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Related Experiment Videos

Hypoglycemia induced by interaction between clarithromycin and disopyramide.

H Iida1, T Morita, E Suzuki

  • 1Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo, Japan.

Japanese Heart Journal
|June 17, 1999
PubMed
Summary

Severe hypoglycemia can occur when clarithromycin (an antibiotic) is taken with disopyramide (a heart medication). This drug interaction increases disopyramide levels, potentially leading to dangerous drops in blood sugar.

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Area of Science:

  • Pharmacology
  • Clinical Medicine
  • Drug Interactions

Background:

  • Disopyramide is prescribed for paroxysmal atrial fibrillation.
  • Clarithromycin is a macrolide antibiotic.
  • Hemodialysis patients are susceptible to drug interactions.

Observation:

  • A patient on hemodialysis experienced severe hypoglycemia after starting clarithromycin while on disopyramide.
  • Serum disopyramide concentrations increased significantly in the presence of clarithromycin.
  • Blood glucose levels and the Turner index were altered by the drug combination.

Findings:

  • Clarithromycin likely inhibited the hepatic cytochrome P-450 system, increasing disopyramide levels.
  • Elevated disopyramide concentrations may have enhanced insulin secretion, causing hypoglycemia.

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  • QT/QTc intervals were prolonged, but torsades de pointes did not occur.

    • Implications:

    • Clinicians should be aware of the potential for life-threatening hypoglycemia from clarithromycin-disopyramide interactions.
    • Monitoring blood glucose and drug levels is crucial in patients taking both medications.
    • This interaction highlights the importance of considering drug metabolism pathways in clinical practice.