Drug interactions
Lopinavir + Metformin-repaglinide
Severity: Moderate
Lopinavir and Metformin-repaglinide: 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, boosted with ritonavir, can inhibit CYP3A4 and raise repaglinide levels, increasing hypoglycemia risk. Protease inhibitors can also cause insulin resistance and hyperglycemia, which may reduce the efficacy of metformin.
What this interaction means in plain words
Lopinavir and Metformin-repaglinide 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 belongs to Anti Virals; Metformin-repaglinide belongs to Endocrine.
Why it happens
CYP3A4 inhibition (mainly via ritonavir) reduces repaglinide clearance, and protease inhibitors cause insulin resistance.
What to do
Monitor blood glucose closely when starting or stopping lopinavir/ritonavir and adjust the repaglinide dose as needed. Be ready to intensify antidiabetic therapy if hyperglycemia develops.
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 Metformin-repaglinide
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 Lopinavir with Metformin-repaglinide?
MediHelp rates the interaction as moderate. Lopinavir and Metformin-repaglinide 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, boosted with ritonavir, can inhibit CYP3A4 and raise repaglinide levels, increasing hypoglycemia risk. Protease inhibitors can also cause insulin resistance and hyperglycemia, which may reduce the efficacy of metformin.
How serious is the interaction between Lopinavir and Metformin-repaglinide?
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 closely when starting or stopping lopinavir/ritonavir and adjust the repaglinide dose as needed. Be ready to intensify antidiabetic therapy if hyperglycemia develops.
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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