Drug interactions
Metformin-repaglinide + Trimethoprim
Severity: Moderate
Metformin-repaglinide and Trimethoprim: 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
Trimethoprim can raise exposure to both metformin and repaglinide. Higher repaglinide levels may cause hypoglycemia, and higher metformin levels increase the risk of adverse effects including lactic acidosis, especially in renal impairment.
What this interaction means in plain words
Metformin-repaglinide and Trimethoprim 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; Trimethoprim belongs to Anti Bacterial.
Why it happens
Trimethoprim inhibits CYP2C8 (reducing repaglinide metabolism) and renal OCT2/MATE transporters (reducing metformin secretion).
What to do
Monitor blood glucose and renal function during co-therapy, and reduce the antidiabetic dose if hypoglycemia or declining renal function occurs. Consider another antibiotic in patients with renal impairment.
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 Trimethoprim
Frequently asked questions
Can I take Metformin-repaglinide with Trimethoprim?
MediHelp rates the interaction as moderate. Metformin-repaglinide and Trimethoprim 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. Trimethoprim can raise exposure to both metformin and repaglinide. Higher repaglinide levels may cause hypoglycemia, and higher metformin levels increase the risk of adverse effects including lactic acidosis, especially in renal impairment.
How serious is the interaction between Metformin-repaglinide and Trimethoprim?
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 renal function during co-therapy, and reduce the antidiabetic dose if hypoglycemia or declining renal function occurs. Consider another antibiotic in patients with renal impairment.
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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