Drug interactions
Gliclazide + Warfarin
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.
Overview
Concomitant use may increase frequency/severity of sulfonylurea-induced hypoglycemia; risk is greatest around initiation or dose changes.
Mechanism of action
Unknown; proposed mechanisms include increased free gliclazide from protein-binding displacement and competition for CYP2C9 metabolism leading to higher sulfonylurea exposure.
Clinical management
When starting or stopping warfarin in a patient on gliclazide (or vice versa), increase glucose monitoring for 1–2 weeks, consider reducing gliclazide dose if hypoglycemia risk is high, and educate patients on hypoglycemia recognition and treatment.
Drug reference
References
- Warfarin: Drug interactions — Lexicomp
- Sulfonylureas (second generation): Drug interactions — UpToDate
Frequently asked questions
Can I take Gliclazide with Warfarin?
The interaction is rated: Moderate. Concomitant use may increase frequency/severity of sulfonylurea-induced hypoglycemia; risk is greatest around initiation or dose changes.
How serious is the interaction between Gliclazide and Warfarin?
The interaction is rated: Moderate. Evidence level: Moderate.
How is the interaction between Gliclazide and Warfarin managed?
When starting or stopping warfarin in a patient on gliclazide (or vice versa), increase glucose monitoring for 1–2 weeks, consider reducing gliclazide dose if hypoglycemia risk is high, and educate patients on hypoglycemia recognition and treatment.
Why do Gliclazide and Warfarin interact?
Unknown; proposed mechanisms include increased free gliclazide from protein-binding displacement and competition for CYP2C9 metabolism leading to higher sulfonylurea exposure.
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