Drug interactions
Glimepiride-pioglitazone + St john's wort
Severity: Moderate
Glimepiride-pioglitazone and St john's wort: 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
St John's wort induces CYP enzymes and may lower exposure to pioglitazone and glimepiride. Glycemic control could worsen.
What this interaction means in plain words
Glimepiride-pioglitazone and St john's wort 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.
Why it happens
St John's wort induces CYP3A4, CYP2C9 and related enzymes, increasing metabolism.
What to do
Monitor blood glucose and adjust antidiabetic doses, or advise avoiding the herbal product.
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
Frequently asked questions
Can I take Glimepiride-pioglitazone with St john's wort?
MediHelp rates the interaction as moderate. Glimepiride-pioglitazone and St john's wort 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. St John's wort induces CYP enzymes and may lower exposure to pioglitazone and glimepiride. Glycemic control could worsen.
How serious is the interaction between Glimepiride-pioglitazone and St john's wort?
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 and adjust antidiabetic doses, or advise avoiding the herbal product.
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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