natgillin/translations-raw huggingface dataset:
Competact may cause a very rare (may affect up to 1 in 10,000), but very serious side effect called lactic acidosis (see section “Risk of lactic acidosis”). 
Zdravilo Competact lahko povzroči zelo redek (pojavi se lahko pri do 1 od 10.000 bolnikov), a zelo resen neželeni učinek, imenovan laktacidoza (glejte poglavje "Tveganje za laktacidozo").
Competact should be used every day to work properly. 
Za pravilno delovanje morate zdravilo Competact jemati vsak dan.
It is an anti-diabetic medicine used in adults to treat type 2 (non-insulin dependent) diabetes mellitus when treatment with metformin alone is not sufficient. 
Je antidiabetično zdravilo za zdravljenje sladkorne bolezni tipa 2 (od insulina neodvisne sladkorne bolezni) pri odraslih, ko zdravljenje samo z metforminom ni zadostno.
It is recommended, therefore, that patients treated with Competact undergo periodic monitoring of liver enzymes. 
Zato je priporočeno, da pri bolnikih, zdravljenih z zdravilom Competact, redno spremljate vrednosti jetrnih encimov.
5 Isolated reports: liver function tests abnormalities or hepatitis resolving upon metformin discontinuation. 
5 Posamezni primeri: nenormalni testi delovanja jeter ali hepatitis, stanje se normalizira po ukinitvi zdravljenja z metforminom.
Blurred vision due to swelling (or fluid) at the back of the eye (macular oedema) has been reported (frequency cannot be estimated from available data). 
Poročali so tudi o motnjah vida zaradi otekanja (ali tekočine) v zadnjem delu očesa (makularni edem) (pogostnosti iz razpoložljivih podatkov ni mogoče oceniti).
Your doctor will ask you to have blood tests periodically during treatment with Competact. 
Zdravnik vas bo v času zdravljenja z zdravilom Competact naročil na redne preiskave krvi.
abdominal pain very common very common diarrhoea very common very common flatulence uncommon loss of appetite very common very common nausea very common very common vomiting very common very common 
bolečine v trebuhu zelo pogosti zelo pogosti driska zelo pogosti zelo pogosti flatulenca občasni izguba apetita zelo pogosti zelo pogosti slabost zelo pogosti zelo pogosti bruhanje zelo pogosti zelo pogosti
- if you are going to have a certain type of X-ray with an injectable dye, talk to your doctor as you must stop taking Competact for a certain period of time before and after the examination. 
- če imate predvideno rentgensko preiskavo, pri kateri vam bodo vbrizgali barvilo, se pogovorite z zdravnikom, saj boste morali za določeno obdobje pred pregledom in po njem prenehati z jemanjem zdravila Competact.
If you need to have an injection of a contrast medium that contains iodine into your bloodstream, for example in the context of an X-ray or scan, you must stop taking Competact before or at the time of the injection. 
Če vam bodo v krvni obtok injicirali kontrastno sredstvo, ki vsebuje jod, na primer zaradi rentgenskega ali drugega slikanja, morate pred časom injiciranja ali v tem času prenehati z jemanjem zdravila Competact.
- The other ingredients are microcrystalline cellulose, povidone (K30), croscarmellose sodium magnesium stearate, hypromellose, macrogol 8000, talc and titanium dioxide (E171). 
- Pomožne snovi so: mikrokristalna celuloza, povidon (K 30), premreženi natrijev karmelozat, magnezijev stearat, hipromeloza, makrogol 8000, smukec in titanov dioksid (E171).
Musculoskeletal and connective tissue disorders bone fracture6 
Bolezni mišično-skeletnega sistema in vezivnega tkiva zlomi kosti6
- if you have uncontrolled diabetes, with for example severe hyperglycaemia (high blood glucose), nausea, vomiting, diarrhoea, rapid weight loss, lactic acidosis (see section“Risk of lactic acidosis”) or ketoacidosis. 
- če imate nenadzorovano sladkorno bolezen, na primer s hudo hiperglikemijo (visoko ravnjo sladkorja v krvi), siljenjem na bruhanje, bruhanjem, drisko, hitro izgubo telesne mase, laktacidozo (glejte poglavje "Tveganje za laktacidozo") ali ketoacidozo.
The recommended dose of Competact is 30 mg/day pioglitazone plus 1,700 mg/day of metformin hydrochloride (this dose is achievable with one tablet of Competact 15 mg/850 mg, taken twice a day). 
