Drug interactions
Glibenclamide + Miconazole
Severity: Major
Glibenclamide and Miconazole: major interaction.
Last updated Sources: US FDA label
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
Glyburide is metabolized by CYP2C9 and CYP3A4, both inhibited by miconazole. Increased levels can cause severe and prolonged hypoglycemia, and cases have been reported with miconazole. The risk is greater in elderly patients and those with renal impairment.
What this interaction means in plain words
Glibenclamide and Miconazole 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.
Glibenclamide belongs to Endocrine; Miconazole belongs to Anti Fungals.
Why it happens
Miconazole inhibits CYP2C9 and CYP3A4, reducing glyburide clearance.
What to do
Monitor blood glucose frequently and counsel on hypoglycemia symptoms. Reduce the glyburide dose or switch to a non-azole antifungal or alternative agent 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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References
Other interactions of Miconazole
Other interactions of Glibenclamide
- Bosentan + Glibenclamide Contraindicated
- Cholic acid + Glibenclamide Major
- Ciprofloxacin + Glibenclamide Major
- Clarithromycin + Glibenclamide Major
- Fluconazole + Glibenclamide Major
- Glibenclamide + Insulin degludec-liraglutide Major
Frequently asked questions
Can I take Glibenclamide with Miconazole?
MediHelp rates the interaction as major. Glibenclamide and Miconazole 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. Glyburide is metabolized by CYP2C9 and CYP3A4, both inhibited by miconazole. Increased levels can cause severe and prolonged hypoglycemia, and cases have been reported with miconazole. The risk is greater in elderly patients and those with renal impairment.
How serious is the interaction between Glibenclamide and Miconazole?
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 frequently and counsel on hypoglycemia symptoms. Reduce the glyburide dose or switch to a non-azole antifungal or alternative agent if feasible.
What other medicines interact with Miconazole?
MediHelp also lists interactions of Miconazole with, for example, Cabazitaxel, Dihydroergotamine intranasal, Dihydroergotamine. The full list is on the Miconazole page.
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