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Gemfibrozil Enhances, Prolongs Repaglinide Effects

KEY POINT

Concomitant use of repaglinide (Prandin— Novo Nordisk) and gemfibrozil should be avoided because of a hepatic cytochrome (CYP) microsomal drug interaction between the drugs. If patients have already been taking both drugs or they need both drugs, doses of repaglinide might require reduction to avoid hypoglycemia. In addition, clinicians need to be aware that the interaction is substantially more pronounced if the patient also receives the CYP3A4 inhibitor itraconazole (Sporanox—Janssen), and the three drugs should not be used simultaneously.

SOURCES

Niemi M et al. Effects of gemfibrozil, itraconazole, and their combination on the pharmacokinetics and pharmacodynamics of repaglinide: potentially hazardous interaction between gemfibrozil and repaglinide. Diabetologia. 2003;46:347–51.

FDA MedWatch alert. http://www.fda.gov/medwatch/SAFETY/2003/safety03.htm#prandin