Drug interactions
Clarithromycin + Glyburide-metformin
Severity: Major
Clarithromycin and Glyburide-metformin: major interaction.
Last updated
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.
Summary
Clarithromycin has been associated with severe hypoglycemia in patients taking sulfonylureas such as glyburide. Cases have required emergency treatment, particularly in older adults and those with renal impairment.
What this interaction means in plain words
Clarithromycin and Glyburide-metformin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Clarithromycin belongs to Anti Bacterial; Glyburide-metformin belongs to Endocrine.
Why it happens
Clarithromycin may raise glyburide exposure through CYP3A4 and P-glycoprotein inhibition and may also stimulate insulin release.
What to do
Where possible choose a non-macrolide antibiotic such as doxycycline or a different agent. If co-prescribed, monitor blood glucose closely and consider reducing the glyburide dose.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Glyburide-metformin
Other interactions of Clarithromycin
- Astemizole + Clarithromycin Contraindicated
- Avanafil + Clarithromycin Contraindicated
- Cisapride + Clarithromycin Contraindicated
- Clarithromycin + Colchicine Contraindicated
- Clarithromycin + Conivaptan Contraindicated
- Clarithromycin + Dihydroergotamine Contraindicated
Frequently asked questions
Can I take Clarithromycin with Glyburide-metformin?
MediHelp rates the interaction as major. Clarithromycin and Glyburide-metformin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Clarithromycin has been associated with severe hypoglycemia in patients taking sulfonylureas such as glyburide. Cases have required emergency treatment, particularly in older adults and those with renal impairment.
How serious is the interaction between Clarithromycin and Glyburide-metformin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Where possible choose a non-macrolide antibiotic such as doxycycline or a different agent. If co-prescribed, monitor blood glucose closely and consider reducing the glyburide dose.
What other medicines interact with Glyburide-metformin?
MediHelp also lists interactions of Glyburide-metformin with, for example, Bosentan, Cholic acid, Contrast media. The full list is on the Glyburide-metformin page.
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