Pioglitazone and metformin interactions
Pioglitazone and metformin (Actoplus Met), a thiazolidinedione has 172 documented interactions across the FDA labels and fact sheets we index: 11 major, 91 moderate, 70 minor, and 0 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.
Major interactions (11)
- Acetazolamidecarbonic anhydrase inhibitorMajor
Risk factors for metformin-associated lactic acidosis include renal impairment, concomitant use of certain drugs (e.g., carbonic anhydrase inhibitors such as topiramate), age 65 years old or greater, having a radiological study with contrast, surgery and other procedures, hypoxic states (e.g., acute congestive heart failure), excessive alcohol intake, hepatic… (Pioglitazone and metformin label, Boxed warning)
…concomitant use of certain drugs (e.g., carbonic anhydrase inhibitors such as topiramate), age 65 years old or greater, having a radiological study with contrast, surgery and other procedures, hypoxic states (e.g., acute congestive heart failure), excessive alcohol intake, hepatic impairment, and mitochondrial diseases [see Warnings and Precautions (5.2) ] . (Pioglitazone and metformin label, Boxed warning)
- ChloroquineantimalarialMajor
Hypoglycemia Chloroquine has been shown to cause severe hypoglycemia including loss of consciousness that could be life-threatening in patients treated with or without antidiabetic medications (see PRECAUTIONS , Drug Interactions ). (Chloroquine label, Warnings)
Antidiabetic agents Hypoglycemia including fatal outcomes have been reported. (Ciprofloxacin label, Drug interactions)
- Dorzolamidecarbonic anhydrase inhibitorMajor
Risk factors for metformin-associated lactic acidosis include renal impairment, concomitant use of certain drugs (e.g., carbonic anhydrase inhibitors such as topiramate), age 65 years old or greater, having a radiological study with contrast, surgery and other procedures, hypoxic states (e.g., acute congestive heart failure), excessive alcohol intake, hepatic… (Pioglitazone and metformin label, Boxed warning)
- Dorzolamide and timololcarbonic anhydrase inhibitorMajor
Risk factors for metformin-associated lactic acidosis include renal impairment, concomitant use of certain drugs (e.g., carbonic anhydrase inhibitors such as topiramate), age 65 years old or greater, having a radiological study with contrast, surgery and other procedures, hypoxic states (e.g., acute congestive heart failure), excessive alcohol intake, hepatic… (Pioglitazone and metformin label, Boxed warning)
Oral hypoglycemics Clinically significant hypoglycemia may be precipitated by the use of fluconazole with oral hypoglycemic agents; one fatality has been reported from hypoglycemia in association with combined fluconazole and glyburide use. (Fluconazole label, Drug interactions)
Hypoglycemia PLAQUENIL can cause severe and potentially life-threatening hypoglycemia, in the presence or absence of antidiabetic agents [see Drug Interactions (7) ]. (Hydroxychloroquine label, Warnings and precautions)
- Phentermine and topiramateCNS stimulantMajor
Risk factors for metformin-associated lactic acidosis include renal impairment, concomitant use of certain drugs (e.g., carbonic anhydrase inhibitors such as topiramate), age 65 years old or greater, having a radiological study with contrast, surgery and other procedures, hypoxic states (e.g., acute congestive heart failure), excessive alcohol intake, hepatic… (Pioglitazone and metformin label, Boxed warning)
Risk factors for metformin-associated lactic acidosis include renal impairment, concomitant use of certain drugs (e.g., carbonic anhydrase inhibitors such as topiramate), age 65 years old or greater, having a radiological study with contrast, surgery and other procedures, hypoxic states (e.g., acute congestive heart failure), excessive alcohol intake, hepatic… (Pioglitazone and metformin label, Boxed warning)
Risk factors for metformin-associated lactic acidosis include renal impairment, concomitant use of certain drugs (e.g., carbonic anhydrase inhibitors such as topiramate), age 65 years old or greater, having a radiological study with contrast, surgery and other procedures, hypoxic states (e.g., acute congestive heart failure), excessive alcohol intake, hepatic… (Pioglitazone and metformin label, Boxed warning)
Moderate interactions (91)
