Sign Out
Contraindicated combination: Miconazole (systemic route, oromucosal gel): Increase the hypoglycemic effect with possible onset of hypoglycemic symptoms, or even coma.
Combinations which are not recommended: Phenylbutazone (systemic route): Increase the hypoglycemic effect of sulfonylurea (displaces their binding to plasma protein and/or reduces elimination). It is preferable to use a different anti-inflammatory agent, or else to warn the patient and emphasize the importance of self-monitoring, where necessary, adjust the dose during and after treatment with the anti-inflammatory agent.
Alcohol: Increases the hypoglycemic reaction (by inhibiting compensatory reactions) that can lead to the onset of hypoglycemia coma. Alcohol or medicinal products containing alcohol should be avoided.
Combination requiring precautions for use: Potentiation of the blood glucose lowering effect and thus, in some instances, hypoglycemia may occur when one of the following drugs is taken: Other antidiabetic agents (insulins, Acarbose, biguanides (e.g. Metformin), Thiazolidinediones, dipeptyl peptidase-4 inhibitors, GLP-1 receptor agonists), beta-blockers, Fluconazole, angiotensin converting enzyme inhibitors (Captopril, Enalapril), H2-receptor antagonists, monoamine oxidase inhibitors (MAOIs), sulfonamides, Clarithromycin and non-steroidal anti-inflammatory agents.
The following products may cause an increase in blood glucose levels: Combination which is not recommended: Danazol: If the use of this active substance cannot be avoided, warn the patient and emphasize the importance of urine and blood glucose monitoring. It may be necessary to adjust the dose of the antidiabetic agent during and after treatment with Danazol.
Combinations requiring precautions during use: Chlorpromazine (neuroleptic agent): High doses (> 100 mg per day of Chlorpromazine) increase blood glucose levels (reduced insulin release). Warn the patient and emphasize the importance of blood glucose monitoring. It may be necessary to adjust the dose of the antidiabetic active substance during and after treatment with the neuroleptic agent.
Glucocorticoids (systemic and local route: intra-articular, cutaneous and rectal preparations) and Tetracosactrin: Increase in blood glucose levels possible ketosis (reduced tolerance to carbohydrates due to glucocorticoids. Warn the patient and emphasize the importance of blood glucose monitoring, particularly at the start of treatment. It may be necessary to adjust the dose of the antidiabetic active substance during and after treatment with glucocorticoids.
Ritodrine, Salbutamol, and Terbutaline (I.V. administration): Increased blood glucose levels due to beta-2 agonist effects. Emphasize the importance of monitoring blood glucose levels. If necessary, switch to insulin.
St. John's Wort (Hypericum perforatum) preparations: Gliclazide exposure is decreased by St. John's Wort (Hypericum perforatum). Emphasize the importance of blood glucose levels monitoring.
The following products may cause dysglycemia: Combinations requiring precautions during use: Fluoroquinolones: In case of a concomitant use of Gliclazide and a fluoroquinolone, the patients should be warned of the risk of dysglycemia, and the importance of blood glucose monitoring should be emphasized.
Combination which must be taken into account: Anticoagulant therapy (e.g. Warfarin): Sulfonylureas may lead to potentiation of anticoagulation during concurrent treatment. Adjustment of the anticoagulant therapy may be necessary.
