Drug interactions
Saxagliptin-metformin + Zonisamide
Severity: Moderate
Saxagliptin-metformin 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 non-anion gap hyperchloremic metabolic acidosis through carbonic anhydrase inhibition. Metformin carries a risk of lactic acidosis, so the combination may increase the likelihood or severity of acidosis, particularly in patients with renal impairment or acute illness.
What this interaction means in plain words
Saxagliptin-metformin 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.
Saxagliptin-metformin belongs to Endocrine; Zonisamide belongs to Central Nervous System.
Why it happens
Zonisamide's weak carbonic anhydrase inhibition lowers serum bicarbonate, and this additive acid-base disturbance may predispose to metformin-associated lactic acidosis.
What to do
Check baseline and periodic serum bicarbonate and renal function during combined therapy. Consider stopping metformin or zonisamide if persistent unexplained acidosis develops.
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 Saxagliptin-metformin
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 Saxagliptin-metformin with Zonisamide?
MediHelp rates the interaction as moderate. Saxagliptin-metformin 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 non-anion gap hyperchloremic metabolic acidosis through carbonic anhydrase inhibition. Metformin carries a risk of lactic acidosis, so the combination may increase the likelihood or severity of acidosis, particularly in patients with renal impairment or acute illness.
How serious is the interaction between Saxagliptin-metformin 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 baseline and periodic serum bicarbonate and renal function during combined therapy. Consider stopping metformin or zonisamide if persistent unexplained acidosis develops.
What other medicines interact with Saxagliptin-metformin?
MediHelp also lists interactions of Saxagliptin-metformin with, for example, Atazanavir, Clozapine, Contrast media. The full list is on the Saxagliptin-metformin page.
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