Diatrizoate meglumine / diatrizoate + Empagliflozin-metformin

MediHelp rates the interaction as major. Diatrizoate meglumine / diatrizoate and Empagliflozin-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. Intravascular iodinated contrast can cause acute kidney injury, which reduces metformin clearance and raises the risk of lactic acidosis. The risk is greatest in patients with impaired renal function or those given intra-arterial contrast.

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, a history of liver disease, alcoholism or heart failure, or receiving intra-arterial contrast. Restart only after renal function has been re-checked and found stable, usually after 48 hours.

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