Treviamet Xr

Metformin (HCl) is known to interact with other drugs

the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAcarboseAcarbose and guar gum both decrease the absorption of metformin.AlcoholEthanol initiate effects of metformin on lactate metabolism.ModerateAvoid intake of alcohol and notify the signs of lactic acidosis like malaise

respiratory distress

somnolence and irregular heart beat.Amiloride (HCl)Amiloride compete with metformin for renal tubular transport thus decreases excretion of metformin leads risk of lactic acidosis.ModerateMonitor patient glucose level and adjust metformin dose.AtenololAtenolol enhance the hypoglycemic effect of metformin.ModerateMonitoring of patient blood glucose level should be done when these drugs are coadministered.Chlorpromazine (HCl)Chlorpromazine decreases the hypoglycemic effect of metformin by interfering with blood glucose control. ModerateClosely monitor the blood glucose level. Adjust the dose of metformin accordingly.Cimetidine (HCl)Cimetidine decreases the renal tubular secretion of metformin result in increased AUC upto 50% and decreases the plasma clearence upto 27% reult in increased plasma level may lead to lactic acidosis.ModerateSlowly reduce the dose of metformin. Monitor thr blood glucose level regularly. Patient should notify to physician if experience any sign of lactic acidosis.DigoxinDigoxin decreases the excretion of metformin by competing the renal tubular transport.ModerateDose of metformin should be reduced.Dolutegravirdolutegravir may increased the level of metforminclose monitoring and dose adjustment recommendedFrusemide or FurosemideFurosemide increases the plasma concentration while mwtformin decreases the peak concentration and elimination half life upto 31%and 32%respectively. Increase plasma level of metformin increases the risk of lactic acidosis.ModerateClosely monitor blood glucose level Patient should notify to physician if experience signs of lactic acidosisGlibenclamideHydrochlorothiazideThiazide (hydrochlorothiazide) antagonize the effect of metformin.Insulin AspartMetformin potentiate the hypoglycemic effect of insulin by increasing cellular mechanism controlled by insulin.ModerateClosely monitor the development of hypoglycaemia in patient.IoxaglateAdministration of intravascular iodinated radiocontrast media in patients treated with biguanides such as metformin may precipitate lactic acidosis

a rare but potentially serious and fatal complication of biguanide therapy. Iodinated contrast material can cause acute alterations in renal function

including acute renal failure

which is a known risk factor for biguanide-induced lactic acidosis.MajorBiguanide therapy should be temporarily discontinued at the time of

or prior to