Glimepiride and Saxagliptin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Saxagliptin
Glimepiride
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 risk of hypoglycemia
Interaction Deep Dive
Concurrent administration of sAXagliptin and insulin or insulin secretagogues may cause an increased risk of hypoglycemia. Rates of symptomatic hypoglycemia were increased with sAXagliptin added onto insulin or to sulfonylureas in clinical studies. A lower dose of the insulin or insulin secretagogue may be required to reduce the risk of hypoglycemia12.
Why it happens (mechanism)
Additive hypoglycemia
Literature reports
4 reports — tap to read
a) In a drug interaction study, coadministration of metFORMIN 1000 mg and sAXagliptin 100 mg resulted in increased sAXagliptin AUC and Cmax by 1.11-fold and 1.11-fold, respectively 1.
b) In a drug interaction study, coadministration of glyBURIDE 5 mg and sAXagliptin 10 mg resulted in increased sAXagliptin AUC and Cmax by 0.98-fold and 1.08-fold, respectively 21.
c) In an add-on to insulin trial (N=455), the rate of confirmed symptomatic hypoglycemia was higher with sAXagliptin 5 mg compared with placebo (5.3% vs 3.3%), including in those patients who were also receiving insulin in combination with metFORMIN where the rate was 4.8% with add-on sAXagliptin versus 1.9% with placebo 2.
d) In a sAXagliptin add-on to metFORMIN plus sulfonylurea trial of 257 patients, the overall reported incidence of hypoglycemia was 10.1% with sAXagliptin 5 mg versus 6.3% with placebo. Hypoglycemia was confirmed in 1.6% of patients who received sAXagliptin versus none of those who received placebo 2.
Common questions
Can I take Glimepiride and Saxagliptin together?
Increased risk of hypoglycemia Always confirm with your pharmacist or prescriber before making any change.
How serious is the Glimepiride and Saxagliptin 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 Glimepiride or Saxagliptin 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 (2)
- Product Information: ONGLYZA(R) oral tablets, saxagliptin oral tablets. AstraZeneca Pharmaceuticals LP (per FDA), Wilmington, DE, 2024. DailyMed
- Product Information: KOMBIGLYZE(R) XR oral extended-release tablets, saxagliptin metformin HCl oral extended-release tablets. AstraZeneca Pharmaceuticals LP (per FDA), Wilmington, DE, 2024.
Keep reading about Saxagliptin
Keep reading about Glimepiride
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:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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