Glimepiride with Fluvoxamine Interaction Details
Brand Names Associated with Glimepiride
- Amaryl®
- Avandaryl® (as a combination product containing Glimepiride, Rosiglitazone)
- Duetact® (as a combination product containing Glimepiride, Pioglitazone)
- Glimepiride
Brand Names Associated with Fluvoxamine
- Fluvoxamine
- Luvox®
- Luvox® CR
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 14, 2023
Interaction Effect
An increase in plasma concentrations of glimepiride
Interaction Summary
Caution is advised when fluvoxamine is coadministered with glimepiride. An increase in plasma concentrations of glimepiride has been documented in healthy patients when used concomitantly with fluvoxamine without a significant effect on blood glucose concentrations.
Severity
Minor
Onset
Rapid
Evidence
Established
How To Manage Interaction
Use glimepiride and fluvoxamine concomitantly with caution or use therapeutic alternative. Monitor the patient for hypoglycemia if used concurrently.
Mechanism Of Interaction
Inhibition of the metabolism of glimepiride through the cytochrome P450 2C9 enzyme
Literature Reports
A) Plasma concentrations of glimepiride were moderately increased when used concomitantly with fluvoxamine. A double-blind, randomized, crossover study with three phases including a 4-week washout period between the phases was conducted in twelve healthy volunteers. The aim of the study is to investigate the effects of fluvoxamine on the pharmacokinetics and pharmacodynamics of glimepiride. Subjects received fluvoxamine 100 mg or placebo orally once daily for 4 days. On day 4, a single oral dose of 0.5 mg of glimepiride was administered after the patients fasted overnight. Meals were served 15 minutes after, 3 hours after, and 7 hours after glimepiride administration. For the fluvoxamine phase, the peak concentration (Cmax) was 143% (p less than 0.05) of the respective placebo value, and the half-life was increased from 2 to 2.3 hours (p less than 0.01). The increase in the area under the concentration-time curve (AUC) was not significant, and differences in blood glucose levels were not statistically significant .
Glimepiride Overview
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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).
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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.
Fluvoxamine Overview
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Fluvoxamine is used to treat obsessive-compulsive disorder (bothersome thoughts that won't go away and the need to perform certain actions over and over) and social anxiety disorder (extreme fear of interacting with others or performing in front of others that interferes with normal life). Fluvoxamine is in a class of medications called selective serotonin reuptake inhibitors (SSRIs). It works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance.
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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:
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.