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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 (a substrate of CYP3A4, CYP2C8, and OATP) with both gemfibrozil (an inhibitor of both CYP2C8 and OATP) and itraconazole (CYP3A4 inhibitor) may have 20-fold increases in repaglinide plasma concentrations. (See CYP Table at front of book for other CYP2C8 and OATP inhibitors.)


Class 3: Assess Risk & Take Action if Necessary