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
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.