Drug interactions
Empagliflozin-linagliptin + Fosphenytoin
Severity: Major
Empagliflozin-linagliptin and Fosphenytoin: 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
Fosphenytoin is converted to phenytoin, a strong inducer of CYP3A4 and P-glycoprotein, which can substantially lower linagliptin exposure. Loss of linagliptin effect may lead to worsened glycemic control.
What this interaction means in plain words
Empagliflozin-linagliptin and Fosphenytoin 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.
Empagliflozin-linagliptin belongs to Endocrine; Fosphenytoin belongs to Central Nervous System.
Why it happens
Phenytoin induces CYP3A4 and P-glycoprotein, increasing linagliptin clearance.
What to do
Linagliptin labeling advises an alternative to strong inducers; use a different antidiabetic agent where possible, otherwise monitor glucose and HbA1c 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 Empagliflozin-linagliptin
Other interactions of Fosphenytoin
- Dronedarone + Fosphenytoin Contraindicated
- Fosphenytoin + Ledipasvir-sofosbuvir Contraindicated
- Fosphenytoin + Lorlatinib Contraindicated
- Fosphenytoin + Lurasidone Contraindicated
- Fosphenytoin + Ranolazine Contraindicated
- Fosphenytoin + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
Frequently asked questions
Can I take Empagliflozin-linagliptin with Fosphenytoin?
MediHelp rates the interaction as major. Empagliflozin-linagliptin and Fosphenytoin 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. Fosphenytoin is converted to phenytoin, a strong inducer of CYP3A4 and P-glycoprotein, which can substantially lower linagliptin exposure. Loss of linagliptin effect may lead to worsened glycemic control.
How serious is the interaction between Empagliflozin-linagliptin and Fosphenytoin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Linagliptin labeling advises an alternative to strong inducers; use a different antidiabetic agent where possible, otherwise monitor glucose and HbA1c closely.
What other medicines interact with Empagliflozin-linagliptin?
MediHelp also lists interactions of Empagliflozin-linagliptin with, for example, Rifampin, Rifapentine, Amiloride. The full list is on the Empagliflozin-linagliptin page.
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