Drug interactions
Repaglinide + St john's wort
Severity: Moderate
Repaglinide and St john's wort: 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
St John's wort induces CYP3A4 and may reduce repaglinide levels, weakening glycemic control. Stopping the herb may raise repaglinide levels again.
What this interaction means in plain words
Repaglinide and St john's wort 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.
Why it happens
St John's wort induces CYP3A4 (via PXR activation), increasing repaglinide metabolism.
What to do
Advise avoiding St John's wort or monitor blood glucose and adjust the repaglinide dose when it is started or stopped.
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 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 St john's wort?
MediHelp rates the interaction as moderate. Repaglinide and St john's wort 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. St John's wort induces CYP3A4 and may reduce repaglinide levels, weakening glycemic control. Stopping the herb may raise repaglinide levels again.
How serious is the interaction between Repaglinide and St john's wort?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Advise avoiding St John's wort or monitor blood glucose and adjust the repaglinide dose when it is started or stopped.
What other medicines interact with Repaglinide?
MediHelp also lists interactions of Repaglinide with, for example, Gemfibrozil, Clarithromycin, Clopidogrel. The full list is on the Repaglinide page.
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