Priporočeni odmerek zdravila Competact je 30 mg/dan pioglitazona in 1.700 mg/dan metforminijevega klorida (dan v obliki ene tablete zdravila Competact 15 mg/850 mg dvakrat na dan).
1 Post-marketing reports of hypersensitivity reactions in patients treated with pioglitazone have been reported. 
1 V poročilih po pridobitvi dovoljenja za promet so poročali o preobčutljivostnih reakcijah pri bolnikih zdravljenih s pioglitazonom.
Avoid excessive alcohol intake while taking Competact since this may increase the risk of lactic acidosis (see section “Risk of lactic acidosis”). 
Med jemanjem zdravila Competact ne uživajte čezmernih količin alkohola, saj lahko to poveča tveganje za laktacidozo (glejte poglavje " Tveganje za laktacidozo").
For Competact no preclinical or clinical data on exposed pregnancies or lactation are available. 
Predklinični ali klinični podatki o uporabi zdravila Competact med nosečnostjo ali dojenjem niso na voljo.
On the basis of the scientific conclusions for glimepiride / pioglitazone hydrochloride, metformin / pioglitazone, pioglitazone the CHMP is of the opinion that the benefit-risk balance of the medicinal product(s) containing glimepiride / pioglitazone hydrochloride, metformin / pioglitazone, pioglitazone is unchanged subject to the proposed changes to the product information. 
Na podlagi znanstvenih zaključkov za glimepirid/pioglitazon hidroklorid, metformin/pioglitazon, pioglitazon odbor CHMP meni, da je razmerje med koristjo in tveganjem zdravil(-a), ki vsebuje(-jo) zdravilno(-e) učinkovino(-e) glimepirid/pioglitazon hidroklorid, metformin/pioglitazon,
Very common (may affect more than 1 in 10 people) - stomach ache - feeling sick (nausea) - vomiting - diarrhoea - loss of appetite 
Zelo pogosti (pojavijo se lahko pri več kot 1 od 10 bolnikov) - bolečine v trebuhu - siljenje na bruhanje (navzea) - bruhanje - driska - izguba apetita
What Competact looks like and contents of the pack 
Izgled zdravila Competact in vsebina pakiranja
If you need to have major surgery you must stop taking Competact during and for some time after the procedure. 
Če morate na večji kirurški poseg, morate v času posega in še nekaj časa po tem prenehati z jemanjem zdravila Competact.
Competact combines two antihyperglycaemic active substances with complementary mechanisms of action to improve glycaemic control in patients with type 2 diabetes mellitus: pioglitazone, a member of the thiazolidinedione class and metformin hydrochloride, a member of the biguanide class. 
Zdravilo Competact je kombinacija dveh antihiperglikemičnih učinkovin s komplementarnim mehanizmom delovanja, namenjeno pa je izboljšanju urejenosti glikemije pri bolnikih s sladkorno boleznijo tipa 2: pioglitazona iz skupine tiazolidindionov in metforminijevega klorida iz skupine bigvanidov.
Multipack: 196 (2 packs of 98) film-coated tablets. 
Večkratno pakiranje: 196 filmsko obloženih tablet (2 pakiranji po 98 tablet)
Risk related to metformin 
Tveganja, ki jih predstavlja metformin
If you experience these symptoms for the first time talk to your doctor as soon as possible. 
Če imate ta simptom prvič, se čim prej posvetujte s svojim zdravnikom.
Post-marketing cases of peripheral oedema and cardiac failure have also been reported in patients with concomitant use of pioglitazone and nonsteroidal anti-inflammatory drugs, including selective COX-2 inhibitors. 
Po prihodu zdravila na trg so o primerih perifernega edema in srčnega popuščanja poročali tudi pri bolnikih, ki so se sočasno zdravili s pioglitazonom in z nesteroidnimi protivnetnimi zdravili, vključno s selektivnimi zaviralci COX-2.
Competact should not be used during pregnancy. 
Zdravila Competact se ne sme dajati ženskam v času nosečnosti.
Physicians should start treatment with the lowest available dose and increase the dose gradually, particularly when pioglitazone is used in combination with insulin (see section 4.4 Fluid retention and cardiac failure). 
