Drug interactions, renal impairment and hypoglycaemia in a patient with Type II diabetes

Collin, Marc; Mucklow, JC

doi:10.1046/j.1365-2125.1999.00996.x

Cited by 14 publications

(3 citation statements)

References 13 publications

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“…This study focuses on only hypoglycemia as a result of potential DDIs. The risk of hypoglycemia due to DDI is even more important in the case of renal failure, a condition that is frequently present in patients with diabetes mellitus and that may lead to the accumulation of a naive compound or an active metabolite . However, subgroup analysis in patients with renal failure will not be valid due to the small number of reports under concomitant use.…”

Section: Discussionmentioning

confidence: 99%

“…The risk of hypoglycemia due to DDI is even more important in the case of renal failure, a condition that is frequently present in patients with diabetes mellitus and that may lead to the accumulation of a naive compound or an active metabolite. 28,29 However, subgroup analysis in patients with renal failure will not be valid due to the small number of reports under concomitant use. It may be helpful to assess renal failure as a consequence of DDI from the concomitant use of antidiabetic, antihypertensive, and antihyperlipidemic medications, and this assessment should be carried out in future research.…”

Section: Discussionmentioning

confidence: 99%

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Risk of Hypoglycemia After Concomitant Use of Antidiabetic, Antihypertensive, and Antihyperlipidemic Medications: A Database Study

Gosho

2018

The Journal of Clinical Pharma

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Hypoglycemia is the most important complication of antidiabetic medications. Most patients with diabetes mellitus take multiple medications. In this study, we explored clinical drug-drug interactions that result in hypoglycemia by analyzing the Japanese Adverse Drug Event Report (JADER) database. The primary outcome was the report of hypoglycemia. The Norén and Gosho methods, which quantitatively measure the discrepancy between the observed and expected number of adverse events under the combination of 2 drugs, were used as the criteria for detecting drug-drug interactions. The JADER database contained patient characteristics with 468 292 records, drug information with 2 973 172 records, and adverse reactions with 741 016 records. We noted that hypoglycemia was reported in 6208 patients. Concomitant use of linagliptin/glibenclamide, sitagliptin/glibenclamide, sitagliptin/buformin, exenatide/voglibose, mitiglinide/perindopril, repaglinide/barnidipine, alogliptin/cilnidipine, teneligliptin/barnidipine, teneligliptin/urapidil, exenatide/candesartan, voglibose/barnidipine, voglibose/guanabenz, or exenatide/tocopherol was noted using the 2 criteria for drug-drug interactions. Concomitant use of teneligliptin and barnidipine produced the highest values for the 2 criteria. The second-and third-highest values were observed for teneligliptin/urapidil and exenatide/candesartan combinations, respectively. The same analysis was performed using the US Food and Drug Administration Adverse Event Reporting System database to assess the validity of the result from the JADER database. The concomitant use of sitagliptin/buformin, exenatide/voglibose, repaglinide/barnidipine, teneligliptin/barnidipine, teneligliptin/urapidil, exenatide/candesartan, voglibose/barnidipine, voglibose/guanabenz, or exenatide/tocopherol was detected in both the JADER and Food and Drug Administration Adverse Event Reporting System databases. Combination therapy with the drugs listed above would show potential interactions that could result in hypoglycemia in patients with diabetes mellitus.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk of Hypoglycemia After Concomitant Use of Antidiabetic, Antihypertensive, and Antihyperlipidemic Medications: A Database Study

Gosho

2018

The Journal of Clinical Pharma

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“…Sulfonylharnstoffe zeigen in der Kombination mit NSAR ein erhöhtes Hypoglykämierisiko [31,32], Fallberichte bestehen über die Kombination von Glibenclamid mit Ibuprofen und Naproxen.…”

Section: Methodikunclassified

Polypharmacy and pain treatment

Gosch

Böhmdorfer

Benvenuti-Falger

et al. 2010

Wien Med Wochenschr

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Pain is a frequent symptom in clinical practice. Elderly and chronically ill patients are particularly affected. On account of the high prevalence of polypharmacy among these patients, pharmacological pain therapy becomes a challenge for physicians. Drug side effects and drug-drug interactions have to be taken into account so as to minimize the health risk for these patients. Especially the group of NSAID has a high risk of adverse drug reactions and drug interactions. The gastrointestinal, the cardiovascular, the renal and the coagulation system are particularly affected. Except for the toxic effect on the liver (in a high dose) Paracetamol (acetaminophen) has similar risks, to a minor degree, though. According to current data Metamizol is actually better than its reputation. The risk of potential drug interactions seems to be low. Beside the risk of sedation in combination with other drugs, Tramadol and other opioids such as Pethidin may induce the Serotonin syndrome. In order to avoid dangerous drug interactions and adverse side effects in the case of polypharmacy, it is recommended to prefer individual choices instead of sticking to the pain management as proposed by the WHO.

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Analgetika beim geriatrischen Patienten

Gosch

2015

Z Gerontol Geriat

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Pain is a widespread symptom in clinical practice. Older adults and chronically ill patients are particularly affected. In multimorbid geriatric patients, pharmacological pain treatment is an extension of a previously existing multimedication. Besides the efficacy of pain treatment, drug side effects and drug-drug interactions have to be taken into account to minimize the health risk for these patients. Apart from the number of prescriptions, the age-related pharmacokinetic and pharmacodynamic changes significantly increase the risk among older adults. The use of non-steroidal anti-inflammatory drugs (NSAID) is widespread but NSAIDs have the highest risk of adverse drug reactions and drug interactions. In particular, the gastrointestinal, cardiovascular, renal and coagulation systems are affected. Apart from the known toxic effect on the liver (in high doses), paracetamol (acetaminophen) has similar risks although to a lesser degree. According to current data, metamizol is actually better than its reputation suggests. The risk of potential drug interactions seems to be low. Apart from the risk of sedation in combination with other drugs, tramadol and other opioids can induce the serotonin syndrome. Among older adults, especially in the case of polypharmacy, an individualized approach should be considered instead of sticking to the pain management recommended by the World Health Organization (WHO) in order to minimize drug-drug interactions and adverse drug reactions.

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Drug interactions, renal impairment and hypoglycaemia in a patient with Type II diabetes

Cited by 14 publications

References 13 publications

Risk of Hypoglycemia After Concomitant Use of Antidiabetic, Antihypertensive, and Antihyperlipidemic Medications: A Database Study

Risk of Hypoglycemia After Concomitant Use of Antidiabetic, Antihypertensive, and Antihyperlipidemic Medications: A Database Study

Polypharmacy and pain treatment

Analgetika beim geriatrischen Patienten

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