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Refractory hypoglycemia from ciprofloxacin and glyburide interaction
George Lin1, Daniel P Hays, Linda Spillane
1Department of Emergency Medicine, University of Rochester, Rochester, New York 14642, USA.
Journal of Toxicology. Clinical Toxicology
|September 15, 2004
Summary
Concurrent use of glyburide and ciprofloxacin can cause prolonged hypoglycemia in diabetic patients. Close glucose monitoring is crucial when starting fluoroquinolones in patients on glyburide.
Area of Science:
- Pharmacology
- Endocrinology
- Infectious Diseases
Background:
- Drug-drug interactions (DDIs) pose significant risks in polypharmacy.
- Hypoglycemia is a known complication of oral hyperglycemic agents.
- Fluoroquinolone antibiotics can have various side effects.
Observation:
- A case of a diabetic patient on glyburide developed prolonged hypoglycemia.
- The hypoglycemia occurred after the concurrent administration of ciprofloxacin.
- The event persisted for over 24 hours.
Findings:
- Concurrent administration of glyburide and ciprofloxacin can lead to severe and prolonged hypoglycemia.
- The interaction mechanism is complex and likely multifactorial.
- This interaction is rarely reported in medical literature.
Implications:
- Clinicians should be aware of the potential for severe hypoglycemia when prescribing fluoroquinolones to patients on glyburide.
- Close blood glucose monitoring is recommended for patients starting fluoroquinolones while on glyburide.
- Further research into the mechanisms of this DDI is warranted.