Drug interactions
Repaglinide + Selpercatinib
Severity: Major
Repaglinide and Selpercatinib: 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
Selpercatinib raises systemic exposure to repaglinide, a sensitive CYP2C8 substrate. Higher repaglinide levels can cause excessive insulin secretion and hypoglycemia.
What this interaction means in plain words
Repaglinide and Selpercatinib 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.
Repaglinide belongs to Endocrine; Selpercatinib belongs to Oncology.
Why it happens
Selpercatinib inhibits CYP2C8, reducing the metabolic clearance of repaglinide.
What to do
Avoid the combination where possible and use an alternative antidiabetic agent. If it cannot be avoided, lower the repaglinide dose and monitor blood glucose closely.
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 Selpercatinib
Other interactions of Repaglinide
- Gemfibrozil + Repaglinide Contraindicated
- Clarithromycin + Repaglinide Major
- Clopidogrel + Repaglinide Major
- Cobicistat + Repaglinide Major
- Cyclosporine + Repaglinide Major
- Cyclosporin + Repaglinide Major
Frequently asked questions
Can I take Repaglinide with Selpercatinib?
MediHelp rates the interaction as major. Repaglinide and Selpercatinib 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. Selpercatinib raises systemic exposure to repaglinide, a sensitive CYP2C8 substrate. Higher repaglinide levels can cause excessive insulin secretion and hypoglycemia.
How serious is the interaction between Repaglinide and Selpercatinib?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible and use an alternative antidiabetic agent. If it cannot be avoided, lower the repaglinide dose and monitor blood glucose closely.
What other medicines interact with Selpercatinib?
MediHelp also lists interactions of Selpercatinib with, for example, Amiodarone, Amisulpride, Amitriptyline. The full list is on the Selpercatinib page.
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