Glyburide pharmacokinetics

Niemi M, Backman JT, Neuvonen M, Neuvonen PJ, Kivisto KT. Effects of rifampin on the pharmacokinetics and pharmacodynamics of glyburide and glipizide. Clin Pharmacol Ther (St. Louis, MO, United States) 2001 69 400-406. 

Glibenclamide (glyburide) causes a small reduction in valsartan plasma levels, but this is unlikely to be of any clinical significance. No clinically relevant pharmacokinetic interaction occurs between glibenclamide and candesartan or tehnisartan, or between tolbutamide and irbesartan. Eprosartan does not alter the efficacy of glibenclamide. Losartan and possibly eprosartan may reduce awareness of hypoglycaemic symptoms. 

Orlistat improved glycaemic control, which resulted in the need to reduce the dose of glibenclamide (glyburide) or glipizide in almost half the patients in one study. In other studies, orlistat also reduced the dose requirement for metformin and for insulin. Orlistat did not alter the pharmacokinetics of glibenclamide or metformin. Orlistat and cimetidine may have contributed to a case of metformin-associated lactic acidosis. The manufacturers recom-... 

Zhi J, Melia AT, Koss-Twardy SG, Min B, Guerciolini R, FreundhchNL, Milla G, Patel IH. The influence of oriistat on the pharmacokinetics and pharmacodynamics of glyburide in healthy volunteers. J Clin Pharmacol (1995) 35,521-5. 

Kubacka RT, Antal EJ, Juhl RP, Welshman IR. Effects of aspirin and ibuprofen on tiie pharmacokinetics and pharmacod3mamics of glyburide in healtiiy subjects. Ann Pharmacoffier (1996) 30, 20-6. 

There is no pharmacokinetic interaction between glibenclamide (glyburide) and pantoprazole, and pantoprazole does not alter the glucose-lowering effect of glibenclamide. 

A study in 18 elderly patients with type 2 diabetes and symptoms of dementia, taking glibenclamide (glyburide), found that 4 days of treatment with vinpocetine 10 mg three times daily did not affect either the pharmacokinetics of the glibenclamide or the control of blood glucose levels. There would seem to be no reason for avoiding concurrent use. 

The manufacturers say that the pharmacokinetics of glibenclamide (glyburide) were not affected by a single 20-mg dose of vardenafil, and that vardenafil had no effect on glibenclamide pharmacodynamics (glucose and insulin levels). Also, although no specific pharmacokinetic study has been conducted, the manufacturers say that population pharmacokinetic analysis suggests that sulphonylureas (not named) and metformin have no effect on vardenafil pharmacokinetics. No additional precautions therefore seem necessary on concurrent use. ... 

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