Metformin lisinopril
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Summary
4 papers analyzed
Some studies suggest that metformin and lisinopril interact by affecting each other's dissolution and release, while other studies indicate that metformin-associated lactic acidosis can occur in low-risk patients.
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Concurrent Determination of Metformin and Lisinopril: Pharmacokinetics and Analytical Methods
High Performance Liquid Chromatographic Method for Metformin and Lisinopril
A study developed and validated a high performance liquid chromatographic (HPLC) method for the simultaneous determination of metformin hydrochloride and angiotensin-converting enzyme inhibitors, including lisinopril, in bulk dosage forms. This method was successfully applied to pharmacokinetic studies, demonstrating good linearity for both metformin and lisinopril over a wide concentration range. This analytical approach is crucial for ensuring accurate dosage and monitoring in clinical settings.
In Vitro Drug Interactions Between Metformin and Lisinopril
Research investigating the in vitro interactions of lisinopril with metformin revealed significant effects on the dissolution profiles of both drugs. The study used various pH levels to simulate the gastrointestinal tract and found that lisinopril decreased the percentage of metformin released at all tested pH levels. Conversely, metformin increased the percentage of lisinopril released at pH 1.2 and 6.8, but not at pH 4.5. These findings highlight the importance of considering drug interactions in the formulation of combination therapies.
Effect of Oral Semaglutide on Metformin and Lisinopril Pharmacokinetics
Another study examined the impact of oral semaglutide, a GLP-1 analog, on the pharmacokinetics of metformin and lisinopril. The results indicated that oral semaglutide increased the area under the plasma concentration-time curve (AUC) of metformin by 32%, although the maximum plasma concentration (Cmax) remained unaffected. However, there were no apparent effects on the pharmacokinetics of lisinopril. This suggests that while semaglutide may alter metformin exposure, it does not significantly impact lisinopril, making it a viable option for combination therapy.
Clinical Case: Metformin-Associated Lactic Acidosis with Lisinopril
A clinical case reported metformin-associated lactic acidosis in a diabetic patient who was also taking lisinopril. Despite having normal renal and cardiac functions, the patient developed lactic acidosis, a potentially lethal condition, after an increase in metformin dosage. The patient was treated by discontinuing metformin and administering insulin, while continuing lisinopril. The patient's condition improved significantly, with lactic acid levels returning to normal. This case underscores the need for careful monitoring of metformin therapy, especially when combined with other medications like lisinopril.
Conclusion
The concurrent use of metformin and lisinopril presents both opportunities and challenges in clinical practice. Analytical methods like HPLC are essential for accurate pharmacokinetic studies, while in vitro interaction studies help in understanding the dissolution profiles of combined drugs. Additionally, the impact of other medications, such as oral semaglutide, on the pharmacokinetics of metformin and lisinopril must be considered. Finally, clinical vigilance is crucial to prevent adverse effects like lactic acidosis, ensuring patient safety and effective treatment outcomes.
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