Drug interactions
Glimepiride-pioglitazone + Voriconazole
Severity: Major
Glimepiride-pioglitazone and Voriconazole: major 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
Voriconazole inhibits CYP2C9 and CYP3A4, which raises glimepiride exposure and can cause pronounced or prolonged hypoglycemia. Pioglitazone is metabolized by CYP2C8 and CYP3A4, so its levels may also rise.
What this interaction means in plain words
Glimepiride-pioglitazone and Voriconazole can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Glimepiride-pioglitazone belongs to Endocrine; Voriconazole belongs to Anti Fungals.
Why it happens
Voriconazole inhibits CYP2C9 (glimepiride) and CYP3A4/CYP2C8 (pioglitazone), reducing their metabolic clearance.
What to do
Monitor blood glucose frequently during and after voriconazole therapy and reduce the glimepiride dose if needed. Watch for fluid retention or edema with pioglitazone.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Glimepiride-pioglitazone
Other interactions of Voriconazole
- Avanafil + Voriconazole Contraindicated
- Butabarbital + Voriconazole Contraindicated
- Carbamazepine + Voriconazole Contraindicated
- Conivaptan + Voriconazole Contraindicated
- Dihydroergotamine intranasal + Voriconazole Contraindicated
- Dihydroergotamine + Voriconazole Contraindicated
Frequently asked questions
Can I take Glimepiride-pioglitazone with Voriconazole?
MediHelp rates the interaction as major. Glimepiride-pioglitazone and Voriconazole can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Voriconazole inhibits CYP2C9 and CYP3A4, which raises glimepiride exposure and can cause pronounced or prolonged hypoglycemia. Pioglitazone is metabolized by CYP2C8 and CYP3A4, so its levels may also rise.
How serious is the interaction between Glimepiride-pioglitazone and Voriconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood glucose frequently during and after voriconazole therapy and reduce the glimepiride dose if needed. Watch for fluid retention or edema with pioglitazone.
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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