The improvement of the therapy of the metabolic syndrome, obesity, and type 2 diabetes is an important task which may be realized through the co-administration of herbal and synthetic medicines. The tincture and extract obtained from the aerial part of goutweed (Aegopodium podagraria L.) have been shown to possess antidiabetic and organoprotective properties. Goutweed tincture exerts a permissive effect on the action of metformin in dexamethasone-treated diabetic rats. Aim. The objective of this study is to determine the efficacy of the combined use of goutweed tincture and extract with metformin on the model of the primary disorder of the lipid metabolism. Materials and Methods. The model was used that presupposed administration of protamine sulfate to rats (10 mg/kg per day intramuscularly) against the background of atherogenic diet with the additional administration of cholestrol. Goutweed extract and tincture (1 g/kg and 1 ml/kg intragastrically, respectively), metformin (50 mg/kg intragastrically) and their combinations were administered during the whole period of model development. The lipid composition of the liver and blood plasma, as well as the content of glycogen in the liver were studied, and, as this model is accompanied with insulin resistance, glucose tolerance test was carried out. Results. It has been shown that all studied drugs and their combinations normalize the lipid composition of the liver, reducing the content of cholesterol and triglycerides and increasing the level of phospholipids. They do not significantly influence on the lipid spectrum of the blood plasma, tend to elevate the level of liver glycogen, their efficacy does not change in combined use. Goutweed tincture and metformin in combination, but not per se, completely normalize area under glucose curve that is significantly increased in the untreated group, the extract does not change this value. Conclusions. Goutweed extract and tincture normalize the lipid composition of the liver in rats with lipid and carbohydrate metabolism disorders caused by protamine sulfate and atherogenic diet, the tincture also exerts a permissive effect on the action of metformin on glucose metabolism, but not on lipid metabolism. (For citation: Tovchiga OV, Gorbatch TV, Shtrygol’ SYu, et al. The effects of goutweed (Aegopodium podagraria L.) preparations and their combinations with metformin in rats with the disorders of the lipid and carbohydrate metabolism induced by protamine sulphate. Reviews on Clinical Pharmacology and Drug Therapy. 2017;15(2):31-41. doi: 10.17816/RCF15231-41).