Azole Antifungals/Sulfonylureas Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

When these two medicines are taken together, your body may not process your diabetes medicine properly.

What might happen:

An increase in the effects of your diabetes medicine may occur and may cause low blood sugar levels.

What you should do about this interaction:

If you experience a sudden onset of a cold sweat, dizziness, fatigue, shakiness, rapid heartbeat, nausea, vision changes, confusion, personality change, nervousness, hunger, or sweating, contact your doctor. It may be necessary to check your blood sugar levels more often. You may need an adjustment in the dose of your diabetes medicine.Your healthcare professionals (e.g. doctor or pharmacist) may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Lazar JD, Wilner KD. Drug interactions with fluconazole. Rev Infect Dis 1990 Mar-Apr;12 Suppl 3:S327-33.
  • 2.Diflucan (fluconazole) US prescribing information. Pfizer Inc. February, 2019.
  • 3.Krishnaiah YS, Satyanarayana S, Visweswaram D. Interaction between tolbutamide and ketoconazole in healthy subjects. Br J Clin Pharmacol 1994 Feb;37(2):205-7.
  • 4.Back DJ, Stevenson P, Tjia JF. Comparative effects of two antimycotic agents, ketoconazole and terbinafine on the metabolism of tolbutamide, ethinyloestradiol, cyclosporin and ethoxycoumarin by human liver microsomes in vitro. Br J Clin Pharmacol 1989 Aug;28(2):166-70.
  • 5.Back DJ, Tjia JF, Karbwang J, Colbert J. In vitro inhibition studies of tolbutamide hydroxylase activity of human liver microsomes by azoles, sulphonamides and quinolines. Br J Clin Pharmacol 1988 Jul;26(1):23-9.
  • 6.Damanhouri Z, Gumbleton M, Nicholls PJ, Shaw MA. In-vivo effects of itraconazole on hepatic mixed-function oxidase. J Antimicrob Chemother 1988 Feb;21(2):187-94.
  • 7.Meurice JC, Lecomte P, Renard JP, Girard JJ. Interaction of miconazole and sulfamides with hypoglycemic action. Presse Med 1983 Jun 18;12(26):1670.
  • 8.Loupi E, Descotes J, Lery N, Evreux JC. Drug interactions involving miconazole. Therapie 1982 Jul-Aug;37(4):437-41.
  • 9.Vfend (voriconazole) US prescribing information. Pfizer Inc. January, 2019.
  • 10.Noxafil (posaconazole) UK summary of product characteristics. Schering-Plough Ltd. February 2, 2006.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.