Drug interactions
Itraconazole + Metformin-repaglinide
Severity: Major
Itraconazole and Metformin-repaglinide: major interaction.
Last updated Sources: US FDA label
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
Itraconazole is a strong CYP3A4 inhibitor and raises repaglinide plasma concentrations, particularly when combined with other inhibitors such as gemfibrozil. This can cause prolonged or severe hypoglycemia.
What this interaction means in plain words
Itraconazole 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.
Itraconazole belongs to Anti Fungals; Metformin-repaglinide belongs to Endocrine.
Why it happens
Inhibition of CYP3A4-mediated metabolism of repaglinide reduces its clearance.
What to do
Monitor blood glucose closely and consider reducing the repaglinide dose or choosing an alternative antidiabetic agent during itraconazole therapy. Warn the patient about hypoglycemia symptoms.
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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References
Other interactions of Metformin-repaglinide
Other interactions of Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole Contraindicated
Frequently asked questions
Can I take Itraconazole with Metformin-repaglinide?
MediHelp rates the interaction as major. Itraconazole 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. Itraconazole is a strong CYP3A4 inhibitor and raises repaglinide plasma concentrations, particularly when combined with other inhibitors such as gemfibrozil. This can cause prolonged or severe hypoglycemia.
How serious is the interaction between Itraconazole 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: Monitor blood glucose closely and consider reducing the repaglinide dose or choosing an alternative antidiabetic agent during itraconazole therapy. Warn the patient about hypoglycemia symptoms.
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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