Drug interactions
Glimepiride-pioglitazone + Levoketoconazole
Severity: Moderate
Glimepiride-pioglitazone and Levoketoconazole: 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
Levoketoconazole is a strong CYP3A4 inhibitor and also inhibits CYP2C9, which may raise glimepiride levels and the risk of hypoglycemia. Pioglitazone exposure may also increase. Levoketoconazole is used for Cushing syndrome, where glucose changes are expected.
What this interaction means in plain words
Glimepiride-pioglitazone and Levoketoconazole 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; Levoketoconazole belongs to Endocrine.
Why it happens
Inhibition of CYP3A4 and CYP2C9 decreases metabolism of pioglitazone and glimepiride.
What to do
Monitor blood glucose frequently and reduce glimepiride dose if hypoglycemia develops.
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 Levoketoconazole
- Alfuzosin + Levoketoconazole Contraindicated
- Alprazolam + Levoketoconazole Contraindicated
- Amiodarone + Levoketoconazole Contraindicated
- Avanafil + Levoketoconazole Contraindicated
- Cisapride + Levoketoconazole Contraindicated
- Clarithromycin + Levoketoconazole Contraindicated
Frequently asked questions
Can I take Glimepiride-pioglitazone with Levoketoconazole?
MediHelp rates the interaction as moderate. Glimepiride-pioglitazone and Levoketoconazole 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. Levoketoconazole is a strong CYP3A4 inhibitor and also inhibits CYP2C9, which may raise glimepiride levels and the risk of hypoglycemia. Pioglitazone exposure may also increase. Levoketoconazole is used for Cushing syndrome, where glucose changes are expected.
How serious is the interaction between Glimepiride-pioglitazone and Levoketoconazole?
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 frequently and reduce glimepiride dose if hypoglycemia develops.
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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