Drug interactions
Metformin-pioglitazone + Selexipag
Severity: Minor
Metformin-pioglitazone and Selexipag: minor 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
Selexipag's active metabolite is formed and cleared via CYP2C8-related pathways, and strong CYP2C8 inhibitors markedly raise exposure. Pioglitazone is only a weak CYP2C8 inhibitor, so any effect is likely small. Higher exposure could cause headache, diarrhea, nausea and jaw pain.
What this interaction means in plain words
Metformin-pioglitazone and Selexipag have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Metformin-pioglitazone belongs to Endocrine; Selexipag belongs to Cardiovascular.
Why it happens
Possible weak CYP2C8 inhibition by pioglitazone reducing selexipag metabolism.
What to do
Monitor for prostacyclin-related adverse effects when pioglitazone is started. Adjust selexipag dose if not tolerated.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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Other interactions of Metformin-pioglitazone
Other interactions of Selexipag
- Gemfibrozil + Selexipag Contraindicated
- Abiraterone + Selexipag Moderate
- Apalutamide + Selexipag Moderate
- Carbamazepine + Selexipag Moderate
- Clopidogrel + Selexipag Moderate
- Cyclosporin + Selexipag Moderate
Frequently asked questions
Can I take Metformin-pioglitazone with Selexipag?
MediHelp rates the interaction as minor. Metformin-pioglitazone and Selexipag have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Selexipag's active metabolite is formed and cleared via CYP2C8-related pathways, and strong CYP2C8 inhibitors markedly raise exposure. Pioglitazone is only a weak CYP2C8 inhibitor, so any effect is likely small. Higher exposure could cause headache, diarrhea, nausea and jaw pain.
How serious is the interaction between Metformin-pioglitazone and Selexipag?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for prostacyclin-related adverse effects when pioglitazone is started. Adjust selexipag dose if not tolerated.
What other medicines interact with Metformin-pioglitazone?
MediHelp also lists interactions of Metformin-pioglitazone with, for example, Contrast media, Diatrizoate meglumine / diatrizoate, Diatrizoate. The full list is on the Metformin-pioglitazone page.
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