Drug Interaction Report

Gemfibrozil and Glyburide: Interaction Details

A pharmacist-reviewed analysis of the Gemfibrozil and Glyburide interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Glyburide

DiaBeta® Glynase Glynase® Micronase®
+

Gemfibrozil

Lopid Lopid®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Moderate
Can be significant — usually manageable with monitoring.
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.

Of 80 documented Gemfibrozil interactions, 23 are rated moderate — including this one.
Onset
delayed
Evidence
probable
Severity
Moderate

What happens

Hypoglycemia

Interaction Deep Dive

Concurrent use of gemfibrozil and glyBURIDE may increase the risk of hypoglycemic events in some patients12. Monitor blood glucose levels closely when gemfibrozil is added to or discontinued from sulfonylurea therapy.

Why it happens (mechanism)

Displacement of glyBURIDE from protein binding sites, competition for renal tubular secretion

Literature reports

2 reports — tap to read

a) In adult patients newly-exposed to a sulfonylurea plus antihyperlipidemic agent (N=592,872), incidence of severe hypoglycemia was 5.8 per 100 person-years, based on retrospective cohort studies. In one cohort (n=13,772), concomitant use of glyBURIDE and gemfibrozil was associated with 187 events of severe hypoglycemia (adjusted HR, 1.5; 95% CI, 1.24 to 1.81) within 181 days. Included patients were newly-exposed to concomitant use of glyBURIDE and gemfibrozil (12 months or less)1.

b) A study reported a drug interaction between glyBURIDE and gemfibrozil in a 53-year-old female. The patient was maintained on glyBURIDE 5 mg daily for diabetes mellitus for nine months. Upon the addition of gemfibrozil 1200 mg daily for hypertriglyceridemia, the patient became hypoglycemic and had to reduce the glyBURIDE dosage to 2.5 mg daily. Subsequent discontinuation and initiation of gemfibrozil was consistent with increased activity of glyBURIDE when gemfibrozil was administered 2.

Common questions

Can I take Gemfibrozil and Glyburide together?

Hypoglycemia Always confirm with your pharmacist or prescriber before making any change.

How serious is the Gemfibrozil and Glyburide interaction?

It is rated moderate. Can be significant — usually manageable with monitoring.

How quickly could this interaction happen?

The documented onset is "delayed". Effects tend to build up gradually over days to weeks.

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 Gemfibrozil 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 anything you'd monitor while I'm on both?

References (2)

  1. Leonard CE, Bilker WB, Brensinger CM, et al: Severe hypoglycemia in users of sulfonylurea antidiabetic agents and antihyperlipidemics. Clin Pharmacol Ther 2016; 99(5):538-547. PubMed
  2. Ahmad S: Gemfibrozil: interaction with glyburide (letter). South Med J 1991; 84:102.
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Glyburide

Keep reading about Glyburide

All Glyburide interactions (79) Glyburide drug information
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Gemfibrozil

Keep reading about Gemfibrozil

All Gemfibrozil interactions (80) Gemfibrozil drug information
Also serious with: Grazoprevir Ciprofibrate Dasabuvir Elagolix
Beyond drug–drug

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:

Glyburide + Activated Charcoal Apple Beer Grapefruit Siberian Cocklebur Sweet Orange Wine Acai + 323 more
Gemfibrozil + Activated Charcoal Beer Siberian Cocklebur Wine Ashwagandha Black Cohosh Boldo Buchu + 51 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.