Sulphonylureas Miconazole

ITRACONAZOLE, FLUCONAZOLE, MICONAZOLE, VORICONAZOLE SULPHONYLUREAS t risk of hypoglycaemic episodes Inhibition of CYP2C9-mediated metabolism of these sulphonylureas Watch for and warn patients about symptoms of hypoglycaemia >- For signs and symptoms of hypoglycaemia, see Clinical Features of Some Adverse Drug Interactions, Hypoglycaemia... 

Miconazole and voriconazole are inhibitors of the cytochrome P450 isoenzyme CYP2C9, by which many of the sulphonylureas are metabolised. Inhibition of this isoenzyme would therefore be expected to lead to an accumulation of the sulphonylurea and therefore an increase in its ef-... 

The interaction between miconazole and the sulphonylureas is established and clinically important, but of uncertain incidence. Concurrent use need not be avoided but it should be monitored and the dosage of the sulphony-lurea reduced if necessary. Patients should be warned. Information about other sulphonylureas not cited is lacking but it seems possible that they may interact similarly with miconazole. 

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