Linagliptin is not an inducer of CYP isozymes.
In vivo interaction studies, linagliptin is considered unlikely to cause interactions with other P-gp substrates.
Co-administration of multiple three times daily doses of 850mg metformin with 10mg linagliptin once daily did not clinical meaningfully alter the pharmacokinetics of linagliptin in healthy volunteers.
Clinically relevant interactions would not be expected with other P-glycoprotein/CYP3A4 inhibitors. Multiple daily doses of linagliptin had a minimal effect on the steady-state pharmacokinetics of simvastatin, a sensitive CYP3A4 substrate, in healthy volunteers. Following administration of a supratherapeutic dose of 10mg linagliptin concomitantly with 40mg of simvastatin daily for 6 days, the plasma AUC of simvastatin was increased by 34%, and the plasma Cmax by 10%.
Co-administration with 5mg linagliptin did not alter the steady-state pharmacokinetics of levonorgestrel or ethinylestradiol.