Zdravniki morajo začeti zdravljenje z najnižjim odmerkom, ki je na voljo in odmerek zviševati postopoma, še posebej, ko se pioglitazon uporablja v kombinaciji z insulinom (glejte poglavje 4.4
How to take Competact 
Kako jemati zdravilo Competact
The observed excess risk of fractures for women on pioglitazone in this study is therefore 0.5 fractures per 100 patient years of use. 
Povečano tveganje za zlome pri ženskah, zdravljenih s pioglitazonom, opaženo v tej študiji, je torej 0,5 zloma na 100 bolnik-let uporabe.
Talk to your doctor or pharmacist before taking Competact (see also section 4). 
Pred začetkom jemanja zdravila Competact se posvetujte z zdravnikom ali farmacevtom (glejte tudi poglavje 4): - če imate težave s srcem.
Hepatobiliary disorders hepatitis5 
Bolezni jeter, žolčnika in žolčevodov hepatitis5
The following side effects have been experienced by some patients taking Competact: 
Pri nekaterih bolnikih, ki so jemali zdravilo Competact, so se pojavili naslednji neželeni učinki:
If a pregnancy occurs, treatment with Competact should be discontinued. 
Če pride do nosečnosti, je potrebno zdravljenje z zdravilom Competact prekiniti.
PARTICULARS TO APPEAR ON THE OUTER PACKAGING INTERMEDIATE CARTON (WITHOUT BLUE BOX) MULTIPACKS ONLY (98 TABLETS) 
PODATKI NA ZUNANJI OVOJNINI VMESNA ŠKATLA (BREZ "BLUE BOX") SAMO "MULTIPACK" PAKIRANJA (98 TABLET)
Multipack of 196 (2 packs of 98) tablets and aluminium/aluminium perforated unit dose blisters in pack of 60 x 1 tablets. 
Večkratno pakiranje, ki vsebuje 196 (2 paketa po 98) tablet in po 60 x 1 tableta v pakiranju z aluminij/aluminij perforiranim enoodmernim pretisnim omotom.
There was a small reduction in mean haemoglobin (4% relative reduction) and haematocrit (4.1% relative reduction) during therapy with pioglitazone, consistent with haemodilution. 
(4% relativno znižanje) in hematokrita (4,1% relativno znižanje), skladno s hemodilucijo.
Competact contains pioglitazone and metformin. 
Zdravilo Competact vsebuje pioglitazon in metformin.
Competact is indicated as second line treatment of type 2 diabetes mellitus adult patients, particularly overweight patients, who are unable to achieve sufficient glycaemic control at their maximally tolerated dose of oral metformin alone. 
Zdravilo Competact je indicirano kot drugi izbor zdravljenja sladkorne bolezni tipa 2 pri odraslih, še posebno pri bolnikih s čezmerno telesno maso, pri katerih ni možno vzdrževati primerne koncentracije glukoze v krvi z največjim dovoljenim peroralnim odmerkom metformina samega.
Competact must be discontinued prior to or at the time of the imaging procedure and not restarted until at least 48 hours after, provided that renal function has been re-evaluated and found to be stable, see sections 4.2 and 4.4. 
Competact je treba pred slikanjem ali v času slikanja ukiniti in se ga sme ponovno uvesti najmanj 48 ur pozneje, če je bilo delovanje ledvic ponovno ovrednoteno in ocenjeno kot stabilno, glejte poglavji 4.2 in 4.4.
Competact should be discontinued prior to or at the time of the imaging procedure and not restarted until at least 48 hours after, provided that renal function has been re-evaluated and found to be stable, see sections 4.2 and 4.5. 
Competact je treba pred slikanjem ali v času slikanja ukiniti in se ga sme ponovno uvesti najmanj 48 ur pozneje, če je bilo delovanje ledvic ponovno ovrednoteno in ocenjeno kot stabilno, glejte poglavji 4.2 in 4.5.
Investigations weight increased8 
Preiskave povečanje telesne mase8
No animal studies have been conducted with the combined products in Competact. 
Raziskave s kombinacijo učinkovin v zdravilu Competact na živalih niso bile narejene.
- The active substances are pioglitazone and metformin hydrochloride. 
- Zdravilni učinkovini sta pioglitazon in metforminijev klorid.
It is recommended that you carry some sugar lumps, sweets, biscuits or sugary fruit juice 
Priporočljivo je, da imate pri sebi nekaj kock sladkorja, bonbone,
The film-coated tablets (tablets) are white to off white, oblong, convex, embossed ‘15 / 850' on one face and ‘4833M' on the other. 
