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Interacting Drugs

OBJECT DRUGS

Antidiabetic Agents: (CYP2C9 Substrates):

PRECIPITANT DRUGS

Enzyme Inhibitors:


Comment:

Oral hypoglycemic drugs that are metabolized by CYP2C9 may produce enhanced hypoglycemic effects when administered with a CYP2C9 inhibitor. Nateglinide and rosiglitazone both have additional pathways of metabolism and may be less affected by inhibitors of only one pathway. Co-trimoxazole, however, inhibits two pathways for rosiglitazone metabolism; the trimethoprim component inhibits CYP2C8, and the sulfamethoxazole component inhibits CYP2C9. Single doses of metronidazole would be unlikely to produce hypoglycemia when combined with these antidiabetic agents.


Class 3: Assess Risk & Take Action if Necessary