Glimepiride with Fenugreek Interaction Details

Brand Names Associated with Glimepiride

Medical Content Editor Dr. Brian Staiger, PharmD
Last updated Nov 14, 2023

Interaction Effect

Increased risk of hypoglycemia

Interaction Summary

Fenugreek alone and combined with glibenclamide (glyburide) reduced blood glucose in patients with diabetes. Concomitant use of fenugreek with antidiabetic agents may result in further reductions of blood glucose over that with the antidiabetic agent alone. Close monitoring of blood glucose is recommended for patients who choose to use fenugreek and antidiabetic agents concomitantly.

Severity

Moderate

Onset

Rapid

Evidence

Probable

How To Manage Interaction

Monitor blood glucose levels and signs and symptoms of hypoglycemia closely if fenugreek and antidiabetic agents are taken together.

Mechanism Of Interaction

Increased metabolic clearance rate of glucose, improved peripheral glucose utilization with increased insulin receptors, and delayed gastric emptying

Literature Reports

A) Fenugreek, when compared with placebo, significantly reduced fasting blood glucose and postprandial blood glucose in 20 patients with mild non-insulin dependent diabetes mellitus. Fenugreek 2.5 grams twice daily for one month reduced fasting blood glucose (from 174.4 to 142 (units not provided), p less than 0.01) and postprandial blood glucose (from 246.4 to 213, p less than 0.01). Patients with mild NIDDM had initial fasting blood glucose of 174.4 +/- 9.3, and initial postprandial blood glucose of 246.4 +/- 8.7. Reduction in blood glucose was not significant in 20 patients with severe NIDDM. Patients with severe NIDDM had initial fasting blood glucose of 219.8 +/- 10.5, and initial postprandial blood glucose of 269.6 +/- 11.2. Fenugreek 2.5 grams twice daily for three months did not affect fasting or postprandial blood glucose levels in healthy subjects .

B) Fenugreek reduced the area under the curve (AUC) and half-life of plasma glucose, and increased the metabolic clearance rate of plasma glucose in a crossover study of 10 non-insulin dependent patients with patients. Fenugreek was administered as 12.5 grams twice daily for 15 days, incorporated into unleavened bread. All patients were taking glibenclamide 2.5 milligrams (mg) to 7.5 mg daily. Diet was similar between treatment and control groups, except the experimental diet with fenugreek was significantly higher in fiber content (p less than 0.001). Following an intravenous glucose tolerance test after an overnight fast, plasma glucose AUC from zero to 60 minutes decreased from 153.3 +/- 11.92 mg min/mL at baseline to 136.4 +/- 6.36 mg min/mL (p less than 0.05). Half-life decreased from 1.76 +/- 0.149 hours to 1.36 +/- 0.075 hours (p less than 0.02), and the metabolic clearance rate increased from 217.8 +/- 21.23 mL/min to 233.6 +/- 19.40 mL/min (p less than 0.02). Erythrocyte insulin receptors increased from 18.5 +/- 4.61 nanograms/milliliter (ng/mL) to 21.9 +/- 5.26 ng/mL (p less than 0.02) .

Glimepiride Overview

• Glimepiride is used along with diet and exercise, and sometimes with other medications, to treat type 2 diabetes (condition in which the body does not use insulin normally and, therefore, cannot control the amount of sugar in the blood). Glimepiride lowers blood sugar by causing the pancreas to produce insulin (a natural substance that is needed to break down sugar in the body) and helping the body use insulin efficiently. This medication will only help lower blood sugar in people whose bodies produce insulin naturally. Glimepiride is not used to treat type 1 diabetes (condition in which the body does not produce insulin and, therefore, cannot control the amount of sugar in the blood) or diabetic ketoacidosis (a serious condition that may occur if high blood sugar is not treated).

• Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems. Taking medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye problems, including changes or loss of vision, or gum disease. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes.

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Definitions

Severity Categories

Contraindicated

These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.

Major

This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.

Moderate

This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.

Minor

While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.

Onset

Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.

Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.

Evidence

Level of documentation of the interaction.

Established: The interaction is documented and substantiated in peer-reviewed medical literature.

Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.

How To Manage The Interaction

Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.

It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.

Mechanism Of Interaction

The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.

Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.

Where Does Our Information Come From?

Information for our drug interactions is compiled from several drug compendia, including:

• Gold Standard Drug Database
• Micromedex
• Lexicomp
• DrugBank

The prescribing information for each drug, as published on DailyMED, is also used. 

Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.

The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.