A number of reports describe severe hypoglycaemia in diabetic patients taking
gatifloxacin with various
antidiabetics including some sulphonylureas, insulin,
metformin, pioglitazone,
repaglinide, rosiglitazone, and voglibose. Isolated cases describe hypoglycaemia in diabetic patients taking glibenclamide (
glyburide) with ciprofloxacin,
levofloxacin, or
norfloxacin.
Studies have shown that
gatifloxacin may cause hypoglycaemia and hyperglycae- mia with at least a 10-fold higher
incidence than other
quinolones. Studies using ciprofloxacin and
levofloxacin with glibenclamide (
glyburide) suggest
plasma glucose levels are not usually affected to a clinically relevant extent Therefore in general these interactions seem unlikely to be clinically significant, although increased blood glucose monitoring may be prudent if
gatifloxacin is given to diabetics.