Pharmacological monitoring of hypoglycemia caused by interaction between clopidogrel and repaglinide
10.3760/cma.j.cn114015-20220317-00214
- VernacularTitle:氯吡格雷与瑞格列奈相互作用致低血糖的药学监护
- Author:
Yue CAI
1
;
Yanchun WANG
;
Xiaohui ZHOU
;
Xiaoran ZHU
;
Dongdong TIAN
;
Zhanjun DONG
Author Information
1. 河北省人民医院药学部，石家庄 050057
- Publication Type:Journal Article
- Keywords:
Clopidogrel;
Repaglinide;
Hypoglycemia;
Drug interactions;
Diabetes mellitus, type 2;
Diabetic nephropathies
- From:
Adverse Drug Reactions Journal
2022;24(12):664-666
- CountryChina
- Language:Chinese
-
Abstract:
A 49-year-old male patient with type 2 diabetes mellitus and diabetic nephropathy received long term use of retaglinide thrice daily orally, 1 mg in the morning, 2 mg in the afternoon and 1 mg in the evening. Because of the sudden acute cerebral infarction, clopidogrel was added, on the 4th day of the medication, the fasting blood glucose in the patient decreased to 2.6 mmol/L. It was considered that the interaction of clopidogrel and repaglinide caused the increase of repaglinide plasma concentration, which resulted in severe hypoglycemia in the patient. Clinical pharmacist suggested stopping repaglinide and using insulin. The physician reduced the dosage of repaglinide to twice daily, 1 mg in the morning and 0.5 mg in the afternoon, and after 3 days the patient′s fasting blood glucose fluctuated between 4.0 and 4.5 mmol/L. Since the patient had diabetes nephropathy and renal insufficiency, which might increase the risk of hypoglycemia, repaglinide was stopped, and insulin glutamine 3 U was injected subcutaneously before meals, at the same time blood glucose was closely monitored. Fasting blood glucose fluctuated between 4.9 and 5.4 mmol/L after insulin treatment.
