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Drug Interactions between metformin / saxagliptin and posaconazole

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

posaconazole sAXagliptin

Applies to: posaconazole and metformin / saxagliptin

Consumer information for this interaction is not currently available.

ADJUST DOSE: Coadministration with potent inhibitors of CYP450 3A4 may significantly alter the plasma concentrations of saxagliptin and its pharmacologically active metabolite, both of which are substrates of the isoenzyme. In one study, administration of a single 100 mg dose of saxagliptin in combination with the potent inhibitor ketoconazole (200 mg every 12 hours at steady state) resulted in increases to saxagliptin peak plasma concentration (Cmax) by 62% and systemic exposure (AUC) by 2.5-fold. These changes were accompanied by corresponding decreases in the Cmax and AUC of the active metabolite by 95% and 88%, respectively. The pharmacokinetics of ketoconazole were not significantly affected, with Cmax and AUC decreasing by just 16% and 13%, respectively. In another study, saxagliptin Cmax increased by 2.4-fold and AUC increased by 3.7-fold during coadministration of a single 20 mg dose of saxagliptin with ketoconazole (200 mg every 12 hours at steady state), while Cmax and AUC of the active metabolite decreased by 96% and 90%, respectively. However, some authorities suggest that these pharmacokinetic effects on saxagliptin and its metabolite are not clinically meaningful.

MANAGEMENT: The daily dosage of saxagliptin should not exceed 2.5 mg daily when used in combination with potent CYP450 3A4 inhibitors such as itraconazole, ketoconazole, voriconazole, nefazodone, delavirdine, protease inhibitors, and ketolide and certain macrolide antibiotics. The use of fixed combinations of dapaglifozin-saxagliptin with potent CYP450 3A4 inhibitors is not recommended.

Drug and food interactions

Major

metFORMIN food

Applies to: metformin / saxagliptin

MetFORMIN should be taken with meals, and excessive alcohol intake (either short-term binge drinking or frequent consumption) should be avoided during treatment. Taking metFORMIN with alcohol may increase the risk of a rare but serious and potentially life-threatening condition known as lactic acidosis, which is a buildup of lactic acid in the blood that can occasionally occur during treatment with metformin-containing products. Lactic acidosis is more likely to occur if you have kidney or liver disease, acute or unstable congestive heart failure, or dehydration. You should seek immediate medical attention if you develop potential signs and symptoms of lactic acidosis such as fatigue, weakness, muscle pain, increasing drowsiness, abdominal pain or discomfort, slow or irregular heartbeat, breathing difficulty, chills, and other unusual symptoms. Alcohol may also affect blood glucose levels in patients with diabetes. Both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) may occur, depending on how much and how often you drink. You should avoid using alcohol if your diabetes is not well controlled or if you have high triglycerides, neuropathy (nerve damage), or pancreatitis. Moderate alcohol consumption generally does not affect blood glucose levels if your diabetes is under control. However, you should limit your alcohol intake due to the risk of lactic acidosis with metformin. Avoid drinking alcohol on an empty stomach or following exercise, as it may increase the risk of hypoglycemia. Talk to your doctor or pharmacist if you have any questions or concerns about metformin.

Moderate

posaconazole food

Applies to: posaconazole

Food significantly increases the absorption of posaconazole from the tablet or suspension formulations. The manufacturer recommends that you take the tablet with food and the oral suspension during or immediately (within 20 minutes) after a full meal. If you cannot eat a full meal, you should take the oral suspension with a liquid nutritional supplement like Ensure or an acidic carbonated beverage like ginger ale. Do not take these medications on an empty stomach, as it may lead to inadequate blood levels and reduced effectiveness. Ask your doctor before using alcohol together with posaconazole from delayed release suspension formulations as this may cause an increase in side effects. Talk to your doctor or pharmacist if you have any questions on how to use the medication properly.

Moderate

sAXagliptin food

Applies to: metformin / saxagliptin

Alcohol may affect blood glucose levels in patients with diabetes. Both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) may occur, depending on how much and how often you drink. You should avoid using alcohol if your diabetes is not well controlled or if you have high triglycerides, neuropathy (nerve damage), or pancreatitis. Moderate alcohol consumption generally does not affect blood glucose levels if your diabetes is under control. However, it may be best to limit alcohol intake to one drink daily for women and two drinks daily for men (1 drink = 5 oz wine, 12 oz beer, or 1.5 oz distilled spirits) in conjunction with your normal meal plan. Avoid drinking alcohol on an empty stomach or following exercise, as it may increase the risk of hypoglycemia. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.