide can cause metabolic acidosis, which may add to the risk of metformin-associated lactic acidosis, particularly in patients with renal impairment or acute illness.
How serious is the interaction between Metformin-repaglinide and Zonisamide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check serum bicarbonate at baseline and periodically, and reassess the combination if acidosis develops or renal function declines.
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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