Thiazolidinediones and their drug interactions involving CYP enzymes


Naina Mohamed Pakkir Maideen

Background: Thiazolidinediones (TZDs) include pioglitazone and rosiglitazone and they are indicated in the treatment of type 2 diabetes mellitus. They are insulin sensitizers and are metabolized primarily by the CYP2C8 enzyme. The drugs inhibiting or inducing CYP2C8 enzyme may result in pharmacokinetic drug interactions of TZDs. The probability of drug interactions is higher in type 2 diabetic patients as they administer many medications to manage blood glucose and to treat other diseases. Clinically significant drug interactions of TZDs are discussed in this review. Methods: The literature review was done in databases like Medline/PubMed/PMC, Science Direct, Google Scholar, Directory of Open Access Journals, and reference lists to identify relevant articles. Results: The drugs inhibiting the CYP2C8 enzyme such as gemfibrozil, clopidogrel, trimethoprim, ketoconazole, and rifampicin have been identified to affect the pharmacokinetics of TZDs. Conclusion: The clinicians need to be aware of adverse drug interactions of TZDs to prevent negative outcomes.