Minor
Probable
Mô tả
Cephalexin competes with metformin for renal tubular secretion via OCT2 and MATE transporters, which can modestly increase metformin plasma concentrations and its renal clearance.
Cơ chế
Both cephalexin and metformin are substrates of organic cation transporter 2 (OCT2) and MATE1/2 in the renal proximal tubule; competitive inhibition of secretion raises metformin exposure slightly.
Ý nghĩa lâm sàng
Pharmacokinetic studies show modest (10–15%) metformin AUC increases; the clinical relevance is low in patients with normal renal function but warrants attention in renal impairment.
Xử trí
No dose adjustment is required in patients with normal renal function; monitor renal function and watch for signs of lactic acidosis in patients with pre-existing renal impairment.