Glibenclamide interactions

Food & lifestyle

• alcohol

  Moderate

  Others

  Alcohol may cause hypoglycemia or hyperglycemia in patients with diabetes. Hypoglycemia most frequently occurs during acute consumption of alcohol. Even modest amounts can lower blood sugar significantly, especially when the alcohol is ingested on an empty stomach or following exercise. The mechanism involves inhibition of both gluconeogenesis as well as the counter-regulatory response to hypoglycemia. Episodes of hypoglycemia may last for 8 to 12 hours after ethanol ingestion. By contrast, chronic alcohol abuse can cause impaired glucose tolerance and hyperglycemia.

  What to do: Patients with diabetes should avoid consuming alcohol if their blood glucose is not well controlled, or if they have hypertriglyceridemia, neuropathy, or pancreatitis. Patients with well controlled diabetes should limit their alcohol intake to one drink daily for women and two drinks daily for men (1 drink = 5 oz wine, 12 oz beer, or 1.5 oz distilled spirits) in conjunction with their normal meal plan. Alcohol should not be consumed on an empty stomach or following exercise.

  10 sources

  1. Jerntorp P, Almer LO "Chlorpropamide-alcohol flushing in relation to macroangiopathy and peripheral neuropathy in non-insulin dependent diabetes." Acta Med Scand 656 (1981): 33-6
  2. Jerntorp P, Almer LO, Holin H, et al. "Plasma chlorpropamide: a critical factor in chlorpropamide-alcohol flush." Eur J Clin Pharmacol 24 (1983): 237-42
  3. Barnett AH, Spiliopoulos AJ, Pyke DA, et al. "Metabolic studies in chlorpropamide-alcohol flush positive and negative type 2 (non-insulin dependent) diabetic patients with and without retinopathy." Diabetologia 24 (1983): 213-5
  4. Hartling SG, Faber OK, Wegmann ML, Wahlin-Boll E, Melander A "Interaction of ethanol and glipizide in humans." Diabetes Care 10 (1987): 683-6
  5. "Product Information. Diabinese (chlorpropamide)." Pfizer U.S. Pharmaceuticals (2002):
  6. "Product Information. Glucotrol (glipizide)." Pfizer U.S. Pharmaceuticals (2002):
  7. "Product Information. Diabeta (glyburide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  8. Skillman TG, Feldman JM "The pharmacology of sulfonylureas." Am J Med 70 (1981): 361-72

  Show all 10 sourcesShow fewer sources

  9. "Position Statement: evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes related complications. American Diabetes Association." Diabetes Care 25(Suppl 1) (2002): S50-S60
  10. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

Conditions

Conditions in which Glibenclamide needs care, as documented in this source.

• Cardiovascular Diseases

  Major

  The use of oral hypoglycemic agents may be associated with an increased risk of cardiovascular mortality compared to treatment with diet alone or diet with insulin. This warning is based on the University Group Diabetes Program (UGDP) study, a long-term prospective clinical trial designed to evaluate the effectiveness of glucose-lowering drugs in preventing or delaying vascular complications in patients with non-insulin-dependent diabetes. Patients treated with diet plus a fixed dosage of either tolbutamide (a sulfonylurea) or phenformin (a biguanide) for 5 to 8 years had a cardiovascular mortality rate approximately 2.5 times that of patients treated with diet alone, resulting in discontinuation of both these treatments in the study. Despite controversy regarding interpretation of these results, clinicians and patients should be aware of the potential risk when making treatment decisions for diabetes, particularly in the presence of underlying cardiovascular disease. Data are not available for other sulfonylureas or biguanides, nor for hypoglycemic agents belonging to other classes. However, given the similarities in chemical structure and/or mode of action, the same caution should be applied.

