Drug Interactions between Kimyrsa and linagliptin

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Coadministration with potent inducers of the CYP450 3A4 isoenzyme and/or P-glycoprotein efflux transporter may significantly decrease the plasma concentrations of linagliptin, which is a substrate for both. The interaction may produce subtherapeutic and likely ineffective plasma concentrations of linagliptin. According to the product labeling, coadministration of linagliptin (5 mg orally once daily) with the potent CYP450 3A4/P-glycoprotein inducer rifampin (600 mg once daily) to steady state resulted in decreases to linagliptin peak plasma concentration (Cmax) by 44% and systemic exposure (AUC) by 40% compared to administration alone.

MANAGEMENT: Due to the potential for reduced efficacy of linagliptin, coadministration with potent CYP450 3A4 and/or P-glycoprotein inducers such as carbamazepine, dexamethasone, enzalutamide, phenobarbital, phenytoin, rifamycins, and St. John's wort should generally be avoided. For patients requiring use of such drugs, an alternative to linagliptin is strongly recommended. Other known inducers of CYP450 3A4 include aminoglutethimide, barbiturates, bexarotene, bosentan, dabrafenib, efavirenz, modafinil, nafcillin, nevirapine, and various other anticonvulsants, although the extent to which they interact with linagliptin is unknown. If concomitant use with these agents is necessary, glycemic control should be closely monitored.