Filmsko obložene tablete (tablete) so bele ali skoraj bele barve, podolgovate, z oznako ‘15 / 850' na eni in ‘4833M' na drugi strani.
PARTICULARS TO APPEAR ON THE OUTER PACKAGING CARTON (WITH BLUE BOX) (EXCLUDING MULTIPACKS) 
PODATKI NA ZUNANJI OVOJNINI ŠKATLA (Z "BLUE BOX") (RAZEN "MULTIPACK" PAKIRANJ)
Each tablet contains 15 mg of pioglitazone (as hydrochloride) and 850 mg of metformin hydrochloride. 
Ena tableta vsebuje 15 mg pioglitazona (v obliki pioglitazonijevega klorida) in 850 mg metforminijevega klorida.
6 A pooled analysis was conducted of adverse reactions of bone fractures from randomised, comparator controlled, double blind clinical trials in over 8,100 patients in the pioglitazone-treated groups and 7,400 in the comparator-treated groups of up to 3.5 years duration. 
6 Opravljena je bila skupna analiza neželenih učinkov zlomov kosti iz randomiziranih, s primerjalnim zdravilom kontroliranih, dvojno slepih kliničnih preskušanj pri več kot 8.100 bolnikov v skupini,
Risk related to pioglitazone 
Tveganja, ki jih predstavlja pioglitazon
An increased incidence in bone fractures in women was seen in a pooled analysis of adverse reactions of bone fracture from randomised, controlled, double blind clinical trials (see section 4.8) 
V skupni analizi neželenih učinkov zlomov kosti iz randomiziranih, kontroliranih, dvojno slepih kliničnih preskušanj, so opazili povečano incidenco zlomov kosti pri ženskah (glejte poglavje 4.8).
PARTICULARS TO APPEAR ON THE OUTER PACKAGING OUTER LABEL (WITH BLUE BOX) MULTIPACKS ONLY (2 x 98 TABLETS) 
PODATKI NA ZUNANJI OVOJNINI ZUNANJA OVOJNINA (Z "BLUE BOX") SAMO VEČKRATNA PAKIRANJA (2 x 98 TABLET)
When activity, concentrations and protein binding are taken into account, pioglitazone and metabolite M-III contribute equally to efficacy. 
Če upoštevamo aktivnost, koncentracije in vezavo na beljakovine, je delež učinkovitosti pioglitazona in presnovka
The effect of pioglitazone (45 mg monotherapy vs. placebo) was studied in a small 18-week trial in type 2 diabetics. 
Učinek pioglitazona (45 mg monoterapija v primerjavi s placebom) so preučevali v majhnem
If necessary, the dose of the antihyperglycaemic medicinal product should be adjusted during therapy with the other medicinal product and on its discontinuation. 
Če je potrebno, odmerek antidiabetikov prilagodimo, bodisi zdravljenju z drugimi zdravili bodisi ukinitvi zdravljenja s takšnimi zdravili.
Allergic reactions have been reported with frequency not known (cannot be estimated from available data) in patients taking Competact. 
Pri bolnikih, ki so jemali zdravilo Competact, so poročali o alergijskih reakcijah z neznano pogostnostjo (iz razpoložljivih podatkov je ni mogoče oceniti).
Preclinical data for metformin reveal no special hazard for humans based on conventional studies of safety pharmacology, repeated dose toxicity, genotoxicity, carcinogenic potential, toxicity to reproduction. 
Predklinični podatki o metforminu na osnovi običajnih študij farmakološke varnosti, toksičnosti pri ponavljajočih odmerkih, genotoksičnosti, kancerogenega potenciala in vpliva na sposobnost razmnoževanja ne kažejo posebnega tveganja za človeka.
If you have taken more Competact that you should have, you may experience lactic acidosis (see section “Risk of lactic acidosis”). 
Če ste vzeli več zdravila Competact, kot bi smeli, se lahko pojavi laktacidoza (glejte poglavje
Vitamin B12 absorption decreased2 
Presnovne in prehranske motnje zmanjšana absorpcija vitamina B122
Dose titration with pioglitazone (added to the optimal dose of metformin) should be considered before the patient is switched to Competact. 
Preden se bolnika prevede na zdravljenje z zdravilom Competact, je treba najprej prilagoditi odmerek pioglitazona (dodajanje k optimalnemu odmerku metformina).
