Diapro Drug Interactions

Potentially hazardous interactions: These may be divided into those which will tend to increase the hypoglycemic effect and those tending to oppose it. In the first category come drugs which displace the sulfonylurea from protein binding, such as aspirin, non-steroidal anti-inflammatory drugs, phenylbutazone, clofibrate, sulfonamides and coumarin anticoagulants, or which inhibit hepatic microsomal enzymes, for example cimetidine, sulfonamides, imidazole antifungal agents and monoamine oxidase inhibitors (MAOI), which may increase the hypoglycemic effect of Gliclazide.
The hypoglycemic action of sulfonylureas may be opposed by the induction of hepatic enzymes, which metabolize the drug causing lower plasma concentrations and less hypoglycemic effect. Common inducers include rifampicin, barbiturates, phenytoin and alcohol, or by drugs that inhibit the release or action of insulin, e.g. thiazide diuretics, dizoxide, glucocorticoids, estrogens or sympathomimetic drugs. Early symptoms of hypoglycemia such as tremor, sweating and tachycardia may be masked by β-adrenoreceptor blocking drugs, such as propranolol allowing severe hypoglycemic episodes without preceding warning symptoms.