Drug interactions
Glyburide + Ketoconazole
Severity: Moderate
Glyburide 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 glyburide exposure and strengthen its glucose-lowering effect. This increases the risk of hypoglycemia, which may be prolonged in older patients or those with renal impairment.
What this interaction means in plain words
Glyburide 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.
Glyburide belongs to Endocrine; Ketoconazole belongs to Anti Fungals.
Why it happens
Ketoconazole inhibits CYP3A4 and CYP2C9, which contribute to glyburide metabolism, reducing its clearance.
What to do
Monitor blood glucose closely when starting or stopping ketoconazole and reduce the glyburide dose if hypoglycemia occurs. Educate the patient on hypoglycemia symptoms.
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 Ketoconazole
- Alfuzosin + Ketoconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Avanafil + Ketoconazole Contraindicated
- Conivaptan + Ketoconazole Contraindicated
- Dihydroergotamine intranasal + Ketoconazole Contraindicated
- Dihydroergotamine + Ketoconazole Contraindicated
Other interactions of Glyburide
- Bosentan + Glyburide Contraindicated
- Cholic acid + Glyburide Major
- Ciprofloxacin + Glyburide Major
- Clarithromycin + Glyburide Major
- Fluconazole + Glyburide Major
- Glyburide + Insulin degludec-liraglutide Major
Frequently asked questions
Can I take Glyburide with Ketoconazole?
MediHelp rates the interaction as moderate. Glyburide 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 glyburide exposure and strengthen its glucose-lowering effect. This increases the risk of hypoglycemia, which may be prolonged in older patients or those with renal impairment.
How serious is the interaction between Glyburide 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 when starting or stopping ketoconazole and reduce the glyburide dose if hypoglycemia occurs. Educate the patient on hypoglycemia symptoms.
What other medicines interact with Ketoconazole?
MediHelp also lists interactions of Ketoconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Ketoconazole page.
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