Drug interactions
Clopidogrel + Metformin-repaglinide
Severity: Major
Clopidogrel 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
Clopidogrel's acyl glucuronide metabolite inhibits CYP2C8 and increases repaglinide exposure substantially, raising the risk of hypoglycemia.
What this interaction means in plain words
Clopidogrel 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.
Clopidogrel belongs to Cardiovascular; Metformin-repaglinide belongs to Endocrine.
Why it happens
Inhibition of CYP2C8-mediated repaglinide metabolism by clopidogrel's glucuronide metabolite.
What to do
Avoid the combination if possible; if needed, begin repaglinide at 0.5 mg per meal and do not exceed 4 mg daily. Monitor blood glucose closely.
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 Clopidogrel
Frequently asked questions
Can I take Clopidogrel with Metformin-repaglinide?
MediHelp rates the interaction as major. Clopidogrel 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. Clopidogrel's acyl glucuronide metabolite inhibits CYP2C8 and increases repaglinide exposure substantially, raising the risk of hypoglycemia.
How serious is the interaction between Clopidogrel 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: Avoid the combination if possible; if needed, begin repaglinide at 0.5 mg per meal and do not exceed 4 mg daily. Monitor blood glucose closely.
What other medicines interact with Metformin-repaglinide?
MediHelp also lists interactions of Metformin-repaglinide with, for example, Gemfibrozil, Apalutamide, Clarithromycin. The full list is on the Metformin-repaglinide page.
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