Trimethoprim-sulfamethoxazole hypoglycemia
DOI:
https://doi.org/10.35954/SM2020.39.2.9Keywords:
Diabetes Mellitus Type 2; Hypoglycemia; Renal Insufficiency; Multiple Myeloma; Trimethoprim, Sulfamethoxazole Drug Combination; Pneumocystis Infections; Pneumonia, Pneumocystis; Pneumocystis cariniiAbstract
Hypoglycemia is a frequent complication in diabetic patients. In most cases it occurs in relation to treatment with antidiabetic drugs or the use of insulin. Its prevention and immediate treatment is important, given the serious complications that can occur as a consequence, especially high mortality and neurological and cardiac sequelae. Hypoglycemia also occurs due to drugs other than those involved in antidiabetic treatment. We analyzed the clinical case of a patient with type 2 Diabetes Mellitus and Multiple Myeloma, who presented an infectious and respiratory complication of polychemotherapy. She required treatment with Trimetropim-Sulfamethoxazole, which produced hypoglycemia as an adverse effect, in a patient who had predisposing factors for its development and also in the context of drug-drug interactions.
After lowering the antibiotic dose, she did not repeat hypoglycemias, with good subsequent evolution. Hypoglycemia due to Trimethoprim-Sulfamethoxazole is an infrequent adverse effect. It is favored in patients who present predisposing factors for its development; in those who receive multiple drugs, pharmacological interactions and possible adverse effects should be taken into account when adding a new drug as described in the present clinical case.
Downloads
References
(1) García de los Ríos M, Durruty P. Diabetes Mellitus. 3a.ed. Santiago de Chile : Mediterráneo, 2014. p. 151-157.
(2) Agencia española de medicamentos y productos sanitarios. Ficha técnica SOLTRIM 160mg/ 800mg POLVO Y SOLUCION PARA SOLUCION INYECTABLE. Disponible en: https://cima.aemps.es/cima/pdfs/es/ft/54920/FT_54920.pdf [Consulta 19/07/2020].
(3) Petri WA Jr. Sulfonamidas, trimetoprim-sulfametoxazol, quinolonas y fármacos contra infecciones de las vías urinarias. En: Brunton L, Lazo J, Parker K, Eds. Goodman y Gilman. Las bases farmacológicas de la terapéutica. Sección VIII. Cap.43. 11a.ed. México : McGraw Hill, 2006. p.1111-1125.
(4) Eshraghian A, Omrani G. Cotrimoxazole-induced hypoglycemia in outpatient setting. Nutrition 2014; 30(7-8):959. doi:10.1016/j.nut.2014.01.002
(5) Caro J, Navarro-Hidalgo I, Civera M, Real J, Ascaso J. Hipoglucemia grave y prolongada secundaria a cotrimoxazol en sujeto con factores predisponentes. Endocrinol Nutr 2012; 59(2):146-8. doi: 10.1016/j.endonu.2011.07.012
(6) Chan J, Cockram C, Critchley J. Drug-induced disorders of glucose metabolism. Mechanisms and management. Drug Saf 1996; 15(2):135-157. doi: 10.2165/00002018-199615020-00005
(7) Okazaki M, Okazaki M, Nakamura M, Asagiri T, Takeuchi S. Consecutive hypoglycemia attacks induced by co-trimoxazole followed by pentamidine in a patient with acquired immunodeficiency syndrome. Int J STD AIDS 2019; 30(1):86-89. doi: 10.1177/0956462418795580
(8) Nunnari G, Celesia BM, Bellissimo F, Tosto S, La Rocca M, Giarratana F, et al. Trimethopim-Sulfamethoxazole-associated severe hypoglycemia: a Sulfonylurea-like effect. Eur Rev Med Pharmacol Sci 2010; 14(12):1015-8.
(9) Hekimsoy Z, Biberoglu S, Comlecki A, Tarhan O, Mermut C, Biberoglu K. Trimethoprim/sulfamethoxazole-induced hypoglycemia in a malnourished patient with severe infection. Eur J Endocrinol 1997; 136(3):304-6. doi: 10.1530/eje.0.1360304
(10) Tan A, Holmes HM, Kuo Y, Raji M, Goodwin J. Coadministration of co-trimoxazole with sulfonylureas: hypoglycemia events and pattern of use. J Gerontol Series A 2015; 70(2):247-254. https://doi.org/10.1093/gerona/glu072
(11) Parekh T, Raji M, Lin Y, Tan A, Kuo Y, Goodwin J. Hypoglycemia after antimicrobial drug prescription for older patients using sulfonylureas. JAMA Intern Med 2014; 174(10):1605-1612. doi:10.1001/jamainternmed.2014.3293
(12) Schelleman H, Bilker W, Brensinger C, Wan F, Hennessy S. Anti-infectives and risk of severe hypoglycemia in glipizide and glyburide users. Clin Pharmacol Ther 2010; 88(2):214-222. doi:10.1038/clpt.2010.74
Published
How to Cite
Issue
Section
License
Copyright (c) 2020 Víctor Edelstein Zarucki , María Florencia Segovia Cervetti. authors retain their copyright and grant the journal the right of first publication of their work, which will be simultaneously subject to the Creative Commons Attribution 4.0 International License that allows sharing the work as long as the initial publication in this journal is indicated.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Until 2024 we use the Creative Commons Attribution/NonCommercial Attribution 4.0 International License https://creativecommons.org/licenses/by-nc/4.0/deed.es. Which states that: you are free to share, copy and redistribute the material in any medium or format, as well as to adapt, remix, transform and build upon the material. Under the following terms:
Attribution: you must give proper credit , provide a link to the license, and indicate if changes have been made . You may do so in any reasonable manner, but not in such a way as to suggest that you or your use is endorsed by the licensor.
NonCommercial: you may not use the material for commercial purposes.
As of 2025 authors retain their copyright and assign to the journal the right of first publication of their work, which shall simultaneously be subject to the license https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es that permits sharing, copying and redistribution of the material in any medium or format provided that initial publication in this journal is indicated. Adapt, remix, transform and build upon the material. If you remix, transform, or build from the material, you must distribute your contribution under the same license as the original and may not make use of the material for commercial purposes.
Under the following terms:
1. Attribution: you must give proper credit, provide a link to the license, and indicate whether changes have been made. You may do so in any reasonable manner, but not in such a way as to suggest that you or your use is endorsed by the licensor.
2. NonCommercial: you may not use the material for commercial purposes.
3. ShareAlike: if you remix, transform or build upon the material, you must distribute your contribution under the same license as the original.
PlumX Metrics
