Drug interactions with oral hypoglycaemic drugs

Abstract

Oral hypoglycaemic drugs may interact with other drugs. Pharmacodynamic interactions occur with medications that alter blood glucose and may require the dose of the oral hypoglycaemic drug to be altered. Pharmacokinetic interactions vary with the drug group. Sulfonylureas and repaglinide are metabolised in the liver. Their plasma concentrations and activity can be reduced by drugs which induce hepatic enzymes and increased by hepatic enzyme inhibitors. Metformin is renally excreted and may have increased toxicity with drugs that impair renal function. Acarbose is only slightly absorbed across the gut and has few significant interactions. Significant interactions with the thiazolidinediones have not yet been reported, but pioglitazone is known to induce cytochrome P450 3A4.