Clopidogrel with Repaglinide Interaction Details

Brand Names Associated with Clopidogrel

  • Clopidogrel
  • Plavix®

Brand Names Associated with Repaglinide

  • Prandimet® (as a combination product containing Metformin, Repaglinide)
  • Prandin®
  • Repaglinide

Medical Content Editor
Last updated Nov 11, 2023

Curious for more information about this interaction?

Ask our pharmacists directly!

Reach out to us

Interaction Effect

Increased repaglinide exposure

Interaction Summary

Concomitant use of clopidogrel, a strong CYP2C8 inhibitor, and repaglinide, a CYP2C8 substrate, has resulted in increased repaglinide exposure and significantly reduced blood glucose levels compared with control in a study in healthy volunteers. Avoid concomitant use . If coadministration is necessary, initiate repaglinide with 0.5 mg before each meal and adjust based on blood glucose levels; do not exceed a total daily dose of 4 mg .

Severity

Major

Onset

Rapid

Evidence

Probable

How To Manage Interaction

Concomitant use of clopidogrel and repaglinide should be avoided. Coadministration has resulted in increased repaglinide exposure and significantly reduced blood glucose levels . If coadministration is necessary, initiate repaglinide at 0.5 mg before each meal and adjust based on blood glucose levels; do not exceed a total daily dose of 4 mg .

Mechanism Of Interaction

Inhibition of CYP2C8-mediated metabolism of repaglinide by clopidogrel metabolite

Literature Reports

A) In a study of 9 healthy volunteers, coadministration of clopidogrel 300 mg on day 1, followed by 75 mg daily for 2 consecutive days, and repaglinide 0.25 mg administered 1 hour after clopidogrel on days 1 and 3 increased repaglinide AUC(0 to infinity) by a significant 5.1-fold on day 1 and a significant 3.9-fold on day 3 compared with control. In addition, the mean blood glucose level was significantly lower until 3 hours after repaglinide administration, with the minimum blood glucose concentrations being 3.3 +/- 0.6 mmol/L on day 1 and 3.9 +/- 0.6 mmol/L on day 3 compared with 4.4 +/- 0.5 mmol/L for control .

Clopidogrel Overview

  • Clopidogrel is used alone or with aspirin to prevent serious or life-threatening problems with the heart and blood vessels in people who have had a stroke, heart attack, or severe chest pain. This includes people who have percutaneous coronary intervention (PCI; angioplasty; a type of heart surgery) that may involve inserting coronary stents (metal tubes surgically placed in clogged blood vessels to improve blood flow) or who have coronary artery bypass grafting (CABG; a type of heart surgery). Clopidogrel is also used to prevent serious or life-threatening problems with the heart and blood vessels in people who have peripheral arterial disease (poor circulation in the blood vessels that supply blood to the legs). Clopidogrel is in a class of medications called antiplatelet medications. It works by preventing platelets (a type of blood cell) from collecting and forming clots that may cause a heart attack or stroke.

See More information Regarding Clopidogrel

Repaglinide Overview

  • Repaglinide is used to treat type 2 diabetes (condition in which the body does not use insulin normally and, therefore, cannot control the amount of sugar in the blood). Repaglinide helps your body regulate the amount of glucose (sugar) in your blood. It decreases the amount of glucose by stimulating the pancreas to release insulin.

  • Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems.Taking medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye problems, including changes or loss of vision, or gum disease. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes.

  • This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

See More information Regarding Repaglinide

Return To Our Drug Interaction Homepage

Feedback, Question Or Comment About This Information?

Ask , our medical editor, directly! He's always more than happy to assist.

Definitions

Severity Categories

Contraindicated

These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.


Major

This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.


Moderate

This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.


Minor

While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.

Onset

Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.

Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.

Evidence

Level of documentation of the interaction.

Established: The interaction is documented and substantiated in peer-reviewed medical literature.

Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.

How To Manage The Interaction

Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.

It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.

Mechanism Of Interaction

The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.

Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.

Where Does Our Information Come From?

Information for our drug interactions is compiled from several drug compendia, including:

The prescribing information for each drug, as published on DailyMED, is also used. 

Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.

The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.