Drug interactions
Metformin-repaglinide + Ombitasvir / paritaprevir / ritonavir and dasabuvir
Severity: Major
Metformin-repaglinide and Ombitasvir / paritaprevir / ritonavir and dasabuvir: major 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
This regimen contains ritonavir and other agents that inhibit CYP3A4 and transporters. It may raise repaglinide exposure and cause hypoglycemia, and dasabuvir (a CYP2C8 substrate/inhibitor effect on glucuronide) may further increase repaglinide. Metformin exposure is not markedly changed, but lactic acidosis risk persists in renal impairment.
What this interaction means in plain words
Metformin-repaglinide and Ombitasvir / paritaprevir / ritonavir and dasabuvir can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Inhibition of CYP3A4 and CYP2C8 (and OATP1B1) by ritonavir, paritaprevir and dasabuvir reduces repaglinide clearance.
What to do
Monitor blood glucose closely and reduce the repaglinide dose or choose another agent during treatment. Check renal function and watch for signs of lactic acidosis with metformin.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Metformin-repaglinide
Frequently asked questions
Can I take Metformin-repaglinide with Ombitasvir / paritaprevir / ritonavir and dasabuvir?
MediHelp rates the interaction as major. Metformin-repaglinide and Ombitasvir / paritaprevir / ritonavir and dasabuvir can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. This regimen contains ritonavir and other agents that inhibit CYP3A4 and transporters. It may raise repaglinide exposure and cause hypoglycemia, and dasabuvir (a CYP2C8 substrate/inhibitor effect on glucuronide) may further increase repaglinide. Metformin exposure is not markedly changed, but lactic acidosis risk persists in renal impairment.
How serious is the interaction between Metformin-repaglinide and Ombitasvir / paritaprevir / ritonavir and dasabuvir?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood glucose closely and reduce the repaglinide dose or choose another agent during treatment. Check renal function and watch for signs of lactic acidosis with metformin.
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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