Empagliflozin and Metformin/Empagliflozin Interaction
Drug interaction information between Empagliflozin and Metformin/Empagliflozin.
Empagliflozin and Metformin/Empagliflozin have a documented moderate interaction in FDA labeling.
FDA drug labeling documents a moderate-severity interaction between Empagliflozin and Metformin/Empagliflozin. Major interactions are generally avoided, moderate ones may need monitoring or a dose adjustment, and minor ones are usually low-risk. This page shows the documented mechanism and guidance. Label-documented interactions are not a complete safety review, so always confirm your own medications with a pharmacist or doctor. Educational information, not medical advice.
How They Interact
Taking certain medications like topiramate along with your diabetes medicine can lower your blood's ability to balance acid. This increases the risk of a serious condition called lactic acidosis.
What To Do
Your doctor should monitor your blood work closely to check for signs of too much acid.
FDA Label Information
7 DRUG INTERACTIONS See Table 4 for clinically relevant interactions with SYNJARDY or SYNJARDY XR. Table 4 Clinically Relevant Interactions with SYNJARDY or SYNJARDY XR Carbonic Anhydrase Inhibitors Clinical Impact Topiramate or other carbonic anhydrase inhibitors (e.g., zonisamide, acetazolamide or dichlorphenamide) frequently causes a decrease in serum bicarbonate and induce non-anion gap, hyperchloremic metabolic acidosis. Concomitant use of these drugs with SYNJARDY or SYNJARDY XR may increase the risk of lactic acidosis.
Empagliflozin Also Interacts With
- Metformin moderate
- Dolutegravir moderate
- Ranolazine moderate
- Cimetidine moderate
- Topiramate minor
Metformin/Empagliflozin Also Interacts With
- Metformin moderate
- Dolutegravir moderate
- Ranolazine moderate
- Cimetidine moderate
- Topiramate minor
Frequently Asked Questions
Can I take Empagliflozin and Metformin/Empagliflozin together?
This is a moderate interaction. Your doctor should monitor your blood work closely to check for signs of too much acid.
How serious is the interaction between Empagliflozin and Metformin/Empagliflozin?
This interaction is classified as "moderate" severity by the FDA. Moderate interactions may worsen your condition or change how your medications work.
Why do Empagliflozin and Metformin/Empagliflozin interact?
Taking certain medications like topiramate along with your diabetes medicine can lower your blood's ability to balance acid. This increases the risk of a serious condition called lactic acidosis.
Understanding the Empagliflozin and Metformin/Empagliflozin Interaction
FDA-approved prescribing information for these two drugs flags their combination as a moderate-severity interaction. Empagliflozin belongs to the SGLT2 Inhibitor class and Metformin/Empagliflozin belongs to the Biguanide / SGLT2 Combination class - two categories that can collide when co-prescribed. The mechanism described in FDA labeling is: Taking certain medications like topiramate along with your diabetes medicine can lower your blood's ability to balance acid. Severity tiers matter: major flags generally advise avoidance, moderate flags often require monitoring or dose adjustment, and minor flags may only call for awareness.
Context around a specific patient determines real-world impact. Empagliflozin has 10 total documented interactions on file in this dataset, and Metformin/Empagliflozin has 9. Each additional medication compounds the interaction surface, which is why pharmacists run full-profile checks rather than evaluating one pair at a time. FDA-derived guidance for this pair is: Your doctor should monitor your blood work closely to check for signs of too much acid. Timing of doses, renal and hepatic function, age, and other concurrent prescriptions all shape whether a labeled interaction matters clinically.
An interaction flag is not a verdict. A large share of labeled interactions are managed routinely in clinical practice, the fix may be as simple as spacing doses or adding a monitoring test. Others require the prescriber to choose a different medication entirely. This page surfaces FDA-sourced labeling and openFDA data for educational purposes only; it is not medical advice and cannot account for your full clinical picture. Never start, stop, or adjust either Empagliflozin or Metformin/Empagliflozin based on a web page, speak with your prescriber or pharmacist before making any change.
Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. Always consult your healthcare provider about drug interactions.
Read our methodology - how this data is sourced, computed, and verified.