ANTIDIABETICS AND QUINOLONES

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.
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