- AcarboseantidiabeticModerate
Congestive Heart Failure Pioglitazone, like other thiazolidinediones, can cause dose-related fluid retention when used alone or in combination with other antidiabetic medications and is most common when pioglitazone is used in combination with insulin. (Pioglitazone and metformin label, Warnings and precautions)
- Amlodipine and benazeprildihydropyridine calcium channel blockerModerate
Antidiabetic Agents: In rare cases, diabetic patients receiving an ACE inhibitor (including benazepril) concomitantly with insulin or oral antidiabetics may develop hypoglycemia. (Amlodipine and benazepril label, Drug interactions)
- Aspirin and dipyridamoleantiplatelet agentModerate
Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Aspirin and dipyridamole label, Drug interactions)
- BenazeprilACE inhibitorModerate
Antidiabetics: Increased risk of hypoglycemia ( 7.2 ) (Benazepril label, Drug interactions)
- Bictegravir, emtricitabine, and tenofovir alafenamideantiretroviralModerate
Metformin ↑ metformin Refer to the prescribing information of metformin for assessing the benefit and risk of concomitant use of BIXLENVO and metformin. (Bictegravir, emtricitabine, and tenofovir alafenamide label, Drug interactions)
- Bisoprololbeta blockerModerate
However, patients subject to spontaneous hypoglycemia, or diabetic patients receiving insulin or oral hypoglycemic agents, should be cautioned about these possibilities and bisoprolol fumarate should be used with caution. (Bisoprolol label, Warnings)
- Bisoprolol and hydrochlorothiazidebeta blockerModerate
Antidiabetic drugs (oral agents and insulin) - dosage adjustment of the antidiabetic drug may be required. (Bisoprolol and hydrochlorothiazide label, Precautions)
- CanagliflozinSGLT2 inhibitorModerate
Congestive Heart Failure Pioglitazone, like other thiazolidinediones, can cause dose-related fluid retention when used alone or in combination with other antidiabetic medications and is most common when pioglitazone is used in combination with insulin. (Pioglitazone and metformin label, Warnings and precautions)
- Cannabidiol (prescription)anticonvulsantModerate
Strong CYP2C8 inhibitors (e.g., gemfibrozil): Limit ACTOPLUS MET dose to 15 mg/850 mg daily. (Pioglitazone and metformin label, Drug interactions)
- CapecitabineantimetaboliteModerate
Closely monitor for adverse reactions of CYP2C9 substrates where minimal concentration changes may lead to serious adverse reactions when used concomitantly with XELODA (e.g., anticoagulants, antidiabetic drugs). (Capecitabine label, Drug interactions)
- Carvedilolbeta blockerModerate
Insulin and oral hypoglycemics action may be enhanced. (Carvedilol label, Drug interactions)
- CephalexincephalosporinModerate
• Metformin: increased metformin concentrations. (Cephalexin label, Drug interactions)
- CimetidineH2 blockerModerate
Drugs that reduce metformin clearance (such as ranolazine, vandetanib, dolutegravir, and cimetidine), may increase the accumulation of metformin. (Pioglitazone and metformin label, Drug interactions)
- Clarithromycinmacrolide antibioticModerate
With certain hypoglycemic drugs such as nateglinide, pioglitazone, repaglinide and rosiglitazone, inhibition of CYP3A enzyme by clarithromycin may be involved and could cause hypoglycemia when used concomitantly. (Clarithromycin label, Warnings and precautions)
- Colesevelambile acid sequestrantModerate
…TG levels occurred when colesevelam hydrochloride was used as monotherapy (median increase 9.7% compared to placebo) and when colesevelam hydrochloride was used in combination with pioglitazone (median increase 11% compared to placebo in combination with pioglitazone), sulfonylureas (median increase 18% compared to placebo in combination with sulfonylureas), and… (Colesevelam label, Warnings and precautions)
- DapagliflozinSGLT2 inhibitorModerate
Congestive Heart Failure Pioglitazone, like other thiazolidinediones, can cause dose-related fluid retention when used alone or in combination with other antidiabetic medications and is most common when pioglitazone is used in combination with insulin. (Pioglitazone and metformin label, Warnings and precautions)
- Deferasiroxiron supplementModerate
Strong CYP2C8 inhibitors (e.g., gemfibrozil): Limit ACTOPLUS MET dose to 15 mg/850 mg daily. (Pioglitazone and metformin label, Drug interactions)