  9 sources

  1. "Product Information. Diabinese (chlorpropamide)." Pfizer U.S. Pharmaceuticals (2002):
  2. "Product Information. Glucotrol (glipizide)." Pfizer U.S. Pharmaceuticals (2002):
  3. "Product Information. Diabeta (glyburide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  4. "Product Information. Glucophage (metformin)." Bristol-Myers Squibb (2001):
  5. "Product Information. Amaryl (glimepiride)." Hoechst Marion Roussel (2001):
  6. "Product Information. Prandin (repaglinide)." Novo Nordisk Pharmaceuticals Inc (2001):
  7. "Product Information. Tolinase (tolazamide)." Pharmacia and Upjohn (2001):
  8. "Product Information. Orinase (tolbutamide)." Pharmacia and Upjohn (2001):

  Show all 9 sourcesShow fewer sources

  9. "Product Information. Dymelor (acetohexamide)." Lilly, Eli and Company (2001):

• Diabetic Ketoacidosis

  Major

  The use of some sulfonylurea agents is contraindicated for the treatment of patients with diabetic ketoacidosis, with or without coma. In addition, these agents should not be used as sole therapy in patients with type I diabetes mellitus.

  7 sources

  1. "Product Information. Diabinese (chlorpropamide)." Pfizer U.S. Pharmaceuticals (2002):
  2. "Product Information. Glucotrol (glipizide)." Pfizer U.S. Pharmaceuticals (2002):
  3. "Product Information. Diabeta (glyburide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  4. "Product Information. Micronase (glyburide)." Pharmacia and Upjohn (2002):
  5. "Product Information. Amaryl (glimepiride)." Hoechst Marion Roussel (2001):
  6. "Product Information. Tolinase (tolazamide)." Pharmacia and Upjohn (2001):
  7. "Product Information. Orinase (tolbutamide)." Pharmacia and Upjohn (2001):

• Liver Diseases

  Major

  Sulfonylureas are metabolized in the liver, and their metabolites (some with pharmacologic activity) are excreted in the urine and feces. Patients with impaired liver and/or renal function treated with sulfonylureas may be exposed to higher serum drug concentrations, which can increase the potential for severe hypoglycemic episodes induced by these agents. In the presence of hepatic impairment, gluconeogenic capacity may also be diminished, further compounding the risk. Therapy with sulfonylureas should be administered cautiously in patients with liver and/or renal disease. Reduced dosages and longer intervals between dosage adjustments may be required. Hypoglycemia, if it occurs during treatment, may be prolonged in these patients because of slowed metabolism and/or excretion of the drugs.

  23 sources

  1. Johnson PC, Hennes AR, Driscoll T, West KM "Metabolic fate of chlorpropamide in man." Ann N Y Acad Sci 74 (1959): 459-72
  2. Brotherton PM, Grieveson P, McMartin C "A study of the metabolic fate of chlorpropamide in man." Clin Pharmacol Ther 10 (1970): 505-14
  3. Petitpierre B, Perrin L, Rudhardt M, et al. "Behaviour of chlorpropamide in renal insufficiency and under the effect of associated drug therapy." Int J Clin Pharmacol 6 (1972): 120-4
  4. Huupponen R, Lammintausta R "Chlorpropamide bioavailability and pharmacokinetics." Int J Clin Pharmacol Ther Toxicol 19 (1981): 331-3
  5. Neuvonen PJ, Karkkainen S, Lehtovaara R "Pharmacokinetics of chlorpropamide in epileptic patients: effects of enzyme induction and urine pH on chlorpropamide elimination." Eur J Clin Pharmacol 32 (1987): 297-301
  6. "Glibenclamide: a review." Drugs 1 (1971): 116-40
  7. Pearson JG, Antal EJ, Raehl CL, Gorsch HK, Craig WA, Albert KS, Welling PG "Pharmacokinetic disposition of 14C-glyburide in patients with varying renal function." Clin Pharmacol Ther 39 (1986): 318-24
  8. Sartor G, Melander A, Schersten B, Wahlin-Boll E "Comparative single-dose kinetics and effects of four sulfonylureas in healthy volunteers." Acta Med Scand 208 (1980): 301-7

