Glyburide-ciprofloxacin interaction with resistant hypoglycemia.
Glyburide, a second-generation sulfonylurea hypoglycemic agent, is metabolized by the P-450 hepatic enzyme system. Ciprofloxacin, a widely used quinolone antibiotic, is a recognized P-450 enzyme inhibitor. Conflicting data exist in the medical literature on the ability of quinolone antibiotics to inhibit glyburide hepatic metabolism. We present a case of hypoglycemia and an elevated serum glyburide level after 1 week of ciprofloxacin use in a patient receiving long-term glyburide therapy. Clinicians should consider this potential interaction in patients taking glyburide who require antibiotic therapy.
From the Department of Emergency Medicine, Western Pennsylvania Hospital,(*) and the Affiliated Residency in Emergency Medicine, University of Pittsburgh School of Medicine,(‡) Pittsburgh, PA.
Raymond J
RJ
Roberge
From the Department of Emergency Medicine, Western Pennsylvania Hospital,(*) and the Affiliated Residency in Emergency Medicine, University of Pittsburgh School of Medicine,(‡) Pittsburgh, PA.
Richard
R
Kaplan
From the Department of Emergency Medicine, Western Pennsylvania Hospital,(*) and the Affiliated Residency in Emergency Medicine, University of Pittsburgh School of Medicine,(‡) Pittsburgh, PA.
Robert
R
Frank
From the Department of Emergency Medicine, Western Pennsylvania Hospital,(*) and the Affiliated Residency in Emergency Medicine, University of Pittsburgh School of Medicine,(‡) Pittsburgh, PA.
Christopher
C
Fore
D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002939:Ciprofloxacin / Q000008:administration & dosage / Q000009:adverse effects*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D003928:Diabetic Nephropathies / Q000188:drug therapy; D004347:Drug Interactions; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D005905:Glyburide / Q000008:administration & dosage / Q000097:blood*; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced* / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000097:blood*; D012008:Recurrence; D018570:Risk Assessment; D014552:Urinary Tract Infections / Q000188:drug therapy
D000890:Anti-Infective Agents; D007004:Hypoglycemic Agents; D002939:Ciprofloxacin; D005905:Glyburide