Competact 15 mg/850 mg film-coated tablets 
Competact 15 mg/850 mg filmsko obložene tablete
If you take Competact with other medicines for diabetes, it is more likely that your blood sugar could fall below the normal level (hypoglycaemia). 
da vam vrednost krvnega sladkorja pade pod normalno raven (hipoglikemija).
There may be an increased possibility of becoming pregnant because you may ovulate again when you take Competact. 
Obstaja povečana možnost zanositve, saj se pri jemanju zdravila Competact ovulacija lahko povrne.
Competact is not recommended in pregnancy. 
Med nosečnostjo zdravila Competact ni priporočljivo jemati.
Alcohol intoxication is associated with an increased risk of lactic acidosis, particularly in case of fasting, malnutrition or hepatic impairment. 
Zastrupitev z alkoholom je povezana s povečanim tveganjem za laktacidozo, zlasti ob postenju,
If a patient wishes to become pregnant, treatment with Competact should be discontinued. 
Če želi bolnica zanositi, je treba zdravljenje z zdravilom Competact prekiniti.
Fluid retention and cardiac failure 
Zastajanje tekočine in srčno popuščanje).
Broken bones have been reported commonly (may affect up to 1 in 10 people) in female patients taking Competact and have also been reported in male patients (frequency cannot be estimated from the available data) taking Competact. 
O zlomih so poročali tudi pri bolnikih, ki so se zdravili z zdravilom Competact (pogostnosti ni mogoče oceniti iz razpoložljivih podatkov).
Bladder cancer has been experienced uncommonly (may affect up to 1 in 100 people) in patients taking Competact. 
Pri bolnikih, ki so jemali zdravilo Competact, so občasno (pri največ 1 od 100 bolnikov) poročali o pojavu raka sečnega mehurja.
- by reduction of hepatic glucose production by inhibiting gluconeogenesis and glycogenolysis - in muscle, by modestly increasing insulin sensitivity, improving peripheral glucose uptake and utilisation - by delaying intestinal glucose absorption. 
- v mišicah zmerno poveča občutljivost za insulin, izboljša periferni vnos in izkoriščanje glukoze;
Symptoms of lactic acidosis include: - vomiting - stomach ache (abdominal pain) - muscle cramps - a general feeling of not being well with severe tiredness - difficulty in breathing - reduced body temperature and heartbeat 
- bolečina v trebuhu (abdominalna bolečina) - mišične krče - splošno slabo počutje s hudo utrujenostjo
Adverse reactions reported in double-blind studies and post-marketing experience are listed below as MedDRA preferred term by system organ class and absolute frequency. 
Neželeni učinki, o katerih so poročali v dvojno slepih študijah in postmarketinških izkušnjah, so našteti spodaj, in sicer po razredih organskih sistemov in absolutni pogostnosti, kot je priporočeno po MedDRA. Pogostnosti so določene kot: zelo pogosti (≥ 1/10); pogosti (≥ 1/100 do < 1/10); občasni
- a significant reduction of the absolute risk of any diabetes-related complication in the metformin group (29.8 events/1,000 patient-years) versus diet alone (43.3 events/1,000 patient-years), p=0.0023, and versus the combined sulphonylurea and insulin monotherapy groups (40.1 events/1,000 patient-years), p=0.0034 - a significant reduction of the absolute risk of any diabetes-related mortality: metformin 7.5 events/1,000 patient-years, diet alone 12.7 events/1,000 patient-years, p=0.017 - a significant reduction of the absolute risk of overall mortality: metformin 13.5 events/1,000 patient-years versus diet alone 20.6 events/1,000 patient-years, (p=0.011), and versus the combined sulphonylurea and insulin monotherapy groups 18.9 events/1,000 patient-years (p=0.021) 
značilno zmanjšanje absolutnega tveganja za katerikoli s sladkorno boleznijo povezan zaplet v skupini bolnikov, ki so se zdravili z metforminom (29,8 primerov/1.000 bolnikov-let), v primerjavi s skupino bolnikov, ki je imela predpisano zgolj dieto (43,3 primerov/1.000 bolnikov-let), p = 0,0023 ter v primerjavi s skupino, ki se je kombinirano zdravila s sulfonilsečnino, in skupino, ki je imela monoterapijo z insulinom
It is especially important to mention the following: - gemfibrozil (used to lower cholesterol) - rifampicin (used to treat tuberculosis and other infections) - cimetidine (used to reduce stomach acid) - glucocorticoids (used to treat inflammation) - beta-2-agonists (used to treat asthma) - medicines which increase urine production (diuretics) - medicines used to treat pain and inflammation (NSAID and COX-2-inhibitors, such as ibuprofen and celecoxib) - certain medicines for the treatment of high blood pressure (angiotensin-converting enzyme 
Posebno pomembno je omeniti naslednje: - gemfibrozil (uporablja se za zniževanje holesterola) - rifampicin (uporablja se za zdravljenje tuberkuloze in drugih okužb)
Food had no effect on the AUC and Cmax of pioglitazone when Competact was administered to healthy volunteers. 
