Metformin Stella Drug Interactions

Anti-diabetic agents: Although hypoglycemia occurs infrequently in patients receiving metformin therapy alone, hypoglycemia may occur when the drug is used concomitantly with a sulfonylurea antidiabetic agent (e.g., glyburide) and/or insulin.
Diuretics: Thiazide diuretics can exacerbate diabetes mellitus, resulting in increased requirements of oral anti-diabetic agents, temporary loss of diabetic control, or secondary failure to the anti-diabetic agent.
Nifedipine: Nifedipine increased the absorption; also the urinary excretion of metformin; half-life and time to peak plasma concentration of metformin remained unchanged. Metformin appears to have minimal effects on the pharmacokinetics of nifedipine.
Cimetidine: Cimetidine may reduce the urinary excretion of metformin by competing for renal tubular organic cationic transport systems. Metformin has negligible effects on cimetidine pharmacokinetics, possibly because cimetidine has a higher affinity for renal tubular transport sites.
Alcohol: Combined use of alcohol and metformin can increase the risk of hypoglycemia and lactic acidosis, since alcohol decreases lactate clearance and hepatic gluconeogenesis and may increase insulin secretion.