Drug Interaction Report

Linagliptin and Mitotane: Interaction Details

A pharmacist-reviewed analysis of the Linagliptin and Mitotane interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Mitotane

Lysodren
+

Linagliptin

Tradjenta Tradjenta® Trijardy® (as a combination product containing Empagliflozin, Linagliptin, Metformin)
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
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.

Of 165 documented Linagliptin interactions, 100 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
theoretical
Severity
Major

What happens

Reduced linagliptin exposure

Interaction Deep Dive

Coadministration of linagliptin (a CYP3A4 substrate) with strong CYP3A4 inducers may reduce linagliptin exposure and lead to a loss of linagliptin efficacy. AUC and Cmax of linagliptin decreased by 40% and 44%, respectively, with concurrent use of the strong CYP3A4 inducer rifampin. Selection of an alternative to the CYP3A4 inducer, with no or minimal enzyme induction potential12, or use of an alternative treatment (other than linagliptin) is strongly recommended 3.

Why it happens (mechanism)

Induction of CYP3A4-mediated linagliptin metabolism

Literature reports

1 report — tap to read

a) AUC and Cmax of a linagliptin 5 mg once daily steady-state regimen decreased by 40% and 44%, respectively, with concurrent use of the strong CYP3A4 inducer rifampin 600 mg/day 12.

Common questions

Can I take Linagliptin and Mitotane together?

Reduced linagliptin exposure Always confirm with your pharmacist or prescriber before making any change.

How serious is the Linagliptin and Mitotane interaction?

It is rated major. Potentially serious — often needs a change or close 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 "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

Questions for your pharmacist

  • Does my dose of Linagliptin or Mitotane 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 (3)

  1. Product Information: GLYXAMBI(R) oral tablets, empagliflozin linagliptin oral tablets. Boehringer Ingelheim Pharmaceuticals Inc. (per manufacturer), Ridgefield, CT, 2015. DailyMed
  2. Product Information: Tradjenta(R) oral tablets, linagliptin oral tablets. Boehringer Ingelheim Pharmaceuticals, Inc. (per FDA), Ridgefield, CT, 2014. DailyMed
  3. Product Information: JENTADUETO(R) XR oral extended-release tablets, linagliptin metformin HCl oral extended-release tablets. Boehringer Ingelheim Pharmaceuticals, Inc. and Eli Lilly and Company (per FDA), Ridgefield, CT, 2017. DailyMed
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Mitotane

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Linagliptin

Keep reading about Linagliptin

All Linagliptin interactions (165) Linagliptin drug information
Also serious with: Ensitrelvir Pramlintide Ofloxacin Otic Pimozide
Beyond drug–drug

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:

Mitotane + Activated Charcoal Coffee Charcoal European Mandrake Glucomannan Guar Gum Gum Arabic Slippery Elm Tragacanth + 9 more
Linagliptin + Activated Charcoal Siberian Cocklebur St. John's Wort Acai Adrafinil African Wild Potato Agaricus Mushroom Agmatine + 276 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.