Clinically and pharmacologically relevant interactions of antidiabetic drugs
Open accessAbstract
Patients with type 2 diabetes mellitus often require multifactorial pharmacological treatment due to different comorbidities. An increasing number of concomitantly taken medications elevate the risk of the patient experiencing adverse drug effects or drug interactions. Drug interactions can be divided into pharmacokinetic and pharmacodynamic interactions affecting cytochrome (CYP) enzymes, absorption properties, transporter activities and receptor affinities. Furthermore, nutrition, herbal supplements, patient’s age and gender are of clinical importance. Relevant drug interactions are predominantly related to sulfonylureas, thiazolidinediones and glinides. Although metformin has a very low interaction potential, caution is advised when drugs that impair renal function are used concomitantly. With the exception of saxagliptin, dipeptidyl peptidase-4 (DPP-4) inhibitors also show a low interaction potential, but all drugs affecting the drug transporter P-glycoprotein should be used with caution. Incretin mimetics and sodium–glucose cotransporter-2 (SGLT-2) inhibitors comprise a very low interaction potential and are therefore recommended as an ideal combination partner from the clinical–pharmacologic point of view.
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Other medication classes often encountered in oral surgery patients that may increase DDI risk include antidiabetic drugs such as GLP-1 agonists and SGLT2 inhibitors, statins, antiepileptics, and antiresorptive osteoporosis drugs associated with medication-related osteonecrosis of the jaw.
“Other medication classes often encountered in oral surgery patients that may increase the risk of DDI include antidiabetic drugs (such as GLP-1 agonists and SGLT2 inhibitors) [13], statins [14], antiepileptics [15,16] and antiresorptive osteoporosis drugs, which are associated with medication-related osteonecrosis of the jaw (MRONJ) [17][18][19][20].”
From Comparing Artificial Intelligence (ChatGPT, Gemini, DeepSeek) and Oral Surgeons in Detecting Clinically Relevant Drug–Drug Interactions in Dental Therapy (2025) · cites this paper as [13]
The GLP-1 analogs section reports a possible additive hypoglycemic effect with sulfonylureas, and the SGLT-2 inhibitors section identifies a few interactions, so these antidiabetic drugs can present DDI risks. The paper also says no clinically relevant drug–drug interactions had been described for exenatide or liraglutide and that SGLT-2 inhibitors generally show none apart from specified exceptions. It does not establish that these drugs are often encountered in oral surgery patients; the statin, antiepileptic, and osteoporosis-drug clauses have separate citations and are not attributed to this source. (LLM, conf=0.85)
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- Authors
- May, M., & Schindler, C.
- Affiliations
- Medizinische Hochschule Hannover (DE)
- Corresponding author
- Schindler, Christoph
- Venue
- Therapeutic Advances in Endocrinology and Metabolism
- Publisher
- SAGE Publications
- Published
- 2016-03-31
- Volume
- 7
- Issue
- 2
- Pages
- 69-83
- ISSN
- 2042-0188 (ISSN-L)
- 2042-0196
- PMC
- PMC4821002
- OpenAlex
- W2324536277
- Cited by
- 160
- References
- 11
- Citations by year
- 2026: 12 · 2025: 15 · 2024: 15 · 2023: 12 · 2022: 15 · 2021: 22 · 2020: 14 · 2019: 14 · 2018: 17 · 2017: 10 · 2016: 14
- FWCI
- 2.70
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Therapeutic Advances in Endocrinology and Metabolism (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacogenetics and Drug Metabolism
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- drug interactions, antidiabetic drugs, type 2 diabetes, pharmacokinetic interactions, pharmacodynamic interactions, cytochrome P450, sulfonylureas, thiazolidinediones, glinides, metformin, renal dysfunction, DPP-4 inhibitors, saxagliptin, herbal supplements, SGLT2 inhibitors, incretin mimetics, adverse drug reactions
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