Drug interactions
Glyburide-metformin + Ketoconazole
Severity: Major
Glyburide-metformin and Ketoconazole: 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
Ketoconazole can raise glyburide concentrations and increase the risk of hypoglycemia. Severe hypoglycemia has been reported with azole antifungals and sulfonylureas.
What this interaction means in plain words
Glyburide-metformin and Ketoconazole 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.
Glyburide-metformin belongs to Endocrine; Ketoconazole belongs to Anti Fungals.
Why it happens
Inhibition of CYP3A4 and CYP2C9-mediated metabolism of glyburide.
What to do
Monitor blood glucose closely and reduce the glyburide dose when ketoconazole is started. Consider an alternative antifungal or antidiabetic agent if feasible.
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 Glyburide-metformin
Other interactions of Ketoconazole
- Alfuzosin + Ketoconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Avanafil + Ketoconazole Contraindicated
- Conivaptan + Ketoconazole Contraindicated
- Dihydroergotamine intranasal + Ketoconazole Contraindicated
- Dihydroergotamine + Ketoconazole Contraindicated
Frequently asked questions
Can I take Glyburide-metformin with Ketoconazole?
MediHelp rates the interaction as major. Glyburide-metformin and Ketoconazole 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. Ketoconazole can raise glyburide concentrations and increase the risk of hypoglycemia. Severe hypoglycemia has been reported with azole antifungals and sulfonylureas.
How serious is the interaction between Glyburide-metformin and Ketoconazole?
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 closely and reduce the glyburide dose when ketoconazole is started. Consider an alternative antifungal or antidiabetic agent if feasible.
What other medicines interact with Glyburide-metformin?
MediHelp also lists interactions of Glyburide-metformin with, for example, Bosentan, Cholic acid, Clarithromycin. The full list is on the Glyburide-metformin page.
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