Drug interactions
Letermovir + Metformin-repaglinide
Severity: Major
Letermovir 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
Letermovir can raise exposure to CYP2C8 and OATP1B1/3 substrates like repaglinide, which increases the risk of hypoglycemia. The effect is greater when cyclosporine is also given, and labeling advises against that triple use.
What this interaction means in plain words
Letermovir 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.
Letermovir belongs to Anti Virals; Metformin-repaglinide belongs to Endocrine.
Why it happens
Letermovir inhibits CYP2C8 and OATP1B1/3, reducing repaglinide clearance and uptake.
What to do
Avoid repaglinide when letermovir is given with cyclosporine. Otherwise monitor blood glucose closely and reduce the repaglinide dose as needed.
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 Letermovir
- Ergotamine + Letermovir Contraindicated
- Letermovir + Pimozide Contraindicated
- Apalutamide + Letermovir Major
- Atorvastatin + Letermovir Major
- Carbamazepine + Letermovir Major
- Colchicine + Letermovir Major
Frequently asked questions
Can I take Letermovir with Metformin-repaglinide?
MediHelp rates the interaction as major. Letermovir 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. Letermovir can raise exposure to CYP2C8 and OATP1B1/3 substrates like repaglinide, which increases the risk of hypoglycemia. The effect is greater when cyclosporine is also given, and labeling advises against that triple use.
How serious is the interaction between Letermovir 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 repaglinide when letermovir is given with cyclosporine. Otherwise monitor blood glucose closely and reduce the repaglinide dose as needed.
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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