Some preliminary evidence suggests that glibenclamide (glyburide) can raise serum ciclosporin levels to a moderate extent. Glipizide caused about a 2-fold increase in ciclosporin levels in 2 patients, but no change was noted in a study. Ciclosporin increased repaglinide bioavailability in one study, but another suggested that this did not affect blood glucose levels.
These interactions are unconfirmed, but note that one of the rare adverse effects of ciclosporin is hyperglycaemia. There is insufficient evidence to generally recom- mend increased monitoring, but be aware of the potential for an interaction with the sulphonylureas if ciclosporin levels are unexpectedly raised, and with repaglinide if blood glucose levels become undesirably lowered.
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