Norizec Drug Interactions

Aspirin: Coadministration of aspirin and glimepiride resulted in an increased mean AUC and decreased mean C_max of glimepiride. However, there is no evidence of clinically significant adverse interactions with concurrent administration of aspirin and other salicylates.
H₂ Receptor Antagonists: Coadministration of either cimetidine or ranitidine with a single oral dose of glimepiride did not significantly alter the absorption and disposition of glimepiride, and no differences were seen in hypoglycemic symptomatology.
Propranolol: Concomitant administration of propranolol and glimepiride may result in significant increases in the Cmax, AUC and t_1/2 of glimepiride.
Miconazole: Potential interactions between oral miconazole and oral hypoglycemic agents including glimepiride leading to severe hypoglycemia have been reported. It is not known whether this interaction also occurs with the intravenous, topical or vaginal preparations of miconazole.
Coumarin Anticoagulants: The pharmacodynamic response to warfarin may be potentiated or weakened by concomitant administration with glimepiride. This may cause very small reductions in mean area under the prothrombin time (PT) curve and maximum PT values during glimepiride treatment.
Cytochrome P450: Glimepiride is metabolized by cytochrome P450 2C9. This should be taken into account when glimepiride is coadministered with inducers, inhibitors or substrates of CYP2C9 (e.g., rifampicin, fluconazole, amiodarone, tolbutamide, diclofenac, ibuprofen, naproxen). In vivo, concomitant administration with fluconazole (a potent CYP2C9) resulted in a 2-fold increase in glimepiride's AUC.
Sympatholytic Agents: Signs of adrenergic counter-regulation to hypoglycemia may be reduced or absent when glimepiride and sympatholytics (e.g., beta-blockers, clonidine, guanethidine, and reserpine) are taken concomitantly.
Colesevelam: Absorption of glimepiride is reduced when concomitantly administered with colesevelam. However, absorption is not reduced when glimepiride is administered 4 hours before taking colesevelam.
Alcohol: Acute and chronic alcohol intake may unpredictably potentiate or reduce the activity of glimepiride.
Drugs that may potentiate the hypoglycemic action of glimepiride and other sulfonylureas: Nonsteroidal anti-inflammatory drugs (NSAIDs), e.g., ibuprofen, phenylbutazone, oxyphenbutazone and azapropazone; clarithromycin, highly protein-bound drugs, coumarins, probenecid, beta blockers, salicylates, aminosalicylic acid, anabolic steroids and male sex hormones, chloramphenicol, certain long-acting sulfonamides, tetracyclines, quinolone antibiotics, fenfluramine, fibrates, ACE inhibitors, fluoxetine, monoamine oxidase inhibitors, disopyramide, allopurinol, sulfinpyrazone, sympatholytics, cyclophosphamide, trosphosphamide, ifosfamide, miconazole, fluconazole, pentoxifylline (high-dose parenteral), tritoqualine, insulin, and other oral antidiabetic drugs.
Drugs that tend to produce hyperglycemia and may lead to loss of glycemic control when coadministered with glimepiride: Thiazides and other diuretics, corticosteroids, phenothiazines, chlorpromazine, thyroid products, estrogens, progestogens, nicotinic acid (high doses) and nicotinic acid derivatives, laxatives (long-term use), oral contraceptives, phenytoin, diazoxide, glucagons, barbiturates, rifampicin, acetazolamide, adrenaline, sympathomimetics, and isoniazid.
Although no specific interaction study was performed, data from pooled clinical studies showed no evidence of clinically significant adverse interactions were observed with uncontrolled concurrent calcium-channel blockers, estrogens, fibrates, NSAIDs, HMG-CoA reductase inhibitors, sulfonamides, or thyroid hormone.