Drug interactions
Atazanavir + Saxagliptin-metformin
Severity: Major
Atazanavir and Saxagliptin-metformin: 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
Atazanavir is a strong CYP3A4 inhibitor and markedly raises saxagliptin exposure. Protease inhibitors may also cause insulin resistance and hyperglycemia that can reduce metformin's effect.
What this interaction means in plain words
Atazanavir and Saxagliptin-metformin 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.
Atazanavir belongs to Anti Virals; Saxagliptin-metformin belongs to Endocrine.
Why it happens
Strong CYP3A4 inhibition reduces saxagliptin metabolism; protease inhibitor-induced insulin resistance opposes metformin.
What to do
Limit the saxagliptin dose to 2.5 mg daily; this may require using separate components instead of the fixed combination. Monitor blood glucose.
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 Saxagliptin-metformin
Other interactions of Atazanavir
- Alfuzosin + Atazanavir Contraindicated
- Atazanavir + Avanafil Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Atazanavir + Eletriptan Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Atazanavir + Ergotamine Contraindicated
Frequently asked questions
Can I take Atazanavir with Saxagliptin-metformin?
MediHelp rates the interaction as major. Atazanavir and Saxagliptin-metformin 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. Atazanavir is a strong CYP3A4 inhibitor and markedly raises saxagliptin exposure. Protease inhibitors may also cause insulin resistance and hyperglycemia that can reduce metformin's effect.
How serious is the interaction between Atazanavir and Saxagliptin-metformin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Limit the saxagliptin dose to 2.5 mg daily; this may require using separate components instead of the fixed combination. Monitor blood glucose.
What other medicines interact with Saxagliptin-metformin?
MediHelp also lists interactions of Saxagliptin-metformin with, for example, Clozapine, Contrast media, Diatrizoate meglumine / diatrizoate. The full list is on the Saxagliptin-metformin page.
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