Drug General Information (ID: DDI9QGIV1K)
Drug Name			Metformin		Drug Info		Patiromer		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antidiabetic Agents				Cation Exchange Resins

Mechanism of Metformin-Patiromer Interaction (Severity Level: Moderate)
Complex formation Click to Show/Hide Mechanism Graph
Drug Name		Metformin				Patiromer
Mechanism		Binds to cation exchange resin/polymer				Cation exchange resin/polymer
Key Mechanism Factor 1
		Factor Name		Chelation
		Factor Description		Chelation is a direct drug interaction that usually involves the formation of dimers or trimers, resulting in larger complexes and poorer absorption.
Mechanism Description		Decreased absorption of Patiromer due to formation of complexes caused by Metformin

Recommended Action
Management		Patiromer should be administered at least 3 hours before or 3 hours after other oral medications, particularly ciprofloxacin, levothyroxine, and metformin. alternatives to patiromer or the other medications should be considered if adequate dosing separation is not possible. Otherwise, clinical response and/or blood levels should be monitored where possible.

References
1	Cerner Multum, Inc. "Australian Product Information.".