- DexamethasonecorticosteroidModerate
Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Dexamethasone label, Warnings and precautions)
- Digoxindigitalis glycosideModerate
…to 49% NA Ticagrelor 31% 28% Tolvaptan 30% 20% Trimethoprim 22 to 28% NA Digoxin Concentrations Increased, but Magnitude is Unclear Alprazolam, Azithromycin, Cyclosporine, Diclofenac, Diphenoxylate, Epoprostenol, Esomeprazole, Ibuprofen, Ketoconazole, Lansoprazole, Metformin, Omeprazole Measure serum digoxin concentrations before initiating concomitant drugs. (Digoxin label, Drug interactions)
- DofetilideantiarrhythmicModerate
In addition, drugs that are actively secreted via this route (e.g., triamterene, metformin, and amiloride) should be co-administered with care as they might increase dofetilide levels. (Dofetilide label, Drug interactions)
- DolutegravirantiretroviralModerate
Drugs that reduce metformin clearance (such as ranolazine, vandetanib, dolutegravir, and cimetidine), may increase the accumulation of metformin. (Pioglitazone and metformin label, Drug interactions)
- DulaglutideGLP-1 receptor agonistModerate
Congestive Heart Failure Pioglitazone, like other thiazolidinediones, can cause dose-related fluid retention when used alone or in combination with other antidiabetic medications and is most common when pioglitazone is used in combination with insulin. (Pioglitazone and metformin label, Warnings and precautions)
- EmpagliflozinSGLT2 inhibitorModerate
Congestive Heart Failure Pioglitazone, like other thiazolidinediones, can cause dose-related fluid retention when used alone or in combination with other antidiabetic medications and is most common when pioglitazone is used in combination with insulin. (Pioglitazone and metformin label, Warnings and precautions)
- Empagliflozin and metforminSGLT2 inhibitorModerate
Congestive Heart Failure Pioglitazone, like other thiazolidinediones, can cause dose-related fluid retention when used alone or in combination with other antidiabetic medications and is most common when pioglitazone is used in combination with insulin. (Pioglitazone and metformin label, Warnings and precautions)
- ExenatideGLP-1 receptor agonistModerate
Congestive Heart Failure Pioglitazone, like other thiazolidinediones, can cause dose-related fluid retention when used alone or in combination with other antidiabetic medications and is most common when pioglitazone is used in combination with insulin. (Pioglitazone and metformin label, Warnings and precautions)
- FludrocortisonecorticosteroidModerate
Monitor for symptoms of hyperglycemia; adjust dosage of antidiabetic drug upward if necessary. (Fludrocortisone label, Drug interactions)
- FluoxetineSSRIModerate
As is true with many other types of medication when taken concurrently by patients with diabetes, insulin and/or oral hypoglycemic, dosage may need to be adjusted when therapy with PROZAC is instituted or discontinued. (Fluoxetine label, Warnings and precautions)
- GemfibrozilfibrateModerate
Strong CYP2C8 inhibitors (e.g., gemfibrozil): Limit ACTOPLUS MET dose to 15 mg/850 mg daily. (Pioglitazone and metformin label, Drug interactions)
- GlimepiridesulfonylureaModerate
Hypoglycemia: Consider a lower dose of insulin or insulin secretagogue to reduce risk of hypoglycemia when used in combination with ACTOPLUS MET. (Pioglitazone and metformin label, Warnings and precautions)
- GlipizidesulfonylureaModerate
Hypoglycemia: Consider a lower dose of insulin or insulin secretagogue to reduce risk of hypoglycemia when used in combination with ACTOPLUS MET. (Pioglitazone and metformin label, Warnings and precautions)
- GlyburidesulfonylureaModerate
Hypoglycemia: Consider a lower dose of insulin or insulin secretagogue to reduce risk of hypoglycemia when used in combination with ACTOPLUS MET. (Pioglitazone and metformin label, Warnings and precautions)
- Glyburide and metforminsulfonylureaModerate
Hypoglycemia: Consider a lower dose of insulin or insulin secretagogue to reduce risk of hypoglycemia when used in combination with ACTOPLUS MET. (Pioglitazone and metformin label, Warnings and precautions)
- Hydrochlorothiazidethiazide diureticModerate
Antidiabetic drugs: Dosage adjustment of antidiabetic may be required (7.2) (Hydrochlorothiazide label, Drug interactions)
