Drug interactions
Metformin-repaglinide + Mitotane
Severity: Moderate
Metformin-repaglinide and Mitotane: 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
Mitotane is a strong CYP3A4 inducer that can substantially lower concentrations of CYP3A4 substrates, including repaglinide. Loss of glycemic control may result, and the induction can persist for weeks after mitotane is stopped.
What this interaction means in plain words
Metformin-repaglinide and Mitotane 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.
Metformin-repaglinide belongs to Endocrine; Mitotane belongs to Oncology.
Why it happens
Induction of CYP3A4 increases the hepatic and intestinal metabolism of repaglinide.
What to do
Monitor blood glucose and titrate the repaglinide dose upward if control worsens, or consider another antidiabetic. Reduce the dose again if mitotane is stopped, as the induction wanes slowly.
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 Mitotane
- Doravirine + Mitotane Contraindicated
- Fostemsavir + Mitotane Contraindicated
- Lorlatinib + Mitotane Contraindicated
- Abiraterone + Mitotane Major
- Apixaban + Mitotane Major
- Aprepitant + Mitotane Major
Frequently asked questions
Can I take Metformin-repaglinide with Mitotane?
MediHelp rates the interaction as moderate. Metformin-repaglinide and Mitotane 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. Mitotane is a strong CYP3A4 inducer that can substantially lower concentrations of CYP3A4 substrates, including repaglinide. Loss of glycemic control may result, and the induction can persist for weeks after mitotane is stopped.
How serious is the interaction between Metformin-repaglinide and Mitotane?
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 titrate the repaglinide dose upward if control worsens, or consider another antidiabetic. Reduce the dose again if mitotane is stopped, as the induction wanes slowly.
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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