Deferasirox and Repaglinide: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Repaglinide
Deferasirox
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased repaglinide plasma concentrations
Interaction Deep Dive
Concomitant administration of repaglinide and a CYP2C8 inhibitor may increase exposure to repaglinide. In a study of healthy volunteers, concomitant use of repaglinide and deferasirox 30 mg/kg/day resulted in increases in repaglinide AUC and Cmax of 2.3-fold2 and in a case report, severe hypoglycemia requiring hospitalization was reported when repaglinide was given with abiraterone, a strong CYP2C8 inhibitor 3. Reduce the dose of repaglinide and increase the frequency of glucose monitoring if concurrent use is clinically indicated 1.
Why it happens (mechanism)
Inhibition of CYP2C8-mediated repaglinide metabolism
Literature reports
2 reports — tap to read
a) Coadministration of deferasirox and repaglinide increased repaglinide exposure in a study with 24 healthy participants. In the study, deferasirox 30 mg/kg was administered once daily for 3 days; on the fourth day participants received a single oral dose of repaglinide 0.5 mg. Results showed that coadministration with deferasirox increased AUC and mean Cmax values of repaglinide by 2.3-fold. Glucose AUC decreased from 63.6 mmol x hr/L to 62 mmol x hr/L with concomitant administration 2.
b) A 79-year-old man receiving repaglinide 4 mg/day for type 2 diabetes mellitus experienced severe hypoglycemia (less than 30 mg/dL) requiring hospitalization, 5 days following initiation of abiraterone plus prednisone as third-line treatment for metastatic castration-resistant prostate cancer. Interruption and subsequent reinitiation of abiraterone coadministered with repaglinide given at a 50% dosage reduction caused a severe hypoglycemia event to reoccur. Repaglinide was discontinued and the patient was initiated on insulin 3.
Common questions
Can I take Deferasirox and Repaglinide together?
Increased repaglinide plasma concentrations Always confirm with your pharmacist or prescriber before making any change.
How serious is the Deferasirox and Repaglinide interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Deferasirox or Repaglinide need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (3)
- Product Information: PRANDIN(R) oral tablets, repaglinide oral tablets. Novo Nordisk Inc. (per FDA), Plainsboro, NJ, 2017. DailyMed
- Skerjanec A, Wang J, Maren K, et al: Investigation of the pharmacokinetic interactions of deferasirox, a once-daily oral iron chelator, with midazolam, rifampin, and repaglinide in healthy volunteers. J Clin Pharmacol 2010; 50(2):205-213. PubMed
- Tucci M, Roca E, Ferrari L, et al: Abiraterone and prednisone therapy may cause severe hypoglycemia when administered to prostate cancer patients with type 2 diabetes receiving glucose-lowering agents. Endocrine 2019; 64(3):724-726. PubMed
Keep reading about Repaglinide
Keep reading about Deferasirox
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
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