Sulfonylureas

Sulfonylureas are metabolic drugs in the antidiabetic family. This group includes Glipizide (Glucotrol), Glyburide (Diabeta), and Glimepiride (Amaryl), and is generally used as antidiabetic medicine.

This page is an educational reference for considering how sulfonylureas and their listed brand medicines may interact with other medicines or supplements you take. It is not medical advice; questions about treatment or a medical condition are best discussed with a clinician.

The main concern with sulfonylureas is additive blood-glucose lowering, which can increase the risk of hypoglycemia. Alpha-Lipoic Acid (ALA), Apple Cider Vinegar, Oregano Oil, Panax Ginseng, and Psyllium Husk are identified as particularly important combinations to review with a healthcare provider. With Apple Cider Vinegar and Psyllium Husk, the concern may be greater when food intake is reduced; glucose monitoring and medication adjustment may be clinically indicated.

A similar concern applies to American Ginseng, Astragalus, Bacopa Monnieri, BCAA, Berberine, Black Elderberry, Black Seed Oil, Chaga, Chlorella, Coenzyme Q10, Cordyceps, Garlic, Ginger, Holy Basil (Tulsi), Lemon Balm (Melissa), L-Leucine, MCT Oil, and Milk Thistle (Silymarin). These combinations may lower blood glucose in addition to the insulin release stimulated by sulfonylureas. Berberine may be of particular concern for older adults or people with renal impairment. Milk Thistle (Silymarin) warrants attention when it is initiated, discontinued, or substantially changed in dose.

For some pairs, the concern is theoretical rather than established. Direct clinical evidence is lacking for Inositol, and direct clinical interaction evidence is limited for Black Elderberry. L-Carnitine has no clinically important interaction established, although precautionary glucose monitoring is described. MCT Oil may alter blood-glucose control, while the mechanism for Ginger is not specified here. A prescriber or pharmacist can help determine whether monitoring or medication adjustment is appropriate for an individual situation.