Sugril Drug Interactions

An increased incidence of elevated liver enzymes was observed in patients receiving Glibenclamide concomitantly with bosentan. Both Glibenclamide and bosentan inhibit the bile salt export pump, leading to intracellular accumulation of cytotoxic bile salts. Therefore this combination should not be used (see Contraindications).
Glibenclamide is mainly metabolized by CYP2C9 and a lesser extent by CYP3A4. This should be taken into account when Glibenclamide is administered with inducers or inhibitors of CYP2C9.
Potentiation of the blood-glucose lowering effect and, thus, in some instances hypoglycemia may occur when taking other drugs, including insulin and other (oral) antidiabetics, ACE inhibitors, anabolic steroids and male sex hormones, chloramphenicol, coumarin derivatives, cyclophosphamide, disopyramide, fenfluramine, fenyramidol, fibrates, fluoxetine, ifosfamide, MAO inhibitors, miconazole, para-aminosalicylic acid, pentoxifylline (high dose parenteral), phenylbutazone, azapropazone, oxyphenbutazone, probenecid, quinolones, salicylates, sulfinpyrazone, sulphonamides, sympatholytic agents (such as beta blockers and guanethidine), clarithromycin, tetracyclines, tritoqualine, trofosfamide.
Weakening of the blood-glucose lowering effect and, thus, raised blood-glucose levels may occur when taking other drugs, including acetazolamide, barbiturates, corticosteroids, diazoxide, diuretics, epinephrine (adrenaline) and other sympathomimetic agents, glucagon, laxatives (after protracted use), nicotinic acid (in high dose), estrogens and progestogens, phenothiazines, phenytoin, thyroid hormones, rifampicin.
H2 antagonists, clonidine and reserpine may lead to either potentiation or weakening of the blood glucose lowering effect.
Under the influence of sympatholytic drugs such as beta blockers, clonidine, guanethidine, and reserpine, the signs of adrenergic counter-regulation to hypoglycemia may be reduced or absent.
Both acute and chronic alcohol intake may potentiate or weaken the blood glucose-lowering action of Glibenclamide in an unpredictable fashion.
Glibenclamide may either potentiate or weaken the effect of coumarin derivatives.
Glibenclamide may increase cyclosporine plasma concentration and potentially lead to its increased toxicity. Monitoring and dosage adjustment of cyclosporine are therefore recommended when both drugs are coadministered.
Colesevelam binds to Glibenclamide and reduces Glibenclamide absorption from the gastro-intestinal tract. No interaction was observed when Glibenclamide was taken at least 4 hours before colesevelam. Therefore, Glibenclamide should be administered at least 4 hours prior to colesevelam.