- HydrocortisonecorticosteroidModerate
Antidiabetic Agents Clinical Impact: Corticosteroids in supraphysiologic doses may increase blood glucose concentrations. (Hydrocortisone label, Drug interactions)
- Insulin aspartinsulinModerate
Combination use with insulin and use in congestive heart failure NYHA Class I and II may increase risk. (Pioglitazone and metformin label, Warnings and precautions)
- Insulin degludecinsulinModerate
Combination use with insulin and use in congestive heart failure NYHA Class I and II may increase risk. (Pioglitazone and metformin label, Warnings and precautions)
- Insulin detemirinsulinModerate
Combination use with insulin and use in congestive heart failure NYHA Class I and II may increase risk. (Pioglitazone and metformin label, Warnings and precautions)
- Insulin glargineinsulinModerate
Combination use with insulin and use in congestive heart failure NYHA Class I and II may increase risk. (Pioglitazone and metformin label, Warnings and precautions)
- Insulin lisproinsulinModerate
Combination use with insulin and use in congestive heart failure NYHA Class I and II may increase risk. (Pioglitazone and metformin label, Warnings and precautions)
- Insulin regular (human)insulinModerate
Combination use with insulin and use in congestive heart failure NYHA Class I and II may increase risk. (Pioglitazone and metformin label, Warnings and precautions)
- Itraconazoleazole antifungalModerate
Antidiabetic Drugs Repaglinide Saxagliptin Monitor for adverse reactions. (Itraconazole label, Drug interactions)
- Ketoconazoleazole antifungalModerate
Antidiabetics repaglinide, saxagliptin Antihelmintics and Antiprotozoals praziquantel Antimigraine Drugs ergot alkaloids, such as dihydroergotamine, ergometrine (ergonovine), ergotamine, methylergometrine (methylergonovine) eletriptan Ergot alkaloids: The potential increase in plasma concentrations of ergot alkaloids when coadministered with ketoconazole tablets… (Ketoconazole label, Drug interactions)
- LeflunomideimmunosuppressantModerate
In patients taking ARAVA, exposure of drugs metabolized by CYP2C8 (e.g., paclitaxel, pioglitazone, repaglinide, rosiglitazone) may be increased. (Leflunomide label, Drug interactions)
- LevofloxacinfluoroquinoloneModerate
Blood Glucose Disturbances Fluoroquinolones, including Levofloxacin in 5% Dextrose Injection, have been associated with disturbances of blood glucose, including symptomatic hyperglycemia and hypoglycemia, usually in diabetic patients receiving concomitant treatment with an oral hypoglycemic agent (e.g., glyburide) or with insulin. (Levofloxacin label, Warnings and precautions)
- Levothyroxinethyroid hormoneModerate
Worsening of Diabetic Control : May worsen glycemic control and result in increased antidiabetic agent or insulin requirements. (Levothyroxine label, Warnings and precautions)
- LinagliptinDPP-4 inhibitorModerate
Congestive Heart Failure Pioglitazone, like other thiazolidinediones, can cause dose-related fluid retention when used alone or in combination with other antidiabetic medications and is most common when pioglitazone is used in combination with insulin. (Pioglitazone and metformin label, Warnings and precautions)
- LinezolidantibioticModerate
• Hypoglycemia: Postmarketing cases of symptomatic hypoglycemia have been reported in patients with diabetes mellitus receiving insulin or oral hypoglycemic agents. (Linezolid label, Warnings and precautions)
- Liothyroninethyroid hormoneModerate
• Worsening of diabetic control: Therapy in patients with diabetes mellitus may worsen glycemic control and result in increased antidiabetic agent or insulin requirements. (Liothyronine label, Warnings and precautions)
- LiraglutideGLP-1 receptor agonistModerate
Congestive Heart Failure Pioglitazone, like other thiazolidinediones, can cause dose-related fluid retention when used alone or in combination with other antidiabetic medications and is most common when pioglitazone is used in combination with insulin. (Pioglitazone and metformin label, Warnings and precautions)
- LisinoprilACE inhibitorModerate
Antidiabetics Concomitant administration of Zestril and antidiabetic medicines (insulins, oral hypoglycemic agents) may cause an increased blood-glucose-lowering effect with risk of hypoglycemia. (Lisinopril label, Drug interactions)
