Drug interactions
Glyburide-metformin + Levoketoconazole
Severity: Major
Glyburide-metformin and Levoketoconazole: 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
Levoketoconazole may raise glyburide levels, raising the risk of prolonged hypoglycemia. Levoketoconazole is also used in Cushing syndrome, where glucose control may be shifting as cortisol falls.
What this interaction means in plain words
Glyburide-metformin and Levoketoconazole 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; Levoketoconazole belongs to Endocrine.
Why it happens
Inhibition of CYP3A4 and possibly CYP2C9-mediated glyburide metabolism reduces its clearance.
What to do
Monitor glucose closely and reduce the glyburide dose when starting levoketoconazole, or switch to an alternative antidiabetic agent if hypoglycemia occurs.
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 Levoketoconazole
- Alfuzosin + Levoketoconazole Contraindicated
- Alprazolam + Levoketoconazole Contraindicated
- Amiodarone + Levoketoconazole Contraindicated
- Avanafil + Levoketoconazole Contraindicated
- Cisapride + Levoketoconazole Contraindicated
- Clarithromycin + Levoketoconazole Contraindicated
Frequently asked questions
Can I take Glyburide-metformin with Levoketoconazole?
MediHelp rates the interaction as major. Glyburide-metformin and Levoketoconazole 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. Levoketoconazole may raise glyburide levels, raising the risk of prolonged hypoglycemia. Levoketoconazole is also used in Cushing syndrome, where glucose control may be shifting as cortisol falls.
How serious is the interaction between Glyburide-metformin and Levoketoconazole?
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 glucose closely and reduce the glyburide dose when starting levoketoconazole, or switch to an alternative antidiabetic agent if hypoglycemia occurs.
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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