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Anti‐Infectives and the Risk of Severe Hypoglycemia in Users of Glipizide or Glyburide
Author(s) -
Schelleman H,
Bilker W B,
Brensinger C M,
Wan F,
Hennessy S
Publication year - 2010
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.2010.74
Subject(s) - glipizide , hypoglycemia , medicine , glibenclamide , pharmacology , diabetes mellitus , endocrinology
The objective of this study was to evaluate whether orally administered anti‐infectives increase the risk of severe hypoglycemia in users of glipizide or glyburide. We performed two case–control studies and two case–crossover studies using US Medicaid data. All the anti‐infectives examined were associated with an elevated risk of severe hypoglycemia. Using cephalexin as the reference category, in glipizide users, statistically significant associations were found with co‐trimoxazole (odds ratio (OR) = 3.14; 95% confidence interval (CI): 1.83–5.37); clarithromycin (OR = 2.90; 95% CI: 1.69–4.98); fluconazole (OR = 2.53; 95% CI: 1.23–5.23); and levofloxacin (OR = 2.09; 95% CI: 1.35–3.25). In glyburide users, with cephalexin as the reference, statistically significant associations were found with clarithromycin (OR = 5.02; 95% CI: 3.35–7.54); levofloxacin (OR = 2.83; 95% CI: 1.73–4.62); co‐trimoxazole (OR = 2.68; 95% CI: 1.59–4.52); fluconazole (OR = 2.20; 95% CI: 1.04–4.68); and ciprofloxacin (OR = 2.08; 95% CI: 1.23–3.52). In conclusion, exposure to all studied anti‐infective agents were associated with subsequent severe hypoglycemia. Using cephalexin as the reference, drug–drug interactions were evident with ciprofloxacin (in glyburide users only), clarithromycin, co‐trimoxazole, fluconazole, and levofloxacin. Clinical Pharmacology & Therapeutics (2010) 88 2, 214–222. doi: 10.1038/clpt.2010.74