Drug interactions
Miconazole vaginal + Tolbutamide
Severity: Moderate
Miconazole vaginal and Tolbutamide: 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
Miconazole is a CYP2C9 inhibitor and vaginal use can produce some systemic absorption, which may raise tolbutamide levels. Hypoglycemia has been reported with miconazole and sulfonylureas, though most reports involve oral gel.
What this interaction means in plain words
Miconazole vaginal and Tolbutamide 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.
Why it happens
Inhibition of CYP2C9-mediated tolbutamide metabolism by absorbed miconazole.
What to do
Monitor blood glucose during and shortly after a vaginal miconazole course, especially with prolonged or repeated use, and reduce the tolbutamide dose if needed.
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 Tolbutamide
- Glyburide-metformin + Tolbutamide Major
- Insulin degludec-liraglutide + Tolbutamide Major
- Aceclofenac + Tolbutamide Moderate
- Acemetacin + Tolbutamide Moderate
- Acetylsalicylic acid + Tolbutamide Moderate
- Albiglutide + Tolbutamide Moderate
Frequently asked questions
Can I take Miconazole vaginal with Tolbutamide?
MediHelp rates the interaction as moderate. Miconazole vaginal and Tolbutamide 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. Miconazole is a CYP2C9 inhibitor and vaginal use can produce some systemic absorption, which may raise tolbutamide levels. Hypoglycemia has been reported with miconazole and sulfonylureas, though most reports involve oral gel.
How serious is the interaction between Miconazole vaginal and Tolbutamide?
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 during and shortly after a vaginal miconazole course, especially with prolonged or repeated use, and reduce the tolbutamide dose if needed.
What other medicines interact with Tolbutamide?
MediHelp also lists interactions of Tolbutamide with, for example, Glyburide-metformin, Insulin degludec-liraglutide, Aceclofenac. The full list is on the Tolbutamide page.
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