Effect of gemfibrozil on the pharmacokinetics and pharmacodynamics of glimepiride

Clin Pharmacol Ther. 2001 Nov;70(5):439-45. doi: 10.1067/mcp.2001.119723.

Abstract

Objective: Our objective was to study the effects of gemfibrozil on the pharmacokinetics and pharmacodynamics of glimepiride, a new sulfonylurea antidiabetic drug and a substrate of cytochrome P4502C9 (CYP2C9).

Methods: In a randomized, 2-phase crossover study, 10 healthy volunteers were treated for 2 days with 600 mg oral gemfibrozil or placebo twice daily. On day 3, they received a single dose of 600 mg gemfibrozil or placebo and 1 hour later a single dose of 0.5 mg glimepiride orally. Plasma glimepiride, serum insulin, and blood glucose concentrations were measured up to 12 hours.

Results: Gemfibrozil increased the mean total area under the plasma concentration-time curve of glimepiride by 23% (range, 6%-56%; P <.005). The mean elimination half-life of glimepiride was prolonged from 2.1 to 2.3 hours (P <.05) by gemfibrozil. No statistically significant differences were found in the serum insulin or blood glucose variables between the two phases.

Conclusions: Gemfibrozil modestly increases the plasma concentrations of glimepiride. This may be caused by inhibition of CYP2C9.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Area Under Curve
  • Aryl Hydrocarbon Hydroxylases*
  • Cross-Over Studies
  • Cytochrome P-450 CYP2C9
  • Cytochrome P-450 Enzyme System / physiology
  • Drug Interactions
  • Female
  • Gemfibrozil / pharmacology*
  • Humans
  • Hypoglycemic Agents / pharmacokinetics*
  • Hypolipidemic Agents / pharmacology*
  • Male
  • Steroid 16-alpha-Hydroxylase*
  • Steroid Hydroxylases / physiology
  • Sulfonylurea Compounds / pharmacokinetics*
  • Sulfonylurea Compounds / pharmacology

Substances

  • Hypoglycemic Agents
  • Hypolipidemic Agents
  • Sulfonylurea Compounds
  • glimepiride
  • Cytochrome P-450 Enzyme System
  • Steroid Hydroxylases
  • CYP2C9 protein, human
  • Cytochrome P-450 CYP2C9
  • Aryl Hydrocarbon Hydroxylases
  • Steroid 16-alpha-Hydroxylase
  • Gemfibrozil