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  9. Prendergast BD "Glyburide and glipizide, second-generation oral sulfonylurea hypoglycemic agents." Clin Pharm 3 (1984): 473-85
  10. Kobayashi KA, Bauer LA, Horn JR, Opheim K, Wood F, Jr Kradjan WA "Glipizide pharmacokinetics in young and elderly volunteers." Clin Pharm 7 (1988): 224-8
  11. Balant L, Zahnd G, Gorgia A, Schwarz R, Fabre J "Pharmacokinetics of glipizide in man: influence of renal insufficiency." Diabetologia Sep (1973): 331-8
  12. Pentikainen PJ, Neuvonen PJ, Penttila A "Pharmacokinetics and pharmacodynamics of glipizide in healthy volunteers." Int J Clin Pharmacol Ther Toxicol 21 (1983): 98-107
  13. Lebovitz HE "Glipizide: a second-generation sulfonylurea hypoglycemic agent. Pharmacology, pharmacokinetics and clinical use." Pharmacotherapy 5 (1985): 63-77
  14. "Product Information. Diabinese (chlorpropamide)." Pfizer U.S. Pharmaceuticals (2002):
  15. "Product Information. Glucotrol (glipizide)." Pfizer U.S. Pharmaceuticals (2002):
  16. "Product Information. Diabeta (glyburide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  17. "Product Information. Micronase (glyburide)." Pharmacia and Upjohn (2002):
  18. Rydberg T, Jonsson A, Roder M, Melander A "Hypoglycemic activity of glyburide (glibenclamide) metabolites in humans." Diabetes Care 17 (1994): 1026-30
  19. Rydberg T, Jonsson A, Melander A "Comparison of the kinetics of glyburide and its active metabolites in humans." J Clin Pharm Ther 20 (1995): 283-95
  20. Badian M, Korn A, Lehr KH, Malerczyk V, Waldhausl W "Determination of the absolute bioavailability of glimepiride (HOE 490), a new sulphonylurea." Int J Clin Pharmacol Ther Toxicol 30 (1992): 481-2
  21. "Product Information. Amaryl (glimepiride)." Hoechst Marion Roussel (2001):
  22. "Product Information. Tolinase (tolazamide)." Pharmacia and Upjohn (2001):
  23. "Product Information. Dymelor (acetohexamide)." Lilly, Eli and Company (2001):

• Glucosephosphate Dehydrogenase Deficiency

  Moderate

  Sulfonylureas can cause hemolytic anemia in patients with glucose 6-phosphate dehydrogenase (G6PD) deficiency. Therapy with these agents should be used with caution in patients with G6PD deficiency and consider the use of a non-sulfonylurea alternative. There have been postmarketing reports of hemolytic anemia in patients receiving these drugs who did not have known G6PD deficiency.

  8 sources

  1. "Product Information. Diabinese (chlorpropamide)." Pfizer U.S. Pharmaceuticals (2002):
  2. "Product Information. Glucotrol (glipizide)." Pfizer U.S. Pharmaceuticals (2002):
  3. "Product Information. Diabeta (glyburide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  4. "Product Information. Micronase (glyburide)." Pharmacia and Upjohn (2002):
  5. "Product Information. Amaryl (glimepiride)." Hoechst Marion Roussel (2001):
  6. "Product Information. Tolinase (tolazamide)." Pharmacia and Upjohn (2001):
  7. "Product Information. Orinase (tolbutamide)." Pharmacia and Upjohn (2001):
  8. "Product Information. Dymelor (acetohexamide)." Lilly, Eli and Company (2001):

• Hypoglycemia

  Moderate

  Hypoglycemia may commonly occur during treatment with insulin and/or oral hypoglycemic agents. Care should be taken in patients who may be particularly susceptible to the development of hypoglycemic episodes during the use of these drugs, including those who are debilitated or malnourished, those with defective counterregulatory mechanisms (e.g., autonomic neuropathy and adrenal or pituitary insufficiency), and those receiving beta-adrenergic blocking agents.

