Fluconazole normally appears not to affect the diabetic control of most patients taking sulphonylureas, but isolated reports describe hypoglycaemic coma and aggressive behaviour following concurrent use. Fluconazole may cause marked increases in plasma levels of glimepiride, but the significance of this is unclear. Nateglinide plasma levels may also be increased by fluconazole, but this did not affect the control of blood glucose levels.
There is no reason to avoid concurrent use but warn patients to report any unexpected changes in blood glucose levels.
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