Drug interactions
Linagliptin-metformin + St john's wort
Severity: Moderate
Linagliptin-metformin and St john's wort: 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
St John's wort induces CYP3A4 and P-glycoprotein and can lower linagliptin exposure, potentially reducing glycemic control. The effect varies with the preparation and duration of use.
What this interaction means in plain words
Linagliptin-metformin and St john's wort 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.
Why it happens
Induction of CYP3A4 and P-gp by hyperforin increases linagliptin clearance.
What to do
Avoid concurrent use where possible; if used, monitor glucose and HbA1c and reassess therapy if control worsens. Review glycemia again when St John's wort is stopped.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Linagliptin-metformin and St john's wort, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Linagliptin-metformin
Frequently asked questions
Can I take Linagliptin-metformin with St john's wort?
MediHelp rates the interaction as moderate. Linagliptin-metformin and St john's wort 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. St John's wort induces CYP3A4 and P-glycoprotein and can lower linagliptin exposure, potentially reducing glycemic control. The effect varies with the preparation and duration of use.
How serious is the interaction between Linagliptin-metformin and St john's wort?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use where possible; if used, monitor glucose and HbA1c and reassess therapy if control worsens. Review glycemia again when St John's wort is stopped.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
