Drug interactions
Glimepiride-pioglitazone + Warfarin
Severity: Moderate
Glimepiride-pioglitazone and Warfarin: 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
Sulfonylureas and warfarin are both highly protein bound and metabolized by CYP2C9, so they may influence each other's levels, altering INR and glycemic control. Changes in anticoagulant effect and hypoglycemia have both been reported.
What this interaction means in plain words
Glimepiride-pioglitazone and Warfarin 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; Warfarin belongs to Cardiovascular.
Why it happens
Competition for CYP2C9 metabolism and plasma protein binding sites between glimepiride and warfarin.
What to do
Check INR more often when starting or stopping glimepiride and adjust warfarin as needed. Monitor blood glucose for hypoglycemia.
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 Warfarin
- Defibrotide + Warfarin Contraindicated
- Ketorolac + Warfarin Contraindicated
- Abciximab + Warfarin Major
- Acetylsalicylic acid + Warfarin Major
- Adagrasib + Warfarin Major
- Amiodarone + Warfarin Major
Frequently asked questions
Can I take Glimepiride-pioglitazone with Warfarin?
MediHelp rates the interaction as moderate. Glimepiride-pioglitazone and Warfarin 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. Sulfonylureas and warfarin are both highly protein bound and metabolized by CYP2C9, so they may influence each other's levels, altering INR and glycemic control. Changes in anticoagulant effect and hypoglycemia have both been reported.
How serious is the interaction between Glimepiride-pioglitazone and Warfarin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check INR more often when starting or stopping glimepiride and adjust warfarin as needed. Monitor blood glucose for hypoglycemia.
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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