Diatrizoate meglumine / diatrizoate + Metformin-pioglitazone

MediHelp rates the interaction as major. Diatrizoate meglumine / diatrizoate and Metformin-pioglitazone 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. Intravascular iodinated contrast can cause acute kidney injury, which reduces metformin clearance. Accumulated metformin may then lead to lactic acidosis.

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Withhold metformin at the time of the procedure in patients with eGFR below 30, or with acute kidney injury or intra-arterial administration. Resume only after renal function is rechecked and found stable, usually after 48 hours.

MediHelp also lists interactions of Metformin-pioglitazone with, for example, Contrast media, Diatrizoate, Diazoxide. The full list is on the Metformin-pioglitazone page.