Drug interactions
Letermovir + Repaglinide
Severity: Major
Letermovir and 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 inhibits OATP1B1/3 and CYP3A and may raise repaglinide exposure, and repaglinide can also inhibit OATP1B1. When letermovir is given with cyclosporine the effect on repaglinide is larger, with a risk of hypoglycemia.
What this interaction means in plain words
Letermovir 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.
Letermovir belongs to Anti Virals; Repaglinide belongs to Endocrine.
Why it happens
Letermovir inhibits OATP1B1/3 and CYP3A, reducing repaglinide clearance, an effect enhanced by cyclosporine.
What to do
Avoid repaglinide when letermovir is used with cyclosporine. Otherwise monitor blood glucose 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 Repaglinide
- Gemfibrozil + Repaglinide Contraindicated
- Clarithromycin + Repaglinide Major
- Clopidogrel + Repaglinide Major
- Cobicistat + Repaglinide Major
- Cyclosporine + Repaglinide Major
- Cyclosporin + Repaglinide Major
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 Repaglinide?
MediHelp rates the interaction as major. Letermovir 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. Letermovir inhibits OATP1B1/3 and CYP3A and may raise repaglinide exposure, and repaglinide can also inhibit OATP1B1. When letermovir is given with cyclosporine the effect on repaglinide is larger, with a risk of hypoglycemia.
How serious is the interaction between Letermovir 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: Avoid repaglinide when letermovir is used with cyclosporine. Otherwise monitor blood glucose and reduce the repaglinide dose as needed.
What other medicines interact with Repaglinide?
MediHelp also lists interactions of Repaglinide with, for example, Gemfibrozil, Clarithromycin, Clopidogrel. The full list is on the Repaglinide page.
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