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6 Interactions found for:

Lexapro and metformin
Interactions Summary
  • 2 Major
  • 1 Moderate
  • 3 Minor
  • Lexapro
  • metformin

Drug Interactions

No drug interactions were found for selected drugs: Lexapro, metformin

This does not necessarily mean no interactions exist. Always consult your healthcare provider.

Drug and Food Interactions

Major
Metformin + Food

The following applies to the ingredients: 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.

Moderate
Lexapro + Food

The following applies to the ingredients: Escitalopram (found in Lexapro)

Alcohol can increase the nervous system side effects of escitalopram such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with escitalopram. Do not use more than the recommended dose of escitalopram, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Drug and Pregnancy Interactions

The following applies to the ingredients: Escitalopram (found in Lexapro)

Professional Content

This drug should be used during pregnancy only if the benefit outweighs the risk to the fetus.

AU TGA Pregnancy Category: C
US FDA Pregnancy Category: C

Comments:
-Newborns should be monitored if the maternal use of this drug continues into the later stages of pregnancy, particularly, the third trimester.
-Abrupt discontinuation should be avoided during pregnancy.

Animal studies have revealed evidence of embryotoxicity (e.g., reduced fetal weight and reversible delay of ossification), offspring mortality, and delayed growth. Animal studies with racemic citalopram have revealed evidence of teratogenicity at doses greater than human therapeutic doses. There are no controlled data in human pregnancy. Human spontaneous abortion has been reported with racemic citalopram.

Neonates exposed to SSRIs late in the third trimester have uncommonly reported clinical findings including respiratory distress, cyanosis, apnea, seizures, temperature instability, feeding difficulty, vomiting, hypoglycemia, hypotonia, hypertonia, hyperreflexia, tremor, jitteriness, irritability, and constant crying. These effects have mostly occurred either at birth or within a few days of birth. These features are consistent with either a direct toxic effect of SSRIs, or possibly a drug discontinuation syndrome; in some cases, the clinical picture is consistent with serotonin syndrome.

Epidemiological data have suggested that the use of SSRIs, particularly in late pregnancy, may increase the risk of persistent pulmonary hypertension in the newborn.

Data from animal studies has shown that escitalopram may affect sperm quality. Human case reports from some SSRIs have shown this effect to be reversible. As yet, the impact of this on human fertility has not been observed.

To monitor the outcomes of pregnant women exposed to antidepressants, a National Pregnancy Registry for Antidepressants has been established. Physicians are encouraged to register patients and pregnant women are encouraged to register themselves. For additional information: https://womensmentalhealth.org/clinical-and-research-programs/pregnancyregistry/antidepressants/

AU TGA pregnancy category C: Drugs which, owing to their pharmacological effects, have caused or may be suspected of causing, harmful effects on the human fetus or neonate without causing malformations. These effects may be reversible. Accompanying texts should be consulted for further details.

US FDA pregnancy category C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. Briggs GG, Freeman RK, Yaffe SJ.. "Drugs in Pregnancy and Lactation. 7th ed." Philadelphia, PA: Lippincott Williams & Wilkins (2005):
  3. "Product Information. Lexapro (escitalopram)." Forest Pharmaceuticals, St. Louis, MO.
  4. Cerner Multum, Inc. "Australian Product Information." O 0

The following applies to the ingredients: Metformin

Professional Content

Benefit should outweigh risk

AU TGA pregnancy category: C
US FDA pregnancy category: Not assigned

Risk Summary: Data are not sufficient to inform a drug-associated risk for major birth defects or miscarriage; published studies have not reported an increased risk. There are risks to the mother and fetus associated with poorly controlled diabetes in pregnancy.

Comments:
-Maternal glucose levels should be well controlled prior to conception and throughout pregnancy to avoid maternal and fetal diabetes-associated risks.
-Premenopausal women should understand the potential for unintended pregnancy with use of this drug as ovulation may occur in some anovulatory women.

Animal studies do not indicate harmful effects with respect to pregnancy, embryo or fetal development, birth or postnatal development. Poorly-controlled diabetes in pregnancy increases the maternal risk for diabetic ketoacidosis, pre-eclampsia, spontaneous abortions, preterm delivery, stillbirth and delivery complications. Poorly controlled maternal diabetes increases the fetal risk for major birth defects, stillbirth, and macrosomia related morbidity. Published evidence suggests this drug has a good safety profile in women with no increased long-term effects in offspring up to 18 months; however, much of the evidence is from observational, small, and/or nonrandomized studies, and therefore data must be interpreted cautiously.

