Drug interactions
Apalutamide + Metformin-repaglinide
Severity: Major
Apalutamide and Metformin-repaglinide: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Apalutamide is a strong CYP3A4 and CYP2C8 inducer and can substantially reduce repaglinide exposure. This may cause loss of glycemic control.
What this interaction means in plain words
Apalutamide and Metformin-repaglinide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Apalutamide belongs to Endocrine; Metformin-repaglinide belongs to Endocrine.
Why it happens
Induction of CYP3A4 and CYP2C8 metabolism of repaglinide by apalutamide.
What to do
Monitor blood glucose closely and titrate repaglinide upward if needed, or switch to an alternative antidiabetic agent. Reassess dosing after apalutamide is stopped.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Metformin-repaglinide
Other interactions of Apalutamide
- Apalutamide + Cabotegravir Contraindicated
- Apalutamide + Cobicistat Contraindicated
- Apalutamide + Doravirine Contraindicated
- Apalutamide + Elbasvir / grazoprevir Contraindicated
- Apalutamide + Ensitrelvir Contraindicated
- Apalutamide + Fostemsavir Contraindicated
Frequently asked questions
Can I take Apalutamide with Metformin-repaglinide?
MediHelp rates the interaction as major. Apalutamide and Metformin-repaglinide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Apalutamide is a strong CYP3A4 and CYP2C8 inducer and can substantially reduce repaglinide exposure. This may cause loss of glycemic control.
How serious is the interaction between Apalutamide and Metformin-repaglinide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood glucose closely and titrate repaglinide upward if needed, or switch to an alternative antidiabetic agent. Reassess dosing after apalutamide is stopped.
What other medicines interact with Metformin-repaglinide?
MediHelp also lists interactions of Metformin-repaglinide with, for example, Gemfibrozil, Clarithromycin, Clopidogrel. The full list is on the Metformin-repaglinide page.
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