Colesevelam and Glipizide and metformin interaction

Colesevelam and Glipizide and metformin: both prescribing labels describe an interaction that usually calls for monitoring, a dose change, or spacing the doses.

Moderate

Usually manageable with monitoring or a dose change. Tell your pharmacist you take both.

What the FDA labels say

From the Colesevelam (COLESEVELAM HYDROCHLORIDE) label · effective 2023-12-28

Moderate

Concomitant use with colesevelam hydrochloride may increase the exposure of the following drugs: Metformin extended release.

Drug interactionsnames Glipizide and metforminView label on DailyMed
Moderate

Examples: Glimepiride, glipizide, and glyburide Oral Vitamin Supplements Clinical Impact: Colesevelam hydrochloride may decrease the absorption of fat-soluble vitamins A, D, E, and K [see Warnings and Precautions (5.3) ].

Drug interactionsnames Glipizide and metforminView label on DailyMed
Moderate

…Interactions that Increase the Exposure of the Concomitant Medication Table 5 Colesevelam Hydrochloride Drug Interactions that Increase the Exposure of the Concomitant Medication Metformin Extended Release (ER) Clinical Impact: In vivo drug interactions studies showed an increase in metformin extended release (ER) when coadministered with colesevelam hydrochloride…

Drug interactionsnames Glipizide and metforminView label on DailyMed
Moderate

…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 insulin (median increase 22% compared to placebo in combination with insulin) [see Adverse…

Warnings and precautionsby drug classView label on DailyMed
Moderate

Concomitant use with colesevelam hydrochloride may decrease the exposure of the following drugs: Drugs with a narrow therapeutic index (e.g., cyclosporine), phenytoin, thyroid hormone replacement therapy, warfarin, oral contraceptives containing ethinyl estradiol and norethindrone, olmesartan medoxomil, and sulfonylureas (glimepiride, glipizide, glyburide).

Drug interactionsby drug classView label on DailyMed

From the Glipizide and metformin (Glipizide and Metformin Hydrochloride) label · effective 2026-06-27

Moderate

In studies assessing the effect of colesevelam on the pharmacokinetics of glipizide ER in healthy volunteers, reductions in glipizide AUC 0-∞ and C max of 12% and 13%, respectively, were observed when colesevelam was coadministered with glipizide ER.

Precautionsnames ColesevelamView label on DailyMed
Moderate

Therefore, glipizide and metformin hydrochloride tablets should be administered at least 4 hours prior to colesevelam to ensure that colesevelam does not reduce the absorption of glipizide.

Precautionsnames ColesevelamView label on DailyMed
No interaction

When glipizide ER was administered 4 hours prior to colesevelam, there was no significant change in glipizide AUC 0-∞ or C max , –4% and 0%, respectively.

Precautionsnames ColesevelamView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.