Many experts continue to recommend insulin as the drug of choice for type 1, type 2, and gestational diabetes when diet alone is unsuccessful in controlling blood sugars. The estimated background risk for major birth defects in women with pre-gestational diabetes mellitus with an HbA1C greater than 7 is 6% to 10% and for women with a HbA1C greater than 10, this risk has been reported to be as high as 20% to 25%. In the US, the estimated risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively. The estimated risk of miscarriage for pregnant women with diabetes is unknown. There are no adequate and well-controlled studies in pregnant women.

AU TGA pregnancy category C: Drugs which, owing to their pharmacological effects, have caused or may be suspected of causing, harmful effects on the human fetus or neonate without causing malformations. These effects may be reversible. Accompanying texts should be consulted for further details.

US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out.

References

  1. "Product Information. Riomet (metFORMIN)." Ranbaxy Pharmaceuticals, Jacksonville, FL.
  2. Kelley KW, Carroll DG, Meyer A "A review of current treatment strategies for gestational diabetes mellitus. Available from: URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4509429/" Drugs Context 4 (2015): epub
  3. "Product Information. Glucophage (metformin)." Bristol-Myers Squibb, Princeton, NJ.
  4. Cerner Multum, Inc. "Australian Product Information." O 0
  5. "Product Information. Fortamet (metFORMIN)." Physicians Total Care, Tulsa, OK.
  6. Lindsay RS, Loeken MR "Metformin use in pregnancy: promises and uncertainties " Diabetologia 60 (2017): 1612-9
  7. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  8. "Product Information. Glumetza (metFORMIN)." Biovail Pharmaceuticals Canada, Mississauga, IA.

Drug and Breastfeeding Interactions

The following applies to the ingredients: Metformin

Professional Content

Benefit should outweigh risk

Excreted into human milk: Yes

Comments:
-Available data have not reported adverse effects in breastfed infants, however, this data is limited.
-Due to this limited data, product manufacturers recommend a decision should be made to discontinue nursing or discontinue the drug, considering the importance of the drug to the mother.
-Published data suggest this drug is compatible with breastfeeding; they recommend caution when nursing a newborn or premature infant, and those with renal impairment.

Drug levels are expected to be 0.5% (range 0.11% to 1%) of the mother's weight-adjusted dosage and milk/plasma ratio range between 0.13 and 1. Since milk levels are expected to be relatively constant, timing of breastfeeding with drug administration is expected to be of little benefit. One large prospective study found no adverse effects in breastfed infants. Low detectable serum levels were found in some breastfed infants.

References

  1. Kelley KW, Carroll DG, Meyer A "A review of current treatment strategies for gestational diabetes mellitus. Available from: URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4509429/" Drugs Context 4 (2015): epub
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  3. "Product Information. Fortamet (metFORMIN)." Physicians Total Care, Tulsa, OK.
  4. Cerner Multum, Inc. "Australian Product Information." O 0
  5. "Product Information. Glumetza (metFORMIN)." Biovail Pharmaceuticals Canada, Mississauga, IA.
  6. Feig DS, Briggs GG, Koren G "Oral antidiabetic agents in pregnancy and lactation: a paradigm shift?" Ann Pharmacother (2007): 1174-80
  7. United States National Library of Medicine "Toxnet. Toxicology Data Network. Available from: URL: http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT." ([cited 2013 -]):
  8. "Product Information. Glucophage (metformin)." Bristol-Myers Squibb, Princeton, NJ.
  9. "Product Information. Riomet (metFORMIN)." Ranbaxy Pharmaceuticals, Jacksonville, FL.

The following applies to the ingredients: Escitalopram (found in Lexapro)

Professional Content

Use with caution; the benefit to the mother should outweigh the risk to the infant.

Excreted into human milk: Yes

Comments:
-Breastfed infants should be monitored for drowsiness and decreased feeding.
-Mothers taking an SSRI during pregnancy and postpartum may have difficulty breastfeeding and may require additional breastfeeding support.

Escitalopram is not expected to cause adverse effects in breastfed infants, particularly in infants over 2 months of age. One case of necrotizing enterocolitis has been reported in a breastfed newborn whose mother was taking escitalopram during pregnancy and lactation; however, causality was not established.

Maternal doses of escitalopram up to 20 mg per day lead to low levels in milk, approximately 3.9% and 1.7% of the maternal weight-adjusted dose of escitalopram and desmethylcitalopram, respectively. Limited data suggest that escitalopram is preferable to racemic citalopram during breastfeeding due to lower dosage and milk levels, and general lack of side effects in breastfed infants.

References

  1. United States National Library of Medicine "Toxnet. Toxicology Data Network. Available from: URL: http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT." ([cited 2013 -]):
  2. "Product Information. Lexapro (escitalopram)." Forest Pharmaceuticals, St. Louis, MO.
  3. Cerner Multum, Inc. "Australian Product Information." O 0
  4. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

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.

Switch to: Professional Interactions

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.

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