A Review on the Potential Interaction Between Pyridostigmine and Glimepiride

Drug–drug interactions are an important concern in patients receiving multiple therapies, especially when treatments for chronic conditions overlap. Pyridostigmine [4,5,6], a cholinesterase inhibitor used in myasthenia gravis, and glimepiride [1,2,3,7], a sulfonylurea antidiabetic, are rarely studied together. Interaction checkers list this combination as a “possible risk,” mainly due to the potential for enhanced hypoglycaemia, but the evidence behind this warning is weak. In this review, we explain why doctors might be cautious about using pyridostigmine and glimepiride together, summarize what has been reported so far, and point out the important questions that research still hasn’t answered.