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Cibenzoline-induced hypoglycemia.

D E Hilleman, S M Mohiuddin, I S Ahmed

Drug Intelligence & Clinical Pharmacy

|January 1, 1987

Summary

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Antiarrhythmic drugs like cibenzoline can rarely cause severe hypoglycemia. This case highlights the importance of considering drug-induced hypoglycemia in patients with cardiac conditions experiencing unexplained low blood sugar.

Area of Science:

Cardiology
Pharmacology

Background:

Antiarrhythmic-induced hypoglycemia is a rare adverse effect.
Disopyramide, a Class IA antiarrhythmic, has been linked to sporadic cases.
Cibenzoline is a Class I antiarrhythmic agent under U.S. clinical investigation.

Observation:

A case of cibenzoline-induced hypoglycemia in an elderly male with multiple comorbidities is presented.
The patient experienced severe hypoglycemia (blood glucose as low as 21 mg/dL) after two years of cibenzoline treatment.
Symptoms included central nervous system depression, hyperkalemia, and respiratory distress, with recurrence upon rechallenge.

Findings:

Hypoglycemia was confirmed to be secondary to cibenzoline, not reactive hypoglycemia or insulinoma.
Fasting blood glucose and plasma insulin levels were normal, ruling out other causes.

Related Experiment Videos

Discontinuation of cibenzoline resolved the hypoglycemic episodes.

Implications:

Clinicians should maintain a high index of suspicion for drug-induced hypoglycemia in patients on cibenzoline or disopyramide.
Awareness of this rare but severe adverse effect is crucial for prompt diagnosis and management.
Further investigation into the mechanisms of antiarrhythmic-induced hypoglycemia may be warranted.