Drug General Information (ID: DDI95BZ4AF)
  Drug Name Glyburide Drug Info Sulfinpyrazone Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Antidiabetic Agents Uricosuric Agents
  Structure

 Mechanism of Glyburide-Sulfinpyrazone Interaction (Severity Level: Moderate)
     Decreased metabolism (Unspecific) Click to Show/Hide Mechanism Graph
      Drug Name Glyburide Sulfinpyrazone
      Mechanism 1 Sulfonylurea Inhibition of sulfonylurea metabolism
      Key Mechanism Factor 1
Factor Name Pharmacokinetics
Factor Description Alters the metabolism of the drug, leading to changes in the plasma concentration of the drug and affecting the pharmacological effects.
      Mechanism Description
  • Decreased metabolism of Glyburide caused by Sulfinpyrazone 
     Decreased renal excretion (Unspecific) Click to Show/Hide Mechanism Graph
      Drug Name Glyburide Sulfinpyrazone
      Mechanism 2 Sulfonylurea Inhibition of sulfonylurea renal clearance
      Key Mechanism Factor 2
Factor Name Pharmacokinetics
Factor Description Alters the excretion of the drug, resulting in changes in the plasma concentration of the drug and affecting the pharmacological effects.
      Mechanism Description
  • Decreased renal excretion of Glyburide caused by Sulfinpyrazone 

Recommended Action
      Management Patients receiving this combination should be monitored for increased hypoglycemic effects and advised to regularly monitor their blood sugar, counseled on how to recognize and treat hypoglycemia (e.g., headache, dizziness, drowsiness, nausea, tremor, hunger, weakness, or palpitations) and to notify their physician if it occurs. The sulfonylurea dosage may require reduction in affected patients.

References
1 Cerner Multum, Inc. "UK Summary of Product Characteristics.".
2 Christensen LK, Hansen JM, Kristensen M "Sulphaphenazole-induced hypoglycemic attacks in tolbutamide-treated diabetics." Lancet 2 (1963): 1298-301. [PMID: 14071924]
3 Eckhardt W, Rudolph R, Sauer H, Schubert WR, Undeutsch D "Zur pharmakologischen interferenz von glibornurid mit sulfaphenazol, phenylbutazon und phenprocoumon beim menschen." Arzneimittelforschung 22 (1972): 2212-9. [PMID: 4679251]
4 Field JB, Ohta M, Boyle C, Remer A "Potentiation of acetohexamide hypoglycemia by phenylbutazone." N Engl J Med 277 (1967): 889-94. [PMID: 6061822]
5 Held H, Kaminski B, von Oldersausen HF "Die beeinflussung der elimination von glycodiazin durch leber- und nierenfunctionssorungen und durch eine behandlung mit phenylbutazone, phenprocumarol und doxycyclin." Diabetologia 6 (1970): 386-91. [PMID: 5452388]
6 Held H, Scheible G "Interaktion von pnenylbutazon und oxyphenbutazon mit glymidin." Arzneimittelforschung 31 (1981): 1036-8. [PMID: 6455124]
7 Hellman B "Potentiating effects of drugs on the binding of glibenclamide to pancreatic beta cells." Metabolism 23 (1974): 839-46. [PMID: 4212254]
8 Mahfouz M, Abdel-Maguid R, El-Dakhakhny M "Potentiation of the hypoglycaemic action of tolbutamide by different drugs." Arzneimittelforschung 20 (1970): 120-2. [PMID: 5467602]
9 Miners JO, Foenander T, Wanwimolruk S, Gallus AS, Birkett DJ "The effect of sulphinpyrazone on oxidative drug metabolism in man: inhibition of tolbutamide elimination." Eur J Clin Pharmacol 22 (1982): 321-6. [PMID: 7106168]
10 Ober KF "Mechanism of interaction of tolbutamide and phenylbutazone in diabetic patients." Eur J Clin Pharmacol 7 (1974): 291-4. [PMID: 4853129]
11 Petitpierre B, Perrin L, Rudhardt M, et al "Behaviour of chlorpropamide in renal insufficiency and under the effect of associated drug therapy." Int J Clin Pharmacol 6 (1972): 120-4. [PMID: 4638970]
12 Pond SM, Birkett DJ, Wade DN "Mechanisms of inhibition of tolbutamide metabolism: phenylbutazone, oxyphenbutazone, sulfaphenazole." Clin Pharmacol Ther 22 (1977): 573-9. [PMID: 913025]
13 Shah SJ, Bhandarkar SD, Satoskar RS "Drug interaction between chlorpropamide and non-steroidal anti-flammatory drugs, ibuprofen and phenylbutazone." Int J Clin Pharmacol Ther Toxicol 22 (1984): 470-2. [PMID: 6500764]
14 Slade IH, and Iosefa RN "Fatal hypoglycemic coma from the use of tolbutamide in elderly patients: report of two cases." J Am Geriatr Soc 15 (1967): 948-50. [PMID: 6046558]
15 Tannenbaum H, Anderson LG, Soeldner JS "Phenylbutazone-tolbutamide drug interaction." N Engl J Med 290 (1974): 344. [PMID: 4809290]
16 Yu T, Berger L, Gutman AB "Hypoglycemic and uricosuric properties of acetohexamide and hydroxyhexamide." Metabolism 17 (1968): 309-16. [PMID: 5646202]
17 Schultz E, Koch K, Schmidt FH "Ursachen der potenzierung der hypoglykamischen wirkung von sulfonylharnstoff-derivaten durch medikamente. II. Pharmakokinetik und metabolismus von glibenclamid (HB 419) in gegenwart von phenylbuazon." Eur J Clin Pharmacol 4 (1971): 32-7. [PMID: 5004903]