Glyburide and Metformin (Glucovance)

FDA has contraindicated the concomitant administration of Bosentan and Colesevelam with Glucovance.

Glyburide a sulfonylurea lowers blood glucose levels by stimulating the release of insulin from the pancreas, an effect dependent upon functioning beta cells in the pancreatic islets.

Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization.

Bosentan is an orally active competitive inhibitor of endothelin used for pulmonary arterial hypertension.

Colesevelam is a bile acid binding resin useful only for isolated increases in LDL.

Recommendations:

Concomitant use of these drugs can lead to an increased risk of liver enzyme elevations.

Glucovance should be administered at least 4 hours prior to Colesevelam as their concomitant administration reduces maximum plasma concentration and total exposure to glyburide.

http://www.fda.gov/Safety/MedWatch/SafetyInformation/ucm194334.htm