Related Experiment Videos
Hypoglycaemia due to azapropazone-tolbutamide interaction.
British Journal of Rheumatology
|February 1, 1984
Summary
A first dose of azapropazone caused severe hypoglycemia in a patient taking tolbutamide. This drug interaction, likely due to protein binding displacement, suggests avoiding azapropazone in patients on tolbutamide.
Area of Science:
- Pharmacology
- Clinical Medicine
- Drug Interactions
Background:
- Tolbutamide is an oral hypoglycemic agent used to manage type 2 diabetes.
- Azapropazone is a non-steroidal anti-inflammatory drug (NSAID) with uricosuric properties.
Observation:
- A patient receiving tolbutamide experienced severe hypoglycemia after initiating azapropazone therapy.
- This event occurred with the first dose of azapropazone, indicating a potential 'first-dose' interaction.
Findings:
- The interaction between azapropazone and tolbutamide led to a significant decrease in blood glucose levels.
- The probable mechanism involves azapropazone displacing tolbutamide from its protein binding sites, increasing free tolbutamide concentrations.
Implications:
- Clinicians should be aware of this potential drug interaction when prescribing azapropazone to patients on tolbutamide.
- Azapropazone should likely be avoided in patients receiving tolbutamide to prevent severe hypoglycemia.
- This case highlights the importance of considering protein binding displacement in drug-drug interactions.