Drug interactions
Glimepiride-pioglitazone + Ketoconazole
Severity: Moderate
Glimepiride-pioglitazone 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 exposure to both glimepiride and pioglitazone. This may lead to hypoglycemia, and increased pioglitazone effects such as edema.
What this interaction means in plain words
Glimepiride-pioglitazone 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.
Glimepiride-pioglitazone belongs to Endocrine; Ketoconazole belongs to Anti Fungals.
Why it happens
Ketoconazole inhibits CYP3A4 and, to a lesser degree, CYP2C9 and CYP2C8, reducing the metabolism of glimepiride and pioglitazone.
What to do
Monitor blood glucose closely during co-administration and reduce the glimepiride dose if hypoglycemia develops. Reassess for fluid retention and adjust the pioglitazone dose as needed.
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?
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Other interactions of Glimepiride-pioglitazone
Other interactions of Ketoconazole
- Alfuzosin + Ketoconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Avanafil + Ketoconazole Contraindicated
- Conivaptan + Ketoconazole Contraindicated
- Dihydroergotamine intranasal + Ketoconazole Contraindicated
- Dihydroergotamine + Ketoconazole Contraindicated
Frequently asked questions
Can I take Glimepiride-pioglitazone with Ketoconazole?
MediHelp rates the interaction as moderate. Glimepiride-pioglitazone 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 exposure to both glimepiride and pioglitazone. This may lead to hypoglycemia, and increased pioglitazone effects such as edema.
How serious is the interaction between Glimepiride-pioglitazone 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 during co-administration and reduce the glimepiride dose if hypoglycemia develops. Reassess for fluid retention and adjust the pioglitazone dose as needed.
What other medicines interact with Glimepiride-pioglitazone?
MediHelp also lists interactions of Glimepiride-pioglitazone with, for example, Fluconazole, Gemfibrozil, Insulin aspart. The full list is on the Glimepiride-pioglitazone page.
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