Gemfibrozil and Selexipag: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Selexipag
Gemfibrozil
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 selexipag exposure and an increased exposure of its active metabolite
Interaction Deep Dive
Concomitant use of selexipag (a strong CYP2C8 substrate) and gemfibrozil (a strong CYP2C8 inhibitor) is contraindicated as this has resulted in significantly increased exposure of selexipag and its active metabolite. During pharmacokinetic studies, coadministration of gemfibrozil (a strong CYP2C8 inhibitor) and selexipag resulted in a 2-fold increase in selexipag exposure and an 11-fold increase in the exposure of its active metabolite1.
Why it happens (mechanism)
Inhibition of CYP2C8-mediated metabolism of selexipag
Literature reports
1 report — tap to read
a) During pharmacokinetic studies, coadministration of gemfibrozil (a strong CYP2C8 inhibitor) and selexipag resulted in a 2-fold increase in selexipag exposure and an 11-fold increase in the exposure of its active metabolite 1.
Common questions
Can I take Gemfibrozil and Selexipag together?
Increased selexipag exposure and an increased exposure of its active metabolite Always confirm with your pharmacist or prescriber before making any change.
How serious is the Gemfibrozil and Selexipag interaction?
It is rated contraindicated. These should generally not be used together.
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 Gemfibrozil or Selexipag 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 a safer alternative to one of these medications for me?
References (1)
- Product Information: UPTRAVI® oral tablets, intravenous injection, selexipag oral tablets, intravenous injection. Actelion Pharmaceuticals US Inc, Titusville, NJ, 2026. DailyMed
Keep reading about Selexipag
Keep reading about Gemfibrozil
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