• Posted by CERC India
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Avoid these antibiotics if you are on certain diabetes drugs

A study published in October 2014 in JAMA Internal Medicine has revealed that older patients taking one of two commonly used oral diabetes drugs known as sulfonylureas – glipizide or glyburide – in combination with one of five antibiotics have an increased risk of developing dangerous low blood sugar levels, a condition called hypoglycemia.

The researchers found that five antibiotics – ciprofloxacin, clarithromycin, levofloxacin, metronidazole and the combination drug sulfamethoxazole and trimethoprim were significantly associated with increased risk of severe hypoglycemia. The risk was the greatest for clarithromycin and least for ciprofloxacin. The antibiotics either increased blood levels of or enhanced the action of the diabetes drugs, exposing the patients to greater risk of hypoglycemia.

Hypoglycemia episodes typically develop suddenly. Symptoms include nervousness, trembling, weakness, sweating, intense hunger, palpitations (a fluttering sensation in the chest due to a rapid or irregular heart rate) and disorientation. In severe cases, patients lose consciousness.

What you can do

  • You should take antibiotics only when you have or are likely to have a bacterial infection. Too often, patients request and doctors prescribe antibiotics for sore throats, cold symptoms and coughs caused by viruses. Antibiotics are not useful for treating such infections.
  • For most infections an alternative antibiotic to these five is available.
  • If for some reason you have to take one of these five antibiotics, discuss with your doctor whether your dose of oral diabetes medication should be temporarily reduced.
  • Increase the frequency of blood sugar monitoring and be alert for symptoms of hypoglycemia. Contact your doctor promptly if your blood sugar level falls below 70 or if you experience any hypoglycemia symptoms.
  • If you develop symptoms of hypoglycemia, drink a sugar-containing beverage, eat a piece of sugar containing candy or a teaspoon of sugar.

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