Drug interactions
Clopidogrel + Repaglinide
Severity: Major
Clopidogrel and 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, through its acyl glucuronide metabolite, inhibits CYP2C8 and markedly raises repaglinide exposure. This increases the risk of prolonged or severe hypoglycemia.
What this interaction means in plain words
Clopidogrel and 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; Repaglinide belongs to Endocrine.
Why it happens
Inhibition of CYP2C8-mediated repaglinide metabolism by clopidogrel's glucuronide metabolite.
What to do
Avoid the combination where possible and choose another antidiabetic agent. If it must be used, reduce the repaglinide dose to the lowest level, cap the daily dose per labeling, and 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 Clopidogrel
Other interactions of Repaglinide
- Gemfibrozil + Repaglinide Contraindicated
- Clarithromycin + Repaglinide Major
- Cobicistat + Repaglinide Major
- Cyclosporine + Repaglinide Major
- Cyclosporin + Repaglinide Major
- Deferasirox + Repaglinide Major
Frequently asked questions
Can I take Clopidogrel with Repaglinide?
MediHelp rates the interaction as major. Clopidogrel and 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, through its acyl glucuronide metabolite, inhibits CYP2C8 and markedly raises repaglinide exposure. This increases the risk of prolonged or severe hypoglycemia.
How serious is the interaction between Clopidogrel and 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 where possible and choose another antidiabetic agent. If it must be used, reduce the repaglinide dose to the lowest level, cap the daily dose per labeling, and monitor blood glucose closely.
What other medicines interact with Clopidogrel?
MediHelp also lists interactions of Clopidogrel with, for example, Ombitasvir / paritaprevir / ritonavir and dasabuvir, Abrocitinib, Acetylsalicylic acid. The full list is on the Clopidogrel page.
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