Interaction between Repaglinide and Semaglutide
Moderate Synergy

ID DDInter1581 and DDInter1660
Interaction Coadministration of a glucagon-like peptide-1 (GLP-1) receptor agonist with an insulin secretagogue (e.g., sulfonylurea, meglitinide) may potentiate the risk of hypoglycemia. GLP-1 receptor agonists lower blood glucose by stimulating insulin secretion and lowering glucagon secretion.
Management A lower dosage of the insulin secretagogue may be required when used in combination with a GLP-1 receptor agonist. Blood glucose should be monitored closely, and patients should be counseled to recognize the symptoms of hypoglycemia such as headache, dizziness, drowsiness, nervousness, confusion, tremor, hunger, weakness, perspiration, palpitation, and tachycardia. If hypoglycemia occurs, patients should initiate appropriate remedial therapy immediately and contact their physician. Patients should also be advised to take precautions to avoid hypoglycemia while driving or operating hazardous machinery.
References
Alternative for Repaglinide A10B
Pioglitazone
Semaglutide
Troglitazone
Alogliptin
Dulaglutide
Liraglutide
Rosiglitazone
Albiglutide
Acarbose
Miglitol
Ertugliflozin
More
Alternative for Semaglutide A10B
Tolazamide
Acetohexamide
Chlorpropamide
Repaglinide
Miglitol
Tolbutamide

Potential Metabolism Interactions

Substrate-Substrate Interaction：If more than one drug is metabolized by the same CYP, it is possible that its metabolism is inhibited because of the competition between the drugs. That means, it can be useful to lower the dosage of the drugs in the drug-cocktail because they remain longer in the organism than in monotherapy.
Inhibitor-Inhibitor Interaction：Combining two or more inhibitors of one CYP, should be compensated by lowering the dosage of these drugs because the metabolism is reduced and the drugs remain longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.
Inhibitor-Substrate Interaction：Combining drugs that have inhibitory effect and are substrates of one particular CYP, should be compensated by lowering the dosage. They rest longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.