A Hypoglycaemia has occurred in patients with diabetes when they were given
fluoxetine or sertraline, and a loss of hypoglycaemic awareness has also been reported with fluoxetine. Conversely, two isolated reports describe hyperglycaemia in patients given fluvoxamine or sertraline.
There would seem to be little reason for avoiding concurrent use of fluoxetine, fluvoxamine or sertraline with sulphonylureas, but the cautious may want to increase blood glucose monitoring. The manufacturers of the SSRIs warn that dosages of insulin or oral antidiabetics may need adjustment during concurrent use, but the available evidence suggests that this is rare.
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