Drug Interactions of Sulfonylurea Antidiabetics

https://www.researchgate.net/publication/327860217_Pharmacokinetic_and_Pharmacodynamic_Interactions_of_Sulfonylurea_Antidiabetics

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.

http://ejournal5.com/journals_n/1536671299.pdf