Metformin with Cimetidine Interaction Details

Brand Names Associated with Metformin

  • Actoplus Met® (as a combination product containing Metformin, Pioglitazone)
  • Avandamet® (as a combination product containing Metformin, Rosiglitazone)
  • Fortamet®
  • Glucophage®
  • Glumetza®
  • Invokamet® (as a combination product containing Canagliflozin, Metformin)
  • Janumet® (as a combination product containing Metformin, Sitagliptin)
  • Jentadueto® (as a combination product containing Linagliptin, Metformin)
  • Kazano® (as a combination product containing Alogliptin, Metformin)
  • Kombiglyze® XR (as a combination product containing Metformin, Saxagliptin)
  • Metaglip® (as a combination product containing Glipizide, Metformin)
  • Metformin
  • Prandimet® (as a combination product containing Metformin, Repaglinide)
  • Qternmet® XR (as a combination product containing Dapagliflozin, Metformin, Saxagliptin), Segluromet® (as a combination product containing Ertugliflozin, Metformin)
  • Riomet®
  • Synjardy® (as a combination product containing Empagliflozin, Metformin)
  • Trijardy® (as a combination product containing Empagliflozin, Linagliptin, Metformin)
  • Xigduo® XR (as a combination product containing Dapagliflozin, Metformin)

Brand Names Associated with Cimetidine

  • Cimetidine
  • Tagamet®
  • Tagamet® HB

Medical Content Editor
Last updated Nov 05, 2023

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Interaction Effect

Increased metFORMIN exposure and an increased risk of lactic acidosis

Interaction Summary

Concomitant use of drugs that interfere with common renal tubular transport systems involved in the renal elimination of metFORMIN (e.g., multidrug and toxin extrusion [MATE] inhibitors such as cimetidine) could increase systemic exposure to metFORMIN and may increase the risk of lactic acidosis. Coadministration of metFORMIN 850 mg with cimetidine 400 mg may increase the exposure of metFORMIN. The geometric mean ration of metFORMIN with or without cimetidine was 1.4 and 1.61 for AUC (0 to infinity) and Cmax respectively. The benefits and risks of concomitant use should be considered.

Severity

Major

Onset

Unspecified

Evidence

Probable

How To Manage Interaction

Concomitant use of drugs that interfere with common renal tubular transport systems involved in the renal elimination of metFORMIN (e.g., multidrug and toxin extrusion [MATE] inhibitors such as cimetidine) could increase systemic exposure to metFORMIN and may increase the risk of lactic acidosis. The benefits and risks of concomitant use should be considered.

Mechanism Of Interaction

Inhibition of MATE1/2-mediated renal elimination of metFORMIN

Literature Reports

A) Coadministration of metFORMIN 850 mg with cimetidine 400 mg may increase the exposure of metFORMIN. The geometric mean ration of metFORMIN with or without cimetidine was 1.4 and 1.61 for AUC (0 to infinity) and Cmax respectively .

Metformin Overview

  • Metformin is used alone or with other medications, including insulin, to treat type 2 diabetes (condition in which the body does not use insulin normally and, therefore, cannot control the amount of sugar in the blood). Metformin is in a class of drugs called biguanides. Metformin helps to control the amount of glucose (sugar) in your blood. It decreases the amount of glucose you absorb from your food and the amount of glucose made by your liver. Metformin also increases your body's response to insulin, a natural substance that controls the amount of glucose in the blood. Metformin is not used to treat type 1 diabetes (condition in which the body does not produce insulin and therefore cannot control the amount of sugar in the blood).

  • Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems. Taking medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye problems, including changes or loss of vision, or gum disease. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes.

See More information Regarding Metformin

Cimetidine Overview

  • Cimetidine is used to treat ulcers; gastroesophageal reflux disease (GERD), a condition in which backward flow of acid from the stomach causes heartburn and injury of the food pipe (esophagus); and conditions where the stomach produces too much acid, such as Zollinger-Ellison syndrome. Over-the-counter cimetidine is used to prevent and treat symptoms of heartburn associated with acid indigestion and sour stomach. Cimetidine is in a class of medications called H2 blockers. It decreases the amount of acid made in the stomach.

See More information Regarding Cimetidine

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Definitions

Severity Categories

Contraindicated

These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.


Major

This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.


Moderate

This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.


Minor

While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.

Onset

Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.

Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.

Evidence

Level of documentation of the interaction.

Established: The interaction is documented and substantiated in peer-reviewed medical literature.

Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.

How To Manage The Interaction

Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.

It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.

Mechanism Of Interaction

The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.

Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.

Where Does Our Information Come From?

Information for our drug interactions is compiled from several drug compendia, including:

The prescribing information for each drug, as published on DailyMED, is also used. 

Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.

The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.