Zoliget Drug Interactions

Ciprofloxacin and Gatifloxacin: Severe and persistent hypoglycemia may occur.
Pioglitazone HCl: Gemfibrozil and Rifampin: An enzyme inhibitor of CYP2C8 (eg, gemfibrozil) may significantly increase the AUC of pioglitazone HCl and an enzyme inducer of CYP2C8 (eg, rifampin) may significantly decrease the AUC of pioglitazone HCl. Therefore, if an inhibitor or inducer of CYP2C8 is started or stopped during treatment with pioglitazone, changes in diabetes treatment may be needed based on clinical response.
Ketoconazole: Co-administration of pioglitazone HCl for 7 days with ketoconazole 200 mg administered twice daily resulted in a ratio of least square mean (90% Cl) values for unchanged pioglitazone HCl of 1.14 (1.06-1.23) for C_max, 1.34 (1.26-1.41) for AUC and 1.87 (1.71-2.04) for C_min.
Atorvastatin Calcium: Co-administration of pioglitazone HCl for 7 days with atorvastatin calcium 80 mg once daily resulted in a ratio of least square mean (90% Cl) values for unchanged pioglitazone HCl of 0.69 (0.57-0.85) for C_max, 0.76 (0.65-0.88) for AUC and 0.96 (0.87-1.05) for C_min. For unchanged atorvastatin, the ratio of least square mean (90% Cl) values were 0.77 (0.66-0.9) for C_max, 0.86 (0.78-0.94) for AUC and 0.92 (0.82-1.02) for C_min.
Midazolam: Administration of pioglitazone HCl for 15 days followed by a single 7.5-mg dose of midazolam syrup resulted in a 26% reduction in midazolam C_max and AUC.
Glimepiride: General: The hypoglycemic action of sulfonylureas may be potentiated by certain drugs, including nonsteroidal anti-inflammatory drugs and other drugs that are highly protein bound eg, salicylates, sulfonamides, chloramphenicol, coumarins, probenecid, monoamine oxidase inhibitors and β-adrenergic blocking agents. Due to the potential drug interaction between these drugs and glimepiride, the patient should be observed closely for hypoglycemia when these drugs are co-administered. Certain drugs tend to produce hyperglycemia and may lead to loss of control. These drugs include thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics and isoniazid. Due to the potential drug interaction between these drugs and glimepiride, the patient should be observed closely for loss of glycemic control when these drugs are co-administered.
Propranolol: Concomitant administration of propranolol (40 mg 3 times daily) and glimepiride significantly increased C_max, AUC and t_½ of glimepiride by 23%, 22% and 15%, respectively, and it decreased apparent clearance (CL/f) by 18%. If β-blockers are used, caution should be exercised and patients should be warned about the potential for hypoglycemia.
Miconazole: A potential interaction between oral miconazole and oral hypoglycemic agents leading to severe hypoglycemia has been reported. There is a potential interaction of glimepiride with inhibitors (eg, fluconazole) and inducers (eg, rifampicin) of cytochrome P450 2C9.