Drug interactions
Itraconazole + Repaglinide
Severity: Major
Itraconazole and 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 can increase repaglinide exposure, raising the risk of prolonged or severe hypoglycemia. The effect is more pronounced when itraconazole is combined with other inhibitors of repaglinide metabolism.
What this interaction means in plain words
Itraconazole 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.
Itraconazole belongs to Anti Fungals; Repaglinide belongs to Endocrine.
Why it happens
Inhibition of CYP3A4 and possibly OATP1B1 transport, reducing repaglinide clearance.
What to do
Monitor blood glucose closely and reduce the repaglinide dose when starting itraconazole. Counsel the patient on recognizing hypoglycemia.
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 Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole Contraindicated
Other interactions of Repaglinide
- Gemfibrozil + Repaglinide Contraindicated
- Clarithromycin + Repaglinide Major
- Clopidogrel + Repaglinide Major
- Cobicistat + Repaglinide Major
- Cyclosporin + Repaglinide Major
- Deferasirox + Repaglinide Major
Frequently asked questions
Can I take Itraconazole with Repaglinide?
MediHelp rates the interaction as major. Itraconazole 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. Itraconazole can increase repaglinide exposure, raising the risk of prolonged or severe hypoglycemia. The effect is more pronounced when itraconazole is combined with other inhibitors of repaglinide metabolism.
How serious is the interaction between Itraconazole 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: Monitor blood glucose closely and reduce the repaglinide dose when starting itraconazole. Counsel the patient on recognizing hypoglycemia.
What other medicines interact with Itraconazole?
MediHelp also lists interactions of Itraconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Itraconazole page.
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