Drug interactions
Indinavir + Saxagliptin-metformin
Severity: Major
Indinavir 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
Indinavir is a strong CYP3A4 inhibitor and markedly increases saxagliptin exposure. Protease inhibitors can also cause insulin resistance and hyperglycemia, reducing the benefit of metformin.
What this interaction means in plain words
Indinavir 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.
Why it happens
Strong CYP3A4/5 inhibition reduces saxagliptin clearance, and protease inhibitor-induced insulin resistance antagonizes metformin.
What to do
The fixed-dose combination cannot be reduced to saxagliptin 2.5 mg/day as labeled for strong CYP3A4 inhibitors, so use separate components or an alternative. Monitor 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 Saxagliptin-metformin
Frequently asked questions
Can I take Indinavir with Saxagliptin-metformin?
MediHelp rates the interaction as major. Indinavir 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. Indinavir is a strong CYP3A4 inhibitor and markedly increases saxagliptin exposure. Protease inhibitors can also cause insulin resistance and hyperglycemia, reducing the benefit of metformin.
How serious is the interaction between Indinavir 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: The fixed-dose combination cannot be reduced to saxagliptin 2.5 mg/day as labeled for strong CYP3A4 inhibitors, so use separate components or an alternative. Monitor glucose closely.
What other medicines interact with Saxagliptin-metformin?
MediHelp also lists interactions of Saxagliptin-metformin with, for example, Atazanavir, Clozapine, Contrast media. The full list is on the Saxagliptin-metformin page.
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