Drug interactions
Glyburide-metformin + Ramipril
Severity: Moderate
Glyburide-metformin and Ramipril: 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
ACE inhibitors such as ramipril can enhance insulin sensitivity and may increase the risk of hypoglycemia in patients taking sulfonylureas like glyburide. The effect is usually modest, but it is more likely at the start of treatment or in patients with renal impairment.
What this interaction means in plain words
Glyburide-metformin and Ramipril 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-metformin belongs to Endocrine; Ramipril belongs to Cardiovascular.
Why it happens
ACE inhibition increases bradykinin and improves insulin sensitivity, adding to the glucose-lowering effect of the sulfonylurea.
What to do
Monitor blood glucose when ramipril is started or the dose changed, and educate the patient about hypoglycemia symptoms. Reduce the glyburide dose if hypoglycemia occurs.
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 Glyburide-metformin
Other interactions of Ramipril
- Aliskiren + Ramipril Contraindicated
- Protein a column + Ramipril Contraindicated
- Ramipril + Sacubitril / valsartan Contraindicated
- Ramipril + Sacubitril-valsartan Contraindicated
- Amifostine + Ramipril Major
- Amiloride + Ramipril Major
Frequently asked questions
Can I take Glyburide-metformin with Ramipril?
MediHelp rates the interaction as moderate. Glyburide-metformin and Ramipril 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. ACE inhibitors such as ramipril can enhance insulin sensitivity and may increase the risk of hypoglycemia in patients taking sulfonylureas like glyburide. The effect is usually modest, but it is more likely at the start of treatment or in patients with renal impairment.
How serious is the interaction between Glyburide-metformin and Ramipril?
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 when ramipril is started or the dose changed, and educate the patient about hypoglycemia symptoms. Reduce the glyburide dose 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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