Drug interactions
Captopril + Glimepiride
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Overview
ACE inhibitors may potentiate the hypoglycemic effect of sulfonylureas, increasing risk of symptomatic hypoglycemia, especially after ACE inhibitor initiation or dose changes and in patients with renal impairment or advanced age.
Mechanism of action
Pharmacodynamic: ACE inhibition can increase insulin sensitivity and peripheral glucose uptake (kinin/prostaglandin-mediated). No clinically meaningful CYP-mediated pharmacokinetic interaction expected.
Clinical management
Monitor capillary blood glucose more frequently for 1–2 weeks after starting or adjusting captopril; consider reducing the glimepiride dose if low readings occur or patient has a history of hypoglycemia; educate on recognition and treatment of hypoglycemia; reassess glycemic targets and renal function and adjust therapy as needed.
Drug reference
References
- Captopril Tablets, USP — Prescribing Information (DailyMed) — FDA Label
- Glimepiride (Amaryl) — Prescribing Information (DailyMed) — FDA Label
- ACE Inhibitors and Sulfonylureas: Drug Interaction Monograph — Lexicomp
- Sulfonylureas: Pharmacology, toxicity, and drug interactions — UpToDate
Frequently asked questions
Can I take Captopril with Glimepiride?
The interaction is rated: Moderate. ACE inhibitors may potentiate the hypoglycemic effect of sulfonylureas, increasing risk of symptomatic hypoglycemia, especially after ACE inhibitor initiation or dose changes and in patients with renal impairment or advanced age.
How serious is the interaction between Captopril and Glimepiride?
The interaction is rated: Moderate. Evidence level: Moderate.
How is the interaction between Captopril and Glimepiride managed?
Monitor capillary blood glucose more frequently for 1–2 weeks after starting or adjusting captopril; consider reducing the glimepiride dose if low readings occur or patient has a history of hypoglycemia; educate on recognition and treatment of hypoglycemia; reassess glycemic targets and renal function and adjust therapy as needed.
Why do Captopril and Glimepiride interact?
Pharmacodynamic: ACE inhibition can increase insulin sensitivity and peripheral glucose uptake (kinin/prostaglandin-mediated). No clinically meaningful CYP-mediated pharmacokinetic interaction expected.
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