Drug interactions
Fluconazole + Glimepiride-pioglitazone
Severity: Major
Fluconazole and Glimepiride-pioglitazone: 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
Fluconazole inhibits CYP2C9, which metabolizes glimepiride, so glimepiride levels rise and hypoglycemia can be prolonged or severe. Fluconazole may also raise pioglitazone exposure via CYP2C8 and CYP3A4 inhibition.
What this interaction means in plain words
Fluconazole and Glimepiride-pioglitazone 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.
Fluconazole belongs to Anti Fungals; Glimepiride-pioglitazone belongs to Endocrine.
Why it happens
Fluconazole inhibits CYP2C9 (and to a lesser extent CYP2C8 and CYP3A4), reducing sulfonylurea and pioglitazone clearance.
What to do
Monitor blood glucose closely and reduce the glimepiride dose when fluconazole is started. Consider an alternative antifungal if feasible.
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 Glimepiride-pioglitazone
Other interactions of Fluconazole
- Dihydroergotamine intranasal + Fluconazole Contraindicated
- Dihydroergotamine + Fluconazole Contraindicated
- Dofetilide + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole Contraindicated
- Flibanserin + Fluconazole Contraindicated
Frequently asked questions
Can I take Fluconazole with Glimepiride-pioglitazone?
MediHelp rates the interaction as major. Fluconazole and Glimepiride-pioglitazone 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. Fluconazole inhibits CYP2C9, which metabolizes glimepiride, so glimepiride levels rise and hypoglycemia can be prolonged or severe. Fluconazole may also raise pioglitazone exposure via CYP2C8 and CYP3A4 inhibition.
How serious is the interaction between Fluconazole and Glimepiride-pioglitazone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood glucose closely and reduce the glimepiride dose when fluconazole is started. Consider an alternative antifungal if feasible.
What other medicines interact with Glimepiride-pioglitazone?
MediHelp also lists interactions of Glimepiride-pioglitazone with, for example, Gemfibrozil, Insulin aspart, Insulin degludec. The full list is on the Glimepiride-pioglitazone page.
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