Metformin and Ranolazine: Drug Interaction Guide
Quick answer: This combination requires caution. Metformin and Ranolazine can be used together with adjustments and monitoring.
How Metformin interacts with Ranolazine
Ranolazine inhibits OCT2-mediated renal tubular secretion of metformin and increases its plasma exposure in a dose-dependent manner, raising the risk of lactic acidosis.
What you should do
Limit metformin to 1700 mg/day when ranolazine is dosed at 1000 mg twice daily, and monitor renal function and for symptoms of lactic acidosis.
Key facts
Severity
Moderate — caution required
Mechanism
Ranolazine inhibits OCT2-mediated renal tubular secretion of metformin and increases its plasma exposure in a dose-depen...
Action
Limit metformin to 1700 mg/day when ranolazine is dosed at 1000 mg twice daily, and monitor renal function and for sympt...
Frequently asked questions
Can I take Metformin and Ranolazine together?
With caution. Limit metformin to 1700 mg/day when ranolazine is dosed at 1000 mg twice daily, and monitor renal function and for symptoms of lactic acidosis.
What is the severity of this interaction?
The interaction between Metformin and Ranolazine is classified as Moderate — caution required. Ranolazine inhibits OCT2-mediated renal tubular secretion of metformin and increases its plasma exposure in a dose-dependent manner, raising the risk of lactic acidosis.
What should I do if I'm prescribed both?
Limit metformin to 1700 mg/day when ranolazine is dosed at 1000 mg twice daily, and monitor renal function and for symptoms of lactic acidosis. Always consult your prescribing clinician — do not stop or change medications without medical guidance.
Last reviewed: by iMedic Medical Editorial Team. Our editorial process.