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Avandamet

Interactions

Metformin/Iodinated Contrast Materials

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:

Severe. These medicines may interact and cause very harmful effects and are usually not taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

When these two medicines are taken together, 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. 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 instruct you to stop taking your metformin before the exam and not to begin using it again until 48 hours after your test. Your doctor may want to check to make sure your kidneys are working properly before instructing you to restart your metformin.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.

References:

1.Glucophage (metformin hydrochloride) US prescribing information. Bristol-Myers Squibb Company June, 2006.

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.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.

5.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.

6.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.

7.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.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, expect as may be authorized by the applicable terms of use.

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.

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