Pri zdravih prostovoljcih, ki so dobivali zdravilo Competact hrana ni vplivala na AUC in Cmax pioglitazona.
Maximum daily dose is 1,000 mg. 
30 do 44 Največji dnevni odmerek je 1.000 mg.
Common (may affect up to 1 in 10 people) - localised swelling (oedema) - weight gain - headache - respiratory infection - abnormal vision - joint pain - impotence - blood in urine - reduction in blood count (anaemia) - numbness - taste disturbance 
- impotenca - kri v urinu - zmanjšanje števila krvnih celic (anemija) - odrevenelost - motnje čuta za okušanje
- Acute conditions with the potential to alter renal function such as: Dehydration Severe infection Shock - Intravascular administration of iodinated contrast agents (see section 4.4) - Breast-feeding (see section 4.6) 
- intravenski uporabi jodiranih kontrastnih sredstev (glejte poglavje 4.4); - dojenju (glejte poglavje 4.6).
How to store Competact 
Shranjevanje zdravila Competact
Competact 15 mg/850 mg tablets pioglitazone/metformin hydrochloride 
Competact 15 mg/850 mg tablete pioglitazon/metforminijev klorid
Combinations requiring precautions for use 
NAVODILA ZA UPORABO
Therapy with Competact should not be initiated in patients with increased baseline liver enzyme levels (ALT > 2.5 x upper limit of normal) or with any other evidence of liver disease. 
(ALT > 2,5-kratna zgornja meja normalnih vrednosti) ali s kakršnimi koli drugimi znaki jetrne bolezni, zdravljenja z zdravilom Competact ne smemo začeti.
Very rare (may affect up to 1 in 10,000) - decrease in amount of vitamin B12 in the blood - redness of the skin - itchy skin - raised and itchy rash (hives) 
Zelo redki (pojavi se lahko pri do 1 od 10.000 bolnikov) - znižanje vrednosti vitamina B12 v krvi
- a significant reduction in the absolute risk of myocardial infarction: metformin 11 events/1,000 patient-years, diet alone 18 events/1,000 patient-years, (p=0.01). 
metformin-11 primerov/1.000 bolnikov-let, dieta sama-18 primerov/1.000 bolnikov-let (p = 0,01).
If you stop using Competact, your blood sugar may go up. 
Če zdravilo Competact prenehate jemati, se lahko raven krvnega sladkorja zviša, zato se pred prekinitvijo zdravljenja najprej posvetujte z zdravnikom.
Competact should be discontinued if any deterioration in cardiac status occurs. 
Če se pojavi kakršnokoli poslabšanje srčnega statusa, je treba zdravljenje z zdravilom Competact ukiniti.
Maximum daily dose is 3,000 mg. 
60 do 89 Največji dnevni odmerek je 3.000 mg.
Not known (frequency can not be estimated from the available data) - inflammation of the liver (hepatitis) - liver does not work as well as it should (changes in liver enzymes) 
- vnetje jeter (hepatitis) - motnje v delovanju jeter (sprememba vrednosti jetrnih encimov)
Some medicinal products that can adversely affect renal function which may increase the risk of lactic acidosis, e.g. NSAIDS, including selective cyclo-oxygenase (COX) II inhibitors, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor antagonists and diuretics, especially loop diuretics. 
Kombinacije, pri katerih so potrebni previdnostni ukrepi Nekatera zdravila lahko škodljivo vplivajo na delovanje ledvic, kar lahko poveča tveganje za laktacidozo, npr. nesteroidna protivnetna zdravila, vključno s selektivnimi zaviralci ciklooksigenaze