Drug interactions
Ketoconazole + Metformin-repaglinide
Severity: Major
Ketoconazole and Metformin-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
Ketoconazole is a strong CYP3A4 inhibitor and increases repaglinide exposure, raising the risk of hypoglycemia. The effect is greater when CYP2C8 is also inhibited.
What this interaction means in plain words
Ketoconazole 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.
Ketoconazole belongs to Anti Fungals; Metformin-repaglinide belongs to Endocrine.
Why it happens
Inhibition of CYP3A4-mediated repaglinide metabolism by ketoconazole.
What to do
Avoid the combination where possible, or reduce the repaglinide dose and monitor blood glucose frequently during and after therapy.
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 Metformin-repaglinide
Other interactions of Ketoconazole
- Alfuzosin + Ketoconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Avanafil + Ketoconazole Contraindicated
- Conivaptan + Ketoconazole Contraindicated
- Dihydroergotamine intranasal + Ketoconazole Contraindicated
- Dihydroergotamine + Ketoconazole Contraindicated
Frequently asked questions
Can I take Ketoconazole with Metformin-repaglinide?
MediHelp rates the interaction as major. Ketoconazole 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. Ketoconazole is a strong CYP3A4 inhibitor and increases repaglinide exposure, raising the risk of hypoglycemia. The effect is greater when CYP2C8 is also inhibited.
How serious is the interaction between Ketoconazole 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: Avoid the combination where possible, or reduce the repaglinide dose and monitor blood glucose frequently during and after therapy.
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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