https://www.researchgate.net/publication/327860217_Pharmacokinetic_and_Pharmacodynamic_Interactions_of_Sulfonylurea_Antidiabetics
http://ejournal5.com/journals_n/1536671299.pdf
http://ejournal5.com/journals_n/1536671299.pdf
§ Sulfonylurea (SUs) antidiabetics include first-generation drugs
such as Tolbutamide, Chlorpropamide, etc and second-generation drugs like
gliclazide, glipizide, glibenclamide, etc.
§ They are insulin
secretogogues, which induce the release of insulin from beta cells of pancreas
and decrease the blood sugar levels.
§ Absorption interactions
Ø Magnesium salts containing antacids (Increase the absorption of SUs)
Ø Bile acid sequestrants (Decrease the absorption of SUs)
§ Metabolism Interactions
Ø Drugs decreasing Therapeutic efficacy of SUs
·
Rifampicin
· St John's Wort (Hypericum perforatum)
Ø Drugs increasing the risk of Hypoglycemia
· Fibrates (Gemfibrozil, Fenofibrate)
· Sulfonamides (Sulfaphenazole, Sulfadiazine, Sulfamethizole, Sulfisoxazole, Sulfaphenazole,
and Sulfamethoxazole)
· Azole antifungals (Voriconazole, Miconazole, Ketoconazole, Fluconazole, etc.)
· Isoniazid
· Metronidazole
·
Cimetidine
· Fluvoxamine
§ Pharmacodynamic Interactions of SUs
Ø ACE Inhibitors
Ø Beta-adrenergic blockers
Ø Disopyramide
Ø Aspirin
Ø Phenylbutazone
Ø Fluoroquinolones
§ Healthcare professionals through the screening, education, and
follow up on suspected drug interactions could reduce the risk of adverse
effects.
§ The diabetic patients should always consult their physician and
pharmacist before taking any new medication.
§ The diabetic patients should bring a list of all of the drugs they
are taking (or simply bring the drugs themselves), including prescription
drugs, over-the-counter drugs, and any supplements, herbal or otherwise, during
their visit to the doctor or pharmacist.
§ They are encouraged to ask their doctor or pharmacist to look over
their list for any potentially dangerous combinations.
§ It is recommended that people fill all their prescriptions at one
pharmacy, if possible.
