Are these medication agreeable taking every day? Metformin 1000mg twice a day, Ramipril 10mg and Sinvastatin 40mg
Interactions between your selected drugs
ramipril ↔ metformin
Applies to: ramipril, metformin
MONITOR: Limited data suggest that ACE inhibitors may potentiate the hypoglycemic effects of oral antidiabetic drugs, including metformin. The mechanism is unknown. Symptomatic and sometimes severe hypoglycemia has occurred.
MANAGEMENT: Close monitoring for the development of hypoglycemia is recommended if ACE inhibitors are coadministered with metformin, particularly in patients with advanced age and/or renal impairment. Dosage adjustments may be required if an interaction is suspected. Patients should be apprised of the signs and symptoms of hypoglycemia (e.g., headache, dizziness, drowsiness, nausea, hunger, tremor, weakness, sweating, palpitations), how to treat it, and to contact their physician if it occurs. Patients should be observed for loss of glycemic control when ACE inhibitors are withdrawn.
No other interactions were found between your selected drugs.
Note: this does not necessarily mean no interactions exist. ALWAYS consult with your doctor or pharmacist.
Other drugs that your selected drugs interact with
metformin interacts with more than 200 other drugs.
ramipril interacts with more than 200 other drugs.
simvastatin interacts with more than 100 other drugs.
Interactions between your selected drugs and food
ramipril ↔ food
Applies to: ramipril
GENERALLY AVOID: Moderate-to-high dietary intake of potassium can cause hyperkalemia in some patients who are using angiotensin converting enzyme (ACE) inhibitors. In some cases, affected patients were using a potassium-rich salt substitute. ACE inhibitors can promote hyperkalemia through inhibition of the renin-aldosterone-angiotensin (RAA) system.
MANAGEMENT: It is recommended that patients who are taking ACE inhibitors be advised to avoid moderately high or high potassium dietary intake. Particular attention should be paid to the potassium content of salt substitutes.
simvastatin ↔ food
Applies to: simvastatin
GENERALLY AVOID: In small studies, the consumption of large amounts of grapefruit juice was associated with significantly increased plasma concentrations of lovastatin and simvastatin and their active acid metabolites. Similar results but to a lesser degree were reported for atorvastatin. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. Increased risk of musculoskeletal toxicity (myopathy with grossly elevated creatine kinase and rhabdomyolysis with or without acute renal failure secondary to myoglobinuria) has been associated with high levels of HMG-CoA reductase inhibitory activity in plasma.
ADJUST DOSING INTERVAL: Fibers such as oat bran and pectin may diminish the pharmacologic effects of HMG-CoA reductase inhibitors by interfering with their absorption from the gastrointestinal tract.
MANAGEMENT: Patients receiving therapy with atorvastatin, lovastatin, simvastatin, or red yeast rice (which contains lovastatin) should be advised to avoid the regular consumption of large amounts of grapefruits and grapefruit juice (the manufacturers of simvastatin and lovastatin advise against ingestion of greater than 1 quart per day). Pravastatin and fluvastatin are metabolized by other enzymes and may be preferable alternatives in some individuals. Patients should be advised to immediately notify their physician if they experience unexplained muscle pain, tenderness, or weakness. In addition, they should either refrain from the use of oat bran and pectin or, if concurrent use cannot be avoided, to separate the administration times by at least 2 to 4 hours.
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