Disopyramide and Glyburide: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Disopyramide
Glyburide
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased risk of hypoglycemia
Interaction Deep Dive
Concurrent administration of disopyramide with sulfonylureas may result in profound hypoglycemia due to increased insulin secretion. The proposed mechanism for disopyramide-induced hypoglycemia is increased insulin secretion due to depolarization of the beta-cell caused by inhibition of the pancreatic beta-cell K(ATP) channels. Sulfonylureas are K(ATP) channel inhibitors, as well. It is believed, both agents act to partially (about 50% to 60%) inhibit K(ATP) channels, but when used together, the inhibition is additive. It is proposed that simultaneous administration of these 2 K(ATP) channel inhibitors results in almost complete inhibition (about 95%) of the K(ATP) channels, which in turn causes continuous depolarization of the beta cell membrane resulting in sustained insulin secretion and hypoglycemia. Use caution when disopyramide is used with sulfonylureas and other K(ATP) channel inhibitors1.
Why it happens (mechanism)
Unknown
Literature reports
1 report — tap to read
a) A 62-year-old women taking glimepiride 0.5 mg daily was started on disopyramide 300 mg daily, and 2 weeks later she experienced a severe hypoglycemic episode requiring hospitalization. At the time she started on disopyramide, she had been on glimepiride for 4 months; her HbA1c was 7.8% to 8.1%, and she had experienced no hypoglycemic episodes. On admission to the hospital, her blood sugar level was 1.1 mmol/L, her HbA1c was 5.8%, her disopyramide level was 3.7 mcg/mL, and her renal and hepatic function were within normal limits. One hour after receiving an IV injection of 50% glucose, her blood glucose normalized. Disopyramide was discontinued and she continued on glimepiride 0.5 mg daily. Two months later, her glimepiride dose was increased to 1 mg daily, and at her 6-month follow-up visit, she reported no further hypoglycemic episodes 1.
Common questions
Can I take Disopyramide and Glyburide together?
Increased risk of hypoglycemia Always confirm with your pharmacist or prescriber before making any change.
How serious is the Disopyramide and Glyburide interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Disopyramide or Glyburide need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Negishi M, Shimomura K, Proks P, et al: Mechanism of disopyramide-induced hypoglycaemia in a patient with Type 2 diabetes. Diabet Med 2009; 26(1):76-78. DOI
Keep reading about Disopyramide
Keep reading about Glyburide
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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