Suganon Drug Interactions

In vitro assessment: Evogliptin is mainly metabolized by CYP3A4. In in vitro studies, evogliptin was not an inhibitor of CYP1A2, 2B6, 2C8, 2C9, 2C19, 2D6, and 3A4 enzymes or an inducer of CYP1A2, 2B6, and 3A4 enzymes. Thus, evogliptin is unlikely to cause interactions with other drugs acting as a substrate of such enzymes. Although evogliptin was proved to be a p-glycoprotein (P-gp) substrate and weak BCRP substrate based on in vitro studies, it did not inhibit transport mediated by these transporters. In addition, evogliptin was not a substrate of OAT1, OAT3, OCT2, OATP1B1, and OATP1B3, and did not inhibit them. Therefore, evogliptin is unlikely to cause interactions with drugs that act as a substrate of such transporters in the clinical dose.
In vivo assessment: Interaction of evogliptin with other drugs: i) Metformin: Multiple administration of evogliptin 5 mg and twice daily Metformin 1,000 mg (a substrate of OCT1 and OCT2) until steady state was reached did not show clinically meaningful change in the pharmacokinetics of evogliptin or Metformin.
ii) Clarithromycin: Multiple administration of a potent CYP3A4 inhibitor, clarithromycin 1,000 mg/day, until steady state was reached and single administration of evogliptin 5 mg showed increased C_max of evogliptin by 2.1 times and its AUC by 2.0 times. Caution needs to be exercised as pharmacokinetic exposure of evogliptin may increase with concomitant administration of CYP3A4 inhibitors.
iii) Rifampicin: Multiple administration of a potent CYP3A4 inducer, rifampicin 600 mg/day, until steady state was reached and single administration of evogliptin 5 mg showed no significant change in C_max of evogliptin but showed a decrease in AUC by 63%.