RJY asked
Can Aleve be taken with Metformin (and blood sugar + blood pressure medication)?
At a glance
- Taking Aleve (naproxen) with metformin may increase the risk of lactic acidosis due to a potential decrease in kidney function.
- NSAIDs, like Aleve, can decrease kidney function and increase blood pressure. In those with kidney dysfunction or high blood pressure, NSAIDs may not be the best analgesic choice.
Answer
There's conflicting information regarding whether or not there is a drug interaction between metformin and Aleve (naproxen), an NSAID (non-steroidal anti-inflammatory drug).
Most online drug interaction checkers do not list an interaction, and the prescribing information for metformin products do not state that there is an interaction with NSAIDs.
Nevertheless, some 'interaction checkers' (like Drugs.com), do state that there could be issues.
The reason why there is a discrepancy is not so much that there is a specific interaction between metformin and Aleve, where one drug directly affects the other, but rather that NSAIDs like Aleve can decrease kidney function, which creates its own set of problems.
The interaction Drugs.com writes about discusses the fact that NSAIDs can increase the risk of a rare, but serious side effect of metformin known as 'lactic acidosis'.
A large risk factor for lactic acidosis is decreased kidney function, which again, can be caused by taking NSAIDs.
In other words, if taking an NSAID could potentially decrease how well your kidneys work, the risk of metformin-induced lactic acidosis increases.
Perhaps a more important thing to discuss here is the use of NSAIDs in general in those with diabetes and take metformin entirely out of the equation.
Many medical guidelines recommend that diabetics avoid NSAIDs altogether because both (NSAIDs and diabetes) are risk factors for kidney disease/impairment.
For example, the National Kidney Foundation recommends the following:
References
- Glumetza Prescribing Information. AccessFDA
- Clinically and pharmacologically relevant interactions of antidiabetic drugs. PubMed
- Lactic Acidosis in Diabetic Population: Is Metformin Implicated? Results of a Matched Case-Control Study Performed on the Type 2 Diabetes Population of Grenoble Hospital University. AAFP
- Choosing Wisely. AAFP
- Use of non-steroidal anti-inflammatory drugs and risk of chronic kidney disease in people with Type 2 diabetes mellitus, a nationwide longitudinal cohort study. PubMed
