Asetazolamid ve Dapagliflozin ve metformin etkileşimi

• 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…

Patients with impaired renal function (eGFR less than 60 mL/min/1.73 m 2 ), elderly patients, or patients on loop diuretics may be at increased risk for volume depletion or hypotension.

Table 6: Clinically Relevant Interactions with XIGDUO XR Carbonic Anhydrase Inhibitors Clinical Impact Topiramate or other carbonic anhydrase inhibitors (e.g., zonisamide, acetazolamide or dichlorphenamide) frequently causes a decrease in serum bicarbonate and induce non-anion gap, hyperchloremic metabolic acidosis.

• Carbonic anhydrase inhibitors: May increase risk of lactic acidosis.

• Volume Depletion: Before initiating XIGDUO XR, assess and correct volume status in the elderly, patients with renal impairment or low systolic blood pressure, and in patients on diuretics.

Consideration should be taken in patients being treated with antidiabetic agents.