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Drug interactions

Gliclazide + Ketoconazole

Severity: Moderate

Gliclazide and Ketoconazole: moderate 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

Ketoconazole can raise sulfonylurea levels and cause hypoglycemia. Although gliclazide is mainly handled by CYP2C9 and CYP2C19, azole antifungals have been reported to enhance its effect.

What this interaction means in plain words

Gliclazide and Ketoconazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.

Gliclazide belongs to Endocrine; Ketoconazole belongs to Anti Fungals.

Evidence level: Moderate

Why it happens

Ketoconazole inhibits CYP enzymes involved in gliclazide metabolism, reducing its clearance.

What to do

Monitor blood glucose closely and reduce the gliclazide dose as needed during ketoconazole therapy. Watch for hypoglycemia after stopping or starting the antifungal.

What to ask your pharmacist

  • Should I take them at different times of day?
  • Does the dose of either medicine need to change?
  • Is there anything I should avoid, such as alcohol or certain foods, while on both?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Gliclazide with Ketoconazole?

MediHelp rates the interaction as moderate. Gliclazide and Ketoconazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Ketoconazole can raise sulfonylurea levels and cause hypoglycemia. Although gliclazide is mainly handled by CYP2C9 and CYP2C19, azole antifungals have been reported to enhance its effect.

How serious is the interaction between Gliclazide and Ketoconazole?

MediHelp rates it moderate, 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 gliclazide dose as needed during ketoconazole therapy. Watch for hypoglycemia after stopping or starting the antifungal.

What other medicines interact with Gliclazide?

MediHelp also lists interactions of Gliclazide with, for example, Ciprofloxacin, Clarithromycin, Disopyramide. The full list is on the Gliclazide page.

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