Biguanides drug interactions

Drug interactions with sulfonylureas and biguanides are common non-steroidal antiinflammatory drugs, warfarin, alcohol, monoamine oxidase inhibitors, some uricosurics, some antibacterials and some antifungals can interact with them. All increase the risk of hypoglycaemia. The mechanism is probably competition for metabolizing enzymes or displacement from plasma protein binding sites. 

Mills PC, Ahlstrom L, Wilson W (2005) Ototoxicity and tolerance assessment of a TrisEDTA and polyhexamethylene biguanide ear flush formulation in dogs. J Vet Pharmacol Ther 28 (4) 391-397. doi 10.1111/j. 1365-2885.2005.00672.x Mozayani A, Raymon L (2004) Handbook of drug interactions a clinical and forensic guide. Humana Press, Totowa... 

Biguanides This class of antidiabetics may cause acute poisoning with adverse effects such as acidosis and may be treated by supportive therapy. These drugs have therapeutic interactions with other antidiabetic drugs, alcohol, drugs that affect kidney function, and cimetidine. 

Biguanides are known to show interaction with furesemide, nifedipine, and cationic drugs. 

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