- Lisinopril and hydrochlorothiazideACE inhibitorModerate
Antidiabetic drugs (oral agents and insulin) - dosage adjustment of the antidiabetic drug may be required. (Lisinopril and hydrochlorothiazide label, Drug interactions)
- Losartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate
Antidiabetic drugs: dosage adjustment of antidiabetic may be required. (Losartan and hydrochlorothiazide label, Drug interactions)
- MetforminbiguanideModerate
Congestive Heart Failure Pioglitazone, like other thiazolidinediones, can cause dose-related fluid retention when used alone or in combination with other antidiabetic medications and is most common when pioglitazone is used in combination with insulin. (Pioglitazone and metformin label, Warnings and precautions)
- MethylprednisolonecorticosteroidModerate
Antidiabetics : Because corticosteroids may increase blood glucose concentrations, dosage adjustments of antidiabetic agents may be required. (Methylprednisolone label, Drug interactions)
- Metolazonethiazide diureticModerate
Insulin And Oral Antidiabetic Agents See Glucose Tolerance under PRECAUTIONS , General . (Metolazone label, Drug interactions)
- MoxifloxacinfluoroquinoloneModerate
Antidiabetic agents Carefully monitor blood glucose. (Moxifloxacin label, Drug interactions)
- Nadololbeta blockerModerate
Beta-blockade also reduces the release of insulin in response to hyperglycemia; therefore, it may be necessary to adjust the dose of antidiabetic drugs. (Nadolol label, Warnings)
- Naltrexone and bupropionopioid antagonistModerate
Use of Antidiabetic Medications: Weight loss may cause hypoglycemia. (Naltrexone and bupropion label, Warnings and precautions)
- OfloxacinfluoroquinoloneModerate
Fluoroquinolones have been associated with disturbances of blood glucose, including symptomatic hyperglycemia and hypoglycemia, usually in diabetic patients receiving concomitant treatment with an oral hypoglycemic agent (e.g., glyburide) or with insulin. (Ofloxacin label, Warnings)
- OrlistatModerate
A reduction in dose of oral hypoglycemic medication (e.g., sulfonylureas) or insulin may be required in some patients [see Clinical Studies (14) ] . (Orlistat label, Warnings and precautions)
- PerampanelanticonvulsantModerate
Strong CYP2C8 inhibitors (e.g., gemfibrozil): Limit ACTOPLUS MET dose to 15 mg/850 mg daily. (Pioglitazone and metformin label, Drug interactions)
- PhentermineCNS stimulantModerate
• A reduction in dose of insulin or oral hypoglycemic medication may be required in some patients. (Phentermine label, Warnings and precautions)
- Pindololbeta blockerModerate
Beta-blockade also reduces the release of insulin in response to hyperglycemia; therefore, it may be necessary to adjust the dose of antidiabetic drugs. (Pindolol label, Warnings)
- PioglitazonethiazolidinedioneModerate
Congestive Heart Failure Pioglitazone, like other thiazolidinediones, can cause dose-related fluid retention when used alone or in combination with other antidiabetic medications and is most common when pioglitazone is used in combination with insulin. (Pioglitazone and metformin label, Warnings and precautions)
- PrednisolonecorticosteroidModerate
Antidiabetic Agents: Because corticosteroids may increase blood glucose concentrations, dosage adjustments of antidiabetic agents may be required. (Prednisolone label, Drug interactions)
- PrednisonecorticosteroidModerate
Antidiabetic agents: May increase blood glucose concentrations. (Prednisone label, Drug interactions)
- PregabalinanticonvulsantModerate
Monitor patients for the development of edema when co-administering LYRICA CR and thiazolidinedione antidiabetic agents. (Pregabalin label, Warnings and precautions)
- RanolazineQT-prolonging drugModerate
Drugs that reduce metformin clearance (such as ranolazine, vandetanib, dolutegravir, and cimetidine), may increase the accumulation of metformin. (Pioglitazone and metformin label, Drug interactions)
- RepaglinidemeglitinideModerate
Hypoglycemia: Consider a lower dose of insulin or insulin secretagogue to reduce risk of hypoglycemia when used in combination with ACTOPLUS MET. (Pioglitazone and metformin label, Warnings and precautions)
- RifampinantibioticModerate
CYP2C8 inducers (e.g., rifampin) may decrease pioglitazone concentrations. (Pioglitazone and metformin label, Drug interactions)
