title: VFEND® (voriconazole)-associated hypoglycaemia without identified drug interaction.
abstract: To report the first case of severe hypoglycaemia episodes related to voriconazole, involving neither over dosage nor any identified interaction with hypoglycaemic drugs. A 51-year-old man developed faints without loss of consciousness, with sweating in the morning for 3-4 days and low blood glucose, about 1 month after initiating voriconazole therapy. Hypoglycaemia was diagnosed and the patient required permanent intravenous glucose solutions for 8 days after voriconazole was stopped, after which glycaemia remained normal. A hyperinsulinaemia peak was observed, which disappeared when glycaemia normalized. Hypoglycaemia is known as a less common adverse event resulting from high voriconazole concentration and hepatic dysfunction. The mechanism of hypoglycaemia may be linked to insulinemia as its serum values are similar to glycaemia. Voriconazole may induce hypoglycaemia in patients without over dosage nor drug interaction.
authors: Regional Centre Régional of Pharmacovigilance and Drugs Information, University Hospital of Dijon, 10 boulevard du Maréchal de Lattre de Tassigny, BP 77 908, 21079, Dijon Cedex, France.
authors: Marion
authors: M
authors: Lyoen
authors: Florian
authors: F
authors: Rostain
authors: Aurélie
authors: A
authors: Grimault
authors: Anne
authors: A
authors: Minello
authors: Catherine
authors: C
authors: Sgro
mesh_terms: D000935:Antifungal Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001228:Aspergillosis / Q000188:drug therapy; D004760:Enterocolitis / Q000188:drug therapy; D005947:Glucose / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D006946:Hyperinsulinism / Q000139:chemically induced; D007003:Hypoglycemia / Q000097:blood / Q000139:chemically induced* / Q000503:physiopathology / Q000628:therapy; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011743:Pyrimidines / Q000009:adverse effects* / Q000627:therapeutic use; D012720:Severity of Illness Index; D013575:Syncope / Q000209:etiology; D016896:Treatment Outcome; D014230:Triazoles / Q000009:adverse effects* / Q000627:therapeutic use; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D005947:Glucose; D065819:Voriconazole