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Interacting Drugs

OBJECT DRUGS

Antidiabetic Agents (CYP3A4 Substrates):

PRECIPITANT DRUGS

Antimicrobials:


Comment:

Some antimicrobials can reduce oral hypoglycemic metabolism and produce hypoglycemic episodes. Pioglitazone and repaglinide are also metabolized by CYP2C8, and people taking a CYP2C8 inhibitor in addition to a CYP3A4 inhibitor may have large interactions. For example, patients taking repaglinide with both gemfibrozil (CYP2C8 inhibitor) and itraconazole (CYP3A4 inhibitor) may have 20-fold increases in repaglinide plasma concentrations. (See CYP Table at front of book for other CYP2C8 inhibitors.)


Class 3: Assess Risk & Take Action if Necessary