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Drug Interactions between Glumetza and ranolazine

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

metFORMIN ranolazine

Applies to: Glumetza (metformin) and ranolazine

Consumer information for this interaction is not currently available.

ADJUST DOSE: Coadministration with ranolazine may increase the plasma concentrations of metformin. The proposed mechanism is inhibition of organic cation transporter 2 (OCT2) by ranolazine, resulting in decreased renal tubular secretion and clearance of metformin. When metformin 1000 mg twice daily was administered concomitantly with ranolazine 500 mg and 1000 mg twice daily in subjects with type 2 diabetes mellitus, metformin systemic exposure (AUC) increased by 40% and 80%, respectively, compared to administration of metformin alone.

MANAGEMENT: The prescribing information for ranolazine recommends limiting the dosage of metformin to 1700 mg/day when coadministered with ranolazine 1000 mg twice daily. Blood glucose, renal function, and adverse effects (e.g., diarrhea, nausea, vomiting, flatulence, indigestion, vitamin B12 deficiency) should be monitored, and the metformin dosage adjusted accordingly. Although rare, an increased risk of lactic acidosis should also be considered, particularly in the elderly and patients with renal impairment.

References

  1. "Product Information. Ranexa (ranolazine)." Gilead Sciences (2023):
  2. "Product Information. Corzyna (ranolazine)." Kye Pharmaceuticals Inc (2020):

Drug and food interactions

Major

metFORMIN food

Applies to: Glumetza (metformin)

MetFORMIN should be taken with meals, and excessive alcohol intake (either short-term binge drinking or frequent consumption) should be avoided during treatment. Taking metFORMIN with alcohol may increase the risk of a rare but serious and potentially life-threatening condition known as lactic acidosis, which is a buildup of lactic acid in the blood that can occasionally occur during treatment with metformin-containing products. Lactic acidosis is more likely to occur if you have kidney or liver disease, acute or unstable congestive heart failure, or dehydration. You should seek immediate medical attention if you develop potential signs and symptoms of lactic acidosis such as fatigue, weakness, muscle pain, increasing drowsiness, abdominal pain or discomfort, slow or irregular heartbeat, breathing difficulty, chills, and other unusual symptoms. Alcohol may also affect blood glucose levels in patients with diabetes. Both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) may occur, depending on how much and how often you drink. You should avoid using alcohol if your diabetes is not well controlled or if you have high triglycerides, neuropathy (nerve damage), or pancreatitis. Moderate alcohol consumption generally does not affect blood glucose levels if your diabetes is under control. However, you should limit your alcohol intake due to the risk of lactic acidosis with metformin. Avoid drinking alcohol on an empty stomach or following exercise, as it may increase the risk of hypoglycemia. Talk to your doctor or pharmacist if you have any questions or concerns about metformin.

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Major

ranolazine food

Applies to: ranolazine

You may take ranolazine with or without food, but should try to take it the same way every time. Grapefruit and grapefruit juice should be avoided if possible. Grapefruit juice can increase the levels of ranolazine in your body. High blood levels of food can occasionally cause an irregular heart rhythm that may be serious. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, or fast or pounding heartbeats during treatment with ranolazine. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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