Glibenclamide Gemfibrozil

Fibrates are highly bound to albumin and displace other similarly bound drugs. This can affect treatment with sulfonylureas. Hypoglycemia occurred in a diabetic patient taking glibenclamide plus gemfibrozil (170). 

A 62-year-old diabetic man on stable oral medication with glibenclamide, metformin, Zestoretic (lisino-pril + hydrochlorothiazide), gemfibrozil, and aspirin developed febrile generalized pustular eruptions after 44 days of therapy with oral terbinafine 250 mg/day (50). Withdrawal of terbinafine and symptomatic treatment with hydrotherapy and topical and systemic steroids resulted in complete resolution of fever and pustulosis within 4 days. The erythematous component responded more slowly, and mildly pruritic erythematous plaques persisted for more than 40 days. 

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