Drug interactions
Gemfibrozil + Glimepiride-pioglitazone
Severity: Major
Gemfibrozil 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
Gemfibrozil strongly inhibits CYP2C8, increasing pioglitazone exposure severalfold. This raises the risk of dose-related adverse effects such as edema, weight gain, heart failure and hypoglycemia with glimepiride.
What this interaction means in plain words
Gemfibrozil 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.
Gemfibrozil belongs to Cardiovascular; Glimepiride-pioglitazone belongs to Endocrine.
Why it happens
Inhibition of CYP2C8-mediated pioglitazone metabolism by gemfibrozil.
What to do
Limit pioglitazone to no more than 15 mg daily with gemfibrozil, per labeling, or use fenofibrate instead. Monitor glucose and for fluid retention.
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 Gemfibrozil
- Daprodustat + Gemfibrozil Contraindicated
- Elagolix + Gemfibrozil Contraindicated
- Gemfibrozil + Mavacamten Contraindicated
- Gemfibrozil + Metformin-repaglinide Contraindicated
- Gemfibrozil + Ombitasvir / paritaprevir / ritonavir and dasabuvir Contraindicated
- Gemfibrozil + Repaglinide Contraindicated
Frequently asked questions
Can I take Gemfibrozil with Glimepiride-pioglitazone?
MediHelp rates the interaction as major. Gemfibrozil 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. Gemfibrozil strongly inhibits CYP2C8, increasing pioglitazone exposure severalfold. This raises the risk of dose-related adverse effects such as edema, weight gain, heart failure and hypoglycemia with glimepiride.
How serious is the interaction between Gemfibrozil 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: Limit pioglitazone to no more than 15 mg daily with gemfibrozil, per labeling, or use fenofibrate instead. Monitor glucose and for fluid retention.
What other medicines interact with Glimepiride-pioglitazone?
MediHelp also lists interactions of Glimepiride-pioglitazone with, for example, Fluconazole, Insulin aspart, Insulin degludec. The full list is on the Glimepiride-pioglitazone page.
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