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gemfibrozil oral

Repaglinide/Gemfibrozil

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Severe. These medicines may interact and cause very harmful effects and are usually not taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Gemfibrozil may slow down how quickly your liver processes repaglinide.

What might happen:

The amount of repaglinide in your blood may increase and it may lower your blood sugar too much.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know right away that you are taking these medicines together. Your doctor may want to change your cholesterol medicine or adjust the dose of your repaglinide. You may need to check your blood sugar more often while taking these medicines together. Let your doctor know if you have any symptoms of low blood sugar, such as sweating, rapid heartbeat, and dizzinessYour healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

References:

1.Niemi M, Backman JT, Neuvonen M, Neuvonen PJ. Effects of gemfibrozil, itraconazole, and their combination on the pharmacokinetics and pharmacodynamics of repaglinide: potentially hazardous interaction between gemfibrozil and repaglinide. Diabetologia 2003 Mar;46(3):347-51.
2.PrandiMet (repaglinide-metformin) US prescribing information. Novo Nordisk, Inc. March, 2012.
3.Lopid (gemfibrozil) US prescribing information. Pfizer Pharmaceuticals, Ltd. October, 2013.
4.Prandin (repaglinide) US prescribing information. Novo Nordisk Pharmaceuticals, Inc. June, 2009.
5.GlucoNorm (repaglinide) Canadian prescribing information. NovoNordisk March 1, 2005.
6.Niemi M, Backman JT, Juntti-Patinen L, Neuvonen M, Neuvonen PJ. Coadministration of gemfibrozil and itraconazole has only a minor effect on the pharmacokinetics of the CYP2C9 and CYP3A4 substrate nateglinide. Br J Clin Pharmacol 2005 Aug;60(2):208-17.
7.US Food and Drug Administration (FDA). Drug Development and Drug Interactions: Table of Substrates, Inhibitors and Inducers. Available at: http://www.fda.gov/Drugs/DevelopmentApprovalProcess/DevelopmentResources/D rugInteractionsLabeling/ucm093664.htm. Updated 08/05/2011.
8.Gan J, Chen W, Shen H, Gao L, Hong Y, Tian Y, Li W, Zhang Y, Tang Y, Zhang H, Humphreys WG, Rodrigues AD. Repaglinide-gemfibrozil drug interaction: inhibition of repaglinide glucuronidation as a potential additional contributing mechanism. Br J Clin Pharmacol 2010 Dec;70(6):870-80.
9.Honkalammi J, Niemi M, Neuvonen PJ, Backman JT. Dose-dependent interaction between gemfibrozil and repaglinide in humans: strong inhibition of CYP2C8 with subtherapeutic gemfibrozil doses. Drug Metab Dispos 2011 Oct; 39(10):1977-86.
10.Kajosaari LI, Backman JT, Neuvonen M, Laitila J, Neuvonen PJ. Lack of effect of bezafibrate and fenofibrate on the pharmacokinetics and pharmacodynamics of repaglinide. Br J Clin Pharmacol 2004 Oct; 58(4):390-6.

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