Pedrazzi F, Bommartini F, Freddo J, Emanueli A
Eur J Rheumatol Inflamm. 1981;4(1):26-31.
Phenylbutazone was shown to impair tolbutamide metabolism with resulting potentiation of its hypoglycemic effect and increased danger of hypoglycemia. As indoprofen is widely used for treating rheumatic conditions, and in particular osteoarthritis, the possibility that it may increase the effect of sulfonylureas on blood glucose levels has been investigated. Clinical studies have been carried out in 24 patients with osteoarthritis. All of them had maturity-onset diabetes mellitus and were on sulfonylurea drugs (tolbutamide or glipizide). The trials were double-blind and were carried out according to two different experimental designs. Twelve patients were treated with 600 mg/daily of indoprofen for five days and placebo for an equivalent period of time according to a cross-over scheme. Another group of patients was treated with indoprofen for eight days preceded and followed by a four-day placebo treatment. In both studies concomitant treatment with the hypoglycemic drug was maintained with a fixed dosage. No important differences were found between blood glucose levels when the periods of treatment with indoprofen and placebo were compared. Consequently, it is unlikely that indoprofen treatment at the doses employed may interfere at the clinical level with the effect of tolbutamide or glipizide on glucose metabolism.
已表明保泰松会损害甲苯磺丁脲的代谢,从而增强其降血糖作用,并增加低血糖的风险。由于吲哚美辛广泛用于治疗风湿性疾病,尤其是骨关节炎,因此对其可能增强磺脲类药物对血糖水平影响的可能性进行了研究。对24例骨关节炎患者进行了临床研究。他们均患有成年型糖尿病,且正在服用磺脲类药物(甲苯磺丁脲或格列吡嗪)。试验采用双盲法,并根据两种不同的实验设计进行。12例患者按照交叉方案,先服用600mg/d的吲哚美辛,持续5天,然后服用同等时间的安慰剂。另一组患者先服用吲哚美辛8天,前后各有4天的安慰剂治疗期。在两项研究中,均以固定剂量维持降糖药物的联合治疗。比较吲哚美辛治疗期和安慰剂治疗期的血糖水平时,未发现显著差异。因此,使用的剂量的吲哚美辛治疗在临床水平上不太可能干扰甲苯磺丁脲或格列吡嗪对葡萄糖代谢的作用。