Practice · Interactions · continued

[2026 update] Antibiotics and a course of something with delayed emptying posts 91–98

Practice › Interactions metformin needs a source delayed gastric emptying insulin

This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.

l.ibarraTL2Regular26 Jul 2026#91

On post #87 — agreed on the reasoning, with one qualification.

Metformin: commonly co-administered and relevant to gastrointestinal tolerability. Gastrointestinal side effects can overlap and additive. Taking them separately or adjusting one if tolerability is poor are reasonable approaches.

2 likes 2d

a.kirchnerTL2 Moderator26 Jul 2026 · edited#92

s.karlsen_rph, post #22: Metformin: commonly co-administered and relevant to gastrointestinal tolerability. Gastrointestinal side effects can overlap and additive. Taking them separately or adjusting one if tolerability is poor are reasonable approaches. Go to post

Sulfonylureas and meglitinides: these agents stimulate insulin release and carry hypoglycemia risk. Combining them with semaglutide or tirzepatide requires dose adjustment of the secretagogue and close monitoring. The combination is not contraindicated but requires active management.

0 likes in reply to #22 2d

resistance_firstTL2Regular26 Jul 2026#93

e.lehtinen, post #84: Practical note that does not fit anywhere else. Whatever you conclude from this topic, write down what you did and when. The single most useful thing in your own records is not any individual result; it is that they are dated and consecutive. Go to post

Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing.

The correction was fair and I had been repeating something I had not checked carefully enough.

21 likes in reply to #84 2d

a.delgadoTL2 Moderator26 Jul 2026#94

Supplements and herbs: many have no established interaction. Some do. If you are taking something unusual, checking a reference (like a pharmacist) is more useful than guessing from forum discussion.

9 likes 1d

preregisteredTL3Research methods27 Jul 2026#95

Worth separating two things that post #91 runs together.

Vitamins: most vitamins have no significant interaction. Fat-soluble vitamins (A, D, E, K) might be affected by the slowing of fat absorption during weight loss, but that is a nutritional consequence rather than an interaction.

5 likes 1d

j.vogelTL2 Moderator27 Jul 2026#96

j.vandermolen, post #13: Coming back to post #11, because the follow-up matters more than the original answer. Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing. The correction was fair and I had been repeating something I had not checked carefully enough. Go to post

post #95 is right about the mechanism and I think understates the practical bit.

For anyone arriving from a search: the marked solution above is the direct answer, and the replies underneath it add the caveats that make it safe to use.

0 likes in reply to #13 1d

appeals_deskTL3Regular27 Jul 2026#97

k.marchand, post #77: Vitamins: most vitamins have no significant interaction. Fat-soluble vitamins (A, D, E, K) might be affected by the slowing of fat absorption during weight loss, but that is a nutritional consequence rather than an interaction. Go to post

28 likes in reply to #77 18h

y.rahimiTL2 Moderator27 Jul 2026#98

Food interactions: most interactions are absorption interactions. Some medications absorb better with food, others better on an empty stomach. With an incretin agonist that already slows gastric emptying, food effects interact with the drug effect as well.

14 likes 13h

This topic was referenced in

Alcohol: what is documented and what is folklore — the long versionPractice › Interactions · 13 replies

Moved from Side effects by s.leclerc. Category placement is not obvious from outside and getting it wrong is expected. This topic will get better answers here. The move is recorded in the public log citing R7.

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