- SemaglutideGLP-1 receptor agonistModerate
Congestive Heart Failure Pioglitazone, like other thiazolidinediones, can cause dose-related fluid retention when used alone or in combination with other antidiabetic medications and is most common when pioglitazone is used in combination with insulin. (Pioglitazone and metformin label, Warnings and precautions)
- SitagliptinDPP-4 inhibitorModerate
Congestive Heart Failure Pioglitazone, like other thiazolidinediones, can cause dose-related fluid retention when used alone or in combination with other antidiabetic medications and is most common when pioglitazone is used in combination with insulin. (Pioglitazone and metformin label, Warnings and precautions)
- Sitagliptin and metforminDPP-4 inhibitorModerate
Congestive Heart Failure Pioglitazone, like other thiazolidinediones, can cause dose-related fluid retention when used alone or in combination with other antidiabetic medications and is most common when pioglitazone is used in combination with insulin. (Pioglitazone and metformin label, Warnings and precautions)
- Sotalolbeta blockerModerate
Insulin and Oral Antidiabetics Hyperglycemia may occur, and the dosage of insulin or antidiabetic drugs may require adjustment. (Sotalol label, Drug interactions)
- Spironolactone and hydrochlorothiazidealdosterone antagonistModerate
Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Spironolactone and hydrochlorothiazide label, Drug interactions)
- Sulfamethoxazole and trimethoprimsulfonamideModerate
Strong CYP2C8 inhibitors (e.g., gemfibrozil): Limit ACTOPLUS MET dose to 15 mg/850 mg daily. (Pioglitazone and metformin label, Drug interactions)
- TeriflunomideimmunosuppressantModerate
In patients taking AUBAGIO, exposure of drugs metabolized by CYP2C8 (e.g., paclitaxel, pioglitazone, repaglinide, rosiglitazone) may be increased. (Teriflunomide label, Drug interactions)
- Timololbeta blockerModerate
Masking of Hypoglycemic Symptoms in Patients with Diabetes Mellitus Beta-adrenergic blocking agents should be administered with caution in patients subject to spontaneous hypoglycemia or to diabetic patients (especially those with labile diabetes) who are receiving insulin or oral hypoglycemic agents. (Timolol label, Warnings and precautions)
- TirzepatideGLP-1 receptor agonistModerate
Combination use with insulin and use in congestive heart failure NYHA Class I and II may increase risk. (Pioglitazone and metformin label, Warnings and precautions)
- TrandolaprilACE inhibitorModerate
(See PRECAUTIONS . ) Antidiabetic Agents Concomitant use of ACE inhibitors and antidiabetic medicines (insulin or oral hypoglycemic agents) may cause an increased blood glucose lowering effect with greater risk of hypoglycemia. (Trandolapril label, Drug interactions)
- TranylcypromineMAO inhibitorModerate
Hypoglycemia in Diabetic Patients Some MAOIs have contributed to hypoglycemic episodes in diabetic patients receiving insulin or other blood-glucose-lowering agents. (Tranylcypromine label, Warnings and precautions)
- TriamcinolonecorticosteroidModerate
Antidiabetics: Because corticosteroids may increase blood glucose concentrations, dosage adjustments of antidiabetic agents may be required. (Triamcinolone label, Drug interactions)
- Triamterenepotassium-sparing diureticModerate
Dyrenium (triamterene) may raise blood glucose levels; for adult-onset diabetes, dosage adjustments of hypoglycemic agents may be necessary during and/or after therapy; concurrent use with chlorpropamide may increase the risk of severe hyponatremia. (Triamterene label, Drug interactions)
- Triamterene and hydrochlorothiazidepotassium-sparing diureticModerate
Oral Hypoglycemic Drugs Concurrent use with chlorpropamide may increase the risk of severe hyponatremia. (Triamterene and hydrochlorothiazide label, Drug interactions)
- TrimethoprimantibioticModerate
Strong CYP2C8 inhibitors (e.g., gemfibrozil): Limit ACTOPLUS MET dose to 15 mg/850 mg daily. (Pioglitazone and metformin label, Drug interactions)
- TrospiumanticholinergicModerate
Concomitant use with metformin immediate release tablets reduced exposure and peak concentration of trospium. (Trospium label, Drug interactions)
- Valsartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate
Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Valsartan and hydrochlorothiazide label, Drug interactions)
- Vitamin B12Vitamin and mineralModerate
Monitor hematologic parameters annually and vitamin B 12 at 2 to 3 year intervals and manage any abnormalities. (Pioglitazone and metformin label, Warnings and precautions)
- Voriconazoleazole antifungalModerate
Sulfonylurea Oral Hypoglycemics (CYP2C9 Inhibition) Not Studied In Vivo or In Vitro , but Drug Plasma Exposure Likely to be Increased Frequent monitoring of blood glucose and for signs and symptoms of hypoglycemia. (Voriconazole label, Drug interactions)
- WarfarinanticoagulantModerate
…ritonavir, saquinavir, telithromycin, tipranavir, voriconazole, zileuton armodafinil, amprenavir, aprepitant, bosentan, carbamazepine, efavirenz, etravirine, modafinil, nafcillin, phenytoin, pioglitazone, prednisone, rifampin, rufinamide 7.3 Drugs that Increase Bleeding Risk Examples of drugs known to increase the risk of bleeding are presented in Table 3 . (Warfarin label, Drug interactions)
Minor mentions (70)
- Albuterolbeta-adrenergic agonistMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Amiloridepotassium-sparing diureticMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Amlodipinedihydropyridine calcium channel blockerMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Amphetamine and dextroamphetamineCNS stimulantMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- ArmodafinilCNS stimulantMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- BeclomethasonecorticosteroidMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- BetamethasonecorticosteroidMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- BudesonidecorticosteroidMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Budesonide and formoterolcorticosteroidMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Bumetanideloop diureticMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- BupropionantidepressantMinor
Additional predisposing conditions include diabetes mellitus treated with oral hypoglycemic drugs or insulin, use of anorectic drugs, excessive use of alcohol, use of benzodiazepines, sedatives/hypnotics, or opiates. (Bupropion label, Warnings and precautions)
- Butalbital, acetaminophen, and caffeinebarbiturateMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Chlorthalidonethiazide diureticMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- ClobetasolcorticosteroidMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- ClozapineantipsychoticMinor
In some cases, hyperglycemia has resolved when the atypical antipsychotic was discontinued; however, some patients required continuation of antidiabetic treatment despite discontinuation of the suspect drug. (Clozapine label, Warnings and precautions)
- Conjugated estrogensestrogenMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- DesonidecorticosteroidMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- DexmethylphenidateCNS stimulantMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Diltiazemcalcium channel blockerMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Drospirenone and ethinyl estradioloral contraceptiveMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- DroxidopasympathomimeticMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- EpinephrinesympathomimeticMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Eplerenonealdosterone antagonistMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- EstradiolestrogenMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Ethacrynic acidloop diureticMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Felodipinedihydropyridine calcium channel blockerMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- FluocinonidecorticosteroidMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- FluticasonecorticosteroidMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Fluticasone and salmeterolcorticosteroidMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Formoterolbeta-adrenergic agonistMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Furosemideloop diureticMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- HalobetasolcorticosteroidMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Indapamidethiazide diureticMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- IsoniazidantibioticMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Isradipinedihydropyridine calcium channel blockerMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Levalbuterolbeta-adrenergic agonistMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- LevonorgestrelprogestinMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Levonorgestrel and ethinyl estradioloral contraceptiveMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- LisdexamfetamineCNS stimulantMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- LovastatinstatinMinor
