Sulphonylureas toxicity

CICLOSPORIN SULPHONYLUREAS- GUPIZIDE May T plasma concentrations of ciclosporin Glipizide inhibits CYP3A4-mediated metabolism of ciclosporin Monitor plasma ciclosporin levels to prevent toxicity... 

SULPHONYLUREAS ANTIPROTOZOALS -PENTAMIDINE May alter sulphonylurea requirements due to altered glycaemic control Attributed to pancreatic beta cell toxicity Need to monitor blood sugar until stable and following withdrawal of pentamidine... 

Instead of first-generation sulphonylureas, second-generation drugs must be preferred in cardiac glycoside-treated diabetics (Ballagi-Pordany et al., 1989). In rabbits and rats, glibenclamide decreased, while tolbutamide and carbutamide increased, strophantidin toxicity and myocardial ischaemia-induced transitory ventricular fibrillation in a dose-dependent manner (Pogatsa et al., 1988). 

Data on relative safety suggest that chlorpropamide is the most toxic sulphonylurea (Ferner, 1988), but glyburide causes more dangerous hypoglycaemias than chlorpropamide. Glibenclamide has been shown to have a delayed effect on stimulating insulin secretion and this may be responsible for many unexpected severe hypoglycaemic episodes (Turner et al., 1987). 

---