Drug interactions
Pioglitazone + Selexipag
Severity: Moderate
Pioglitazone and Selexipag: 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
Selexipag's active metabolite is formed and cleared via CYP2C8-related pathways, and pioglitazone is a moderate CYP2C8 inhibitor. Coadministration may raise selexipag and active metabolite exposure, increasing prostacyclin-type adverse effects such as headache, flushing, diarrhea and hypotension.
What this interaction means in plain words
Pioglitazone and Selexipag 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.
Pioglitazone belongs to Endocrine; Selexipag belongs to Cardiovascular.
Why it happens
Inhibition of CYP2C8 reduces metabolism of selexipag and its active metabolite.
What to do
Reduce selexipag to once-daily dosing when used with a moderate CYP2C8 inhibitor, and return to the usual schedule after the inhibitor is stopped. Monitor tolerability.
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 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 Pioglitazone with Selexipag?
MediHelp rates the interaction as moderate. Pioglitazone and Selexipag 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. Selexipag's active metabolite is formed and cleared via CYP2C8-related pathways, and pioglitazone is a moderate CYP2C8 inhibitor. Coadministration may raise selexipag and active metabolite exposure, increasing prostacyclin-type adverse effects such as headache, flushing, diarrhea and hypotension.
How serious is the interaction between Pioglitazone and Selexipag?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce selexipag to once-daily dosing when used with a moderate CYP2C8 inhibitor, and return to the usual schedule after the inhibitor is stopped. Monitor tolerability.
What other medicines interact with Pioglitazone?
MediHelp also lists interactions of Pioglitazone with, for example, Insulin aspart-insulin aspart protamine, Insulin aspart, Insulin degludec-insulin aspart. The full list is on the Pioglitazone page.
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