Drug interactions
Saxagliptin-metformin + St john's wort
Severity: Moderate
Saxagliptin-metformin 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 P-gp, which may lower saxagliptin and its active metabolite exposure. The result may be somewhat reduced glucose-lowering effect, though the effect on saxagliptin is likely modest.
What this interaction means in plain words
Saxagliptin-metformin 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
Induction of CYP3A4 (and P-gp) increases saxagliptin clearance.
What to do
Monitor glycemic control (blood glucose and HbA1c) and consider avoiding St John's wort or adjusting therapy if control worsens.
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 Saxagliptin-metformin
Frequently asked questions
Can I take Saxagliptin-metformin with St john's wort?
MediHelp rates the interaction as moderate. Saxagliptin-metformin 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 P-gp, which may lower saxagliptin and its active metabolite exposure. The result may be somewhat reduced glucose-lowering effect, though the effect on saxagliptin is likely modest.
How serious is the interaction between Saxagliptin-metformin 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: Monitor glycemic control (blood glucose and HbA1c) and consider avoiding St John's wort or adjusting therapy if control worsens.
What other medicines interact with Saxagliptin-metformin?
MediHelp also lists interactions of Saxagliptin-metformin with, for example, Atazanavir, Clozapine, Contrast media. The full list is on the Saxagliptin-metformin page.
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