Drug interactions
Linagliptin-metformin + Lopinavir
Severity: Moderate
Linagliptin-metformin and Lopinavir: moderate 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
Lopinavir/ritonavir inhibits CYP3A4 and may modestly raise linagliptin exposure, which is generally well tolerated given linagliptin's wide safety margin. Protease inhibitors can also cause insulin resistance and hyperglycemia, which may reduce the glucose-lowering effect of the combination.
What this interaction means in plain words
Linagliptin-metformin and Lopinavir can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Linagliptin-metformin belongs to Endocrine; Lopinavir belongs to Anti Virals.
Why it happens
CYP3A4 and P-gp inhibition by the ritonavir-boosted protease inhibitor raises linagliptin levels, while protease inhibitor-induced insulin resistance opposes antidiabetic effect.
What to do
Monitor blood glucose and HbA1c after starting or stopping lopinavir and adjust antidiabetic therapy as needed. No empiric linagliptin dose change is required.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Linagliptin-metformin
Other interactions of Lopinavir
- Alfuzosin + Lopinavir Contraindicated
- Avanafil + Lopinavir Contraindicated
- Cisapride + Lopinavir Contraindicated
- Dronedarone + Lopinavir Contraindicated
- Eletriptan + Lopinavir Contraindicated
- Eplerenone + Lopinavir Contraindicated
Frequently asked questions
Can I take Linagliptin-metformin with Lopinavir?
MediHelp rates the interaction as moderate. Linagliptin-metformin and Lopinavir can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Lopinavir/ritonavir inhibits CYP3A4 and may modestly raise linagliptin exposure, which is generally well tolerated given linagliptin's wide safety margin. Protease inhibitors can also cause insulin resistance and hyperglycemia, which may reduce the glucose-lowering effect of the combination.
How serious is the interaction between Linagliptin-metformin and Lopinavir?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood glucose and HbA1c after starting or stopping lopinavir and adjust antidiabetic therapy as needed. No empiric linagliptin dose change is required.
What other medicines interact with Linagliptin-metformin?
MediHelp also lists interactions of Linagliptin-metformin with, for example, Apalutamide, Carbamazepine, Contrast media. The full list is on the Linagliptin-metformin page.
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