Metformin/Iodinated Contrast Materials 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:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

If you are taking metformin when you have your imaging test procedure, your kidneys may not be able to properly remove metformin from your blood.

What might happen:

The effects of metformin may increase and cause a serious condition called lactic acidosis, especially if you have kidney problems. Symptoms of lactic acidosis are: feeling very weak, tired, or uncomfortable, unusual muscle pain, trouble breathing, unusual or unexpected stomach discomfort, feeling cold, dizziness or lightheadedness, suddenly developing a slow or irregular heartbeat.

What you should do about this interaction:

Contact your doctor about taking these two medicines together before you have any tests done that use an iodine dye. Your doctor may want to check to make sure your kidneys are working properly before and after the imaging test. In some cases, your doctor may instruct you to stop taking your metformin before the exam and not to begin using it again until 48 hours after your test.Your healthcare professionals (e.g. doctor or pharmacist) may already be aware of this drug interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

View Reference
  • 1.Glucophage (metformin hydrochloride) US prescribing information. Bristol-Myers Squibb Company May, 2018.
  • 2.Avandamet (rosiglitazone maleate-metformin HCl) Australia prescribing information. GlaxoSmithKline January 11, 2012.
  • 3.Avandamet (rosiglitazone maleate-metformin HCl) Canadian prescribing information. GlaxoSmithKline April 18, 2013.
  • 4.USFood and Drug Administration (FDA). FDA Drug Safety Communication: FDA revises warnings regarding use of the diabetes medicine metformin in certain patients with reduced kidney function. Accessed at: http://www.fda.gov/Drugs/DrugSafety/ucm493244.htm April 8, 2016.
  • 5.ACR Committee on Drugs and Contrast Media. ACR Manual on Contrast Media. Available at https://www.acr.org/Clinical-Resources/Contrast-Manual. American College of Radiology;Version 10.
  • 6:.
  • 7.Nawaz S, Cleveland T, Gaines PA, Chan P. Clinical risk associated with contrast angiography in metformin treated patients: a clinical review. Clin Radiol 1998 May;53(5):342-4.
  • 8.Parra D, Legreid AM, Beckey NP, Reyes S. Metformin monitoring and change in serum creatinine levels in patients undergoing radiologic procedures involving administration of intravenous contrast media. Pharmacotherapy 2004 Aug;24(8):987-93.
  • 9.Radwan MA, Al Taweel ES, Al-Moghairi AM, Aloudah NM, Al Babtain MA, Al-Amri HS. Monitoring metformin in cardiac patients exposed to contrast media using ultra-high-performance liquid chromatography tandem mass-spectrometry. Ther Drug Monit 2011 Dec;33(6):742-9.
  • 10.McCartney MM, Gilbert FJ, Murchison LE, Pearson D, McHardy K, Murray AD. Metformin and contrast media--a dangerous combination?. Clin Radiol 1999 Jan;54(1):29-33.
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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.