Dapagliflozin and Pioglitazone interaction

Dapagliflozin and Pioglitazone: 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 Dapagliflozin label · effective 2026-06-03

Moderate

…Coadministered Drug (Dose Regimen) * Dapagliflozin (Dose Regimen) * Effect on Dapagliflozin Exposure [% Change (90% CI)] C max AUC † No dosing adjustments required for the following: Oral Antidiabetic Agents Metformin (1000 mg) 20 mg ↔ ↔ Pioglitazone (45 mg) 50 mg ↔ ↔ Sitagliptin (100 mg) 20 mg ↔ ↔ Glimepiride (4 mg) 20 mg ↔ ↔ Voglibose (0.2 mg three times daily) 10…

Drug interactionsby drug classView label on DailyMed
Moderate

…Drug (Dose Regimen) * Dapagliflozin (Dose Regimen) * Effect on Coadministered Drug Exposure [% Change (90% CI)] C max AUC † No dosing adjustments required for the following: Oral Antidiabetic Agents Metformin (1000 mg) 20 mg ↔ ↔ Pioglitazone (45 mg) 50 mg ↓7% [↓25%, ↑15%] ↔ Sitagliptin (100 mg) 20 mg ↔ ↔ Glimepiride (4 mg) 20 mg ↔ ↑13% [0%, ↑29%] Other Medications…

Drug interactionsby drug classView label on DailyMed

From the Pioglitazone (Actos) label · effective 2025-03-28

Moderate

Congestive Heart Failure ACTOS, like other thiazolidinediones, can cause dose-related fluid retention when used alone or in combination with other antidiabetic medications and is most common when ACTOS is used in combination with insulin.

Warnings and precautionsby drug classView label on DailyMed
Moderate

Hypoglycemia Patients receiving ACTOS in combination with insulin or other antidiabetic medications (particularly insulin secretagogues such as sulfonylureas) may be at risk for hypoglycemia.

Warnings and precautionsby drug classView label on DailyMed
Moderate

A reduction in the dose of the concomitant antidiabetic medication may be necessary to reduce the risk of hypoglycemia [see Dosage and Administration (2.2) ] .

Warnings and precautionsby drug classView label on DailyMed

Taking more than these two? Interactions stack. Check your whole list at once; it stays in your browser.

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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.