  18 sources

  1. "Product Information. Diabinese (chlorpropamide)." Pfizer U.S. Pharmaceuticals (2002):
  2. "Product Information. Glucotrol (glipizide)." Pfizer U.S. Pharmaceuticals (2002):
  3. "Product Information. Diabeta (glyburide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  4. "Product Information. Micronase (glyburide)." Pharmacia and Upjohn (2002):
  5. "Multum Information Services, Inc. Expert Review Panel"
  6. "Product Information. Humulin BR (insulin)." Lilly, Eli and Company, Indianapolis, IN.
  7. "Product Information. Glucophage (metformin)." Bristol-Myers Squibb (2001):
  8. "Product Information. Amaryl (glimepiride)." Hoechst Marion Roussel (2001):

  Show all 18 sourcesShow fewer sources

  9. "Product Information. Prandin (repaglinide)." Novo Nordisk Pharmaceuticals Inc (2001):
  10. Braunwald E, Hauser SL, Kasper DL, Fauci AS, Isselbacher KJ, Longo DL, Martin JB, eds., Wilson JD "Harrison's Principles of Internal Medicine." New York, NY: McGraw-Hill Health Professionals Division (1998):
  11. "Product Information. Tolinase (tolazamide)." Pharmacia and Upjohn (2001):
  12. "Product Information. Dymelor (acetohexamide)." Lilly, Eli and Company (2001):
  13. "Product Information. Lantus (insulin glargine)." Aventis Pharmaceuticals (2001):
  14. "Product Information. NovoLOG (insulin aspart)." Novo Nordisk Pharmaceuticals Inc (2022):
  15. "Product Information. Starlix (nateglinide)." Novartis Pharmaceuticals (2001):
  16. "Product Information. Apidra (insulin glulisine)." Aventis Pharmaceuticals (2004):
  17. "Product Information. Levemir (insulin detemir)." Novo Nordisk Pharmaceuticals Inc (2005):
  18. "Product Information. Tresiba FlexTouch (insulin degludec)." Novo Nordisk Pharmaceuticals Inc (2015):

• Hyponatremia

  Moderate

  Treatment with sulfonylureas may cause hyponatremia, in patients who are on other medications or have medical conditions known to cause hyponatremia or increase release of antidiuretic hormone. The syndrome of inappropriate antidiuretic hormone (SIADH) secretion has been reported with certain sulfonylureas and these drugs may augment the peripheral (antidiuretic) action of ADH and/or increase release of ADH. Caution should be used when treating patients with hyponatremia or at greater risk of developing hyponatremia such as elderly patients, patients taking diuretics or those who are volume-depleted.

  8 sources

  1. "Product Information. Diabinese (chlorpropamide)." Pfizer U.S. Pharmaceuticals (2002):
  2. "Product Information. Glucotrol (glipizide)." Pfizer U.S. Pharmaceuticals (2002):
  3. "Product Information. Diabeta (glyburide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  4. "Product Information. Micronase (glyburide)." Pharmacia and Upjohn (2002):
  5. "Product Information. Amaryl (glimepiride)." Hoechst Marion Roussel (2001):
  6. "Product Information. Tolinase (tolazamide)." Pharmacia and Upjohn (2001):
  7. "Product Information. Orinase (tolbutamide)." Pharmacia and Upjohn (2001):
  8. "Product Information. Dymelor (acetohexamide)." Lilly, Eli and Company (2001):

Therapeutic duplication

Drug classes that overlap with Glibenclamide, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.

• insulin secretagogues

  The recommended maximum number of medicines in the 'insulin secretagogues' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'insulin secretagogues' category.

  Example product in the source data (US market): Metaglip

• insulin secretagogues

  The recommended maximum number of medicines in the 'insulin secretagogues' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'insulin secretagogues' category.

  Example product in the source data (US market): Metformin/repaglinide