Medscape Staff Report
Sept. 29, 2003 — The U.S. Food and Drug Administration announced today that an adverse drug reaction has been seen during co-administration of repaglinide (Prandin), a short-acting insulin secretagogue, and gemfibrozil (Lopid), a lipid-lowering agent used to treat dyslipidemia.
A study that evaluated the co-administration of gemfibrozil with repaglinide in healthy subjects found a significant increase in repaglinide blood levels. Concomitant use may result in enhanced and prolonged blood glucose-lowering effects of repaglinide. Co-administration of itraconazole (Sporanox), an antifungal, with gemfibrozil and repaglinide further increased such effects.
According to the "Drug-Drug Interactions" section of repaglinide's updated labeling, co-administration of both gemfibrozil and itraconazole with repaglinide resulted in a 19-fold higher repaglinide area under the curve and prolonged repaglinide half-life to 6.1 hours. Plasma repaglinide concentration at 7 hours increased 28.6-fold with gemfibrozil co-administration and 70.4-fold with the gemfibrozil-itraconazole combination.
For patients already receiving repaglinide and gemfibrozil, blood glucose levels should be monitored and repaglinide dose adjustment may be needed, recommended a letter to healthcare professionals from Novo-Nordisk, the maker of Prandin.
Reviewed by Gary D. Vogin, MD
Medscape Medical News © 2003
Cite this: Adverse Drug Reaction Seen With Repaglinide and Gemfibrozil - Medscape - Sep 29, 2003.