Metformin/Carbonic Anhydrase Inhibitors Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Both medicines may change the way your kidneys normally remove certain acids or bases from the body.

What might happen:

You could rarely develop a condition called lactic acidosis which can be very serious.Symptoms of lactic acidosis include: feeling very weak, unusually tired or sleepy, unusual muscle pain, trouble breathing, unusual or unexpected stomach discomfort, feeling cold, dizziness or lightheadedness, or suddenly developing a slow or irregular heartbeat.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Your doctor may want to adjust your medicines, perform additional laboratory tests, or monitoring to make sure you are tolerating the combination.Let your doctor know right away if you develop any symptoms of lactic acidosis.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Topamax (topiramate) US prescribing information. Janssen Pharmaceuticals, Inc. May, 2019.
  • 2.Glucophage (metformin hydrochloride) US prescribing information. Bristol-Myers Squibb Company May, 2018.
  • 3.Xigduo XR (dapagliflozin and metformin) US prescribing information. AstraZeneca Pharmaceuticals LP October, 2022.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.