Contrast media + Glipizide-metformin

MediHelp rates the interaction as major. Contrast media and Glipizide-metformin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Iodinated contrast can cause acute kidney injury, and metformin is eliminated unchanged by the kidneys. Reduced clearance leads to metformin accumulation and raises the risk of metformin-associated lactic acidosis, particularly in patients with impaired renal function.

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Hold metformin at the time of or before the procedure in patients with reduced eGFR, liver disease, alcoholism or heart failure, or receiving intra-arterial contrast. Re-check renal function about 48 hours afterward and restart metformin only if it is stable.

MediHelp also lists interactions of Glipizide-metformin with, for example, Diatrizoate meglumine / diatrizoate, Diatrizoate, Diazoxide. The full list is on the Glipizide-metformin page.