Oral Hypoglycemic Agents In pharmacokinetic studies of lovastatin in hypercholesterolemic non-insulin dependent diabetic patients, there was no drug interaction with glipizide or with chlorpropamide (see CLINICAL PHARMACOLOGY , Clinical Studies in Adults ). (Lovastatin label, Drug interactions)
- MedroxyprogesteroneprogestinMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- MegestrolprogestinMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Methimazoleantithyroid drugMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- MethylphenidateCNS stimulantMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Miconazoleazole antifungalMinor
Although the systemic absorption of miconazole following ORAVIG administration is minimal and plasma concentrations of miconazole are substantially lower than when given intravenously, the potential for interaction with drugs metabolized through CYP2C9 and CYP3A4 such as oral hypoglycemics, phenytoin, or ergot alkaloids cannot be ruled out. (Miconazole label, Drug interactions)
- Midodrinealpha-adrenergic agonistMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Mirabegronbeta-adrenergic agonistMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- ModafinilCNS stimulantMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- MoexiprilACE inhibitorMinor
Moexipril hydrochloride has been used in clinical trials concomitantly with calcium-channel-blocking agents, diuretics, H 2 blockers, digoxin, oral hypoglycemic agents, and cholesterol-lowering agents. (Moexipril label, Drug interactions)
- MometasonecorticosteroidMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Nicardipinedihydropyridine calcium channel blockerMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Nifedipinedihydropyridine calcium channel blockerMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Nisoldipinedihydropyridine calcium channel blockerMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- NorethindroneprogestinMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Norethindrone and ethinyl estradioloral contraceptiveMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Norgestimate and ethinyl estradioloral contraceptiveMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- PhenylephrinedecongestantMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- PhenytoinanticonvulsantMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- ProgesteroneprogestinMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Propylthiouracilantithyroid drugMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- PseudoephedrinedecongestantMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Salmeterolbeta-adrenergic agonistMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- SolriamfetolCNS stimulantMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Spironolactonealdosterone antagonistMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Terbutalinebeta-adrenergic agonistMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Torsemideloop diureticMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Umeclidinium and vilanterolanticholinergicMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Verapamilcalcium channel blockerMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- Vibegronbeta-adrenergic agonistMinor
These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)
- ZiprasidoneantipsychoticMinor
In some cases, hyperglycemia has resolved when the atypical antipsychotic was discontinued; however, some patients required continuation of antidiabetic treatment despite discontinuation of the suspect drug. (Ziprasidone label, Warnings and precautions)
Check Pioglitazone and metformin against everything you take. Add your full list; every pair is checked at once.
Open in the checkerNot medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.