pioglitazone and Clotrimazole Interactions

Interactions between pioglitazone and Clotrimazole (clotrimazole)

clotrimazole and pioglitazone (Moderate Drug-Drug)

MONITOR: Imidazole antifungal agents may enhance the effects of some oral hypoglycemic agents, including sulfonylureas, meglitinides, and thiazolidinediones. The proposed mechanism is inhibition of CYP450 3A4 and/or 2C9 hepatic metabolism by the imidazoles, resulting in increased plasma concentrations and prolonged effects of the hypoglycemic agents. Some cases of severe hypoglycemia have been reported.

MANAGEMENT: Frequent monitoring of serum glucose levels is recommended during coadministration and upon discontinuation of the antifungal agent. Patients should be counseled to recognize and treat the symptoms of hypoglycemia (e.g., such as headache, dizziness, drowsiness, nausea, tremor, weakness, palpitations, and hunger) and to notify their doctor if it occurs.