Department of Diabetes and Endocrinology, Osaka Police Hospital, Japan.
Intern Med. 2021;60(6):905-910. doi: 10.2169/internalmedicine.5578-20. Epub 2021 Mar 15.
Hypoglycemia should be avoided when treating patients with diabetes. Repaglinide is an insulin secretagogue with a low hypoglycemic risk because of its rapid- and short-acting effects. However, its blood concentration has been reported to increase in combination with clopidogrel, an antiplatelet drug, and in patients with severe renal insufficiency. We herein report an elderly patient with type 2 diabetes mellitus and severe renal insufficiency who received repaglinide and hypoglycemia three days after starting clopidogrel. The concomitant use of repaglinide and clopidogrel can lead to hypoglycemia, especially in patients with severe renal insufficiency.
在治疗糖尿病患者时应避免低血糖。瑞格列奈是一种胰岛素促泌剂,由于其起效快、作用时间短,低血糖风险低。然而,已有报道称,瑞格列奈与抗血小板药物氯吡格雷联合使用时,以及在严重肾功能不全的患者中,其血药浓度会升高。本文报告了一例 2 型糖尿病伴严重肾功能不全的老年患者,在开始使用氯吡格雷 3 天后出现低血糖。瑞格列奈和氯吡格雷的联合使用可导致低血糖,尤其是在严重肾功能不全的患者中。