二甲双胍与阿司匹林

**Drug Interaction Safety Check: Metformin + Aspirin** **Interaction Risk:** Potential (Moderate clinical significance) **Mechanism:** Aspirin may enhance the hypoglycemic effect of metformin. High doses of salicylates (e.g., >2 g/day aspirin) can have intrinsic hypoglycemic activity and may also reduce renal clearance of metformin, potentially increasing the risk of lactic acidosis. **Clinical Recommendation:** - **Low-dose aspirin** (75–325 mg/day for cardioprotection): Generally considered safe. No dose adjustment is routinely required, but monitor blood glucose levels more frequently upon initiation or dose changes. - **High-dose aspirin** (anti-inflammatory doses, e.g., >2 g/day): Use with caution. Increased risk of hypoglycemia and lactic acidosis. Consider alternative anti-inflammatory therapy if possible. - **Monitoring:** Blood glucose, renal function (serum creatinine/eGFR), and signs/symptoms of lactic acidosis (e.g., malaise, myalgia, respiratory distress, abdominal pain). **Severity:** Moderate – Requires monitoring and caution, especially with high-dose aspirin or in patients with renal impairment. **Note:** This is a general safety check. Individual patient factors (e.g., renal function, age, concurrent medications) must be considered. Please consult a clinical pharmacist or physician for personalized assessment.