Metformin/Pioglitazone and Ranolazine Interaction
Drug interaction information between Metformin/Pioglitazone and Ranolazine.
Metformin/Pioglitazone and Ranolazine have a documented moderate interaction in FDA labeling.
FDA drug labeling documents a moderate-severity interaction between Metformin/Pioglitazone and Ranolazine. This page displays the available source-record category and label text. The category is not an individual risk estimate or medication-combination direction.
How They Interact
Ranolazine blocks the pathways your kidneys use to get rid of metformin, which can cause metformin levels to rise too high. High levels of this drug increase the risk of a life-threatening acid imbalance.
FDA Label Information
( 7.3 ) Drugs that reduce metformin clearance (such as ranolazine, vandetanib, dolutegravir, and cimetidine), may increase the accumulation of metformin. 7.4 Drugs that Reduce Metformin Clearance Concomitant use of drugs that interfere with common renal tubular transport systems involved in the renal elimination of metformin (e.g., organic cationic transporter-2 [OCT2]/multidrug and toxin extrusion [MATE] inhibitors such as ranolazine, vandetanib, dolutegravir, and cimetidine) could increase systemic exposure to metformin and may increase the risk for lactic acidosis [see Clinical...
Metformin/Pioglitazone Also Interacts With
- Dolutegravir moderate
- Cimetidine moderate
- Metformin minor
- Topiramate minor
- Pioglitazone minor
Ranolazine Also Interacts With
- Ketoconazole major
- Carbamazepine major
- Clarithromycin major
- Rifampin major
- Phenytoin major
Frequently Asked Questions
What SPL severity band is on file for Metformin/Pioglitazone + Ranolazine?
Compiled FDA labeling labels this pair moderate. That is a source-record field, not an individual medication-combination decision.
Which drug in this pair has the larger labeled-interaction portfolio?
Ranolazine has 31 labeled pairs on file vs Metformin/Pioglitazone's 10. In the moderate band specifically: Metformin/Pioglitazone has 3 (also Dolutegravir, Cimetidine); Ranolazine has 7 (also Empagliflozin, Empagliflozin/Linagliptin, Ertugliflozin, Linagliptin).
What mechanism field is on file for Metformin/Pioglitazone and Ranolazine?
Ranolazine blocks the pathways your kidneys use to get rid of metformin, which can cause metformin levels to rise too high. High levels of this drug increase the risk of a life-threatening acid imbalance.
Ranolazine carries more major-labeled pairs than Metformin/Pioglitazone
SPL source-record counts only. This page's band is moderate · classes on file: Metformin/Pioglitazone (Biguanide / TZD Combination); Ranolazine (Late Sodium Current Inhibitor (Antianginal)).
Ranolazine has 12 major-labeled pairs vs Metformin/Pioglitazone's 0. This page itself is in the moderate band, not the major band.
0 major · 3 moderate · 7 minor · 10 total
- Other moderate peers for Metformin/Pioglitazone
- Dolutegravir
- Cimetidine
12 major · 7 moderate · 12 minor · 31 total
- Other moderate peers for Ranolazine
- Empagliflozin
- Empagliflozin/Linagliptin
- Ertugliflozin
- Linagliptin
Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. This registry does not provide individual medication-combination directions.
Read our methodology - how this data is sourced, computed, and verified.