Leonard, Charles E.Bilker, Warren B.Brensinger, Colleen M.Han, XuFlory, James H.Flockhart, David A.Gagne, Joshua J.Cardillo, SerenaHennessy, Sean2017-08-032017-08-032016-05Leonard, C. E., Bilker, W. B., Brensinger, C. M., Han, X., Flory, J. H., Flockhart, D. A., … Hennessy, S. (2016). SEVERE HYPOGLYCEMIA IN USERS OF SULFONYLUREA ANTIDIABETIC AGENTS AND ANTIHYPERLIPIDEMICS. Clinical Pharmacology and Therapeutics, 99(5), 538–547. http://doi.org/10.1002/cpt.297https://hdl.handle.net/1805/13740Drug-drug interactions causing severe hypoglycemia due to antidiabetic drugs is a major clinical and public health problem. We assessed whether sulfonylurea use with a statin or fibrate was associated with severe hypoglycemia. We conducted cohort studies of users of glyburide, glipizide, and glimepiride plus a statin or fibrate within a Medicaid population. The outcome was a validated, diagnosis-based algorithm for severe hypoglycemia. Among 592,872 persons newly exposed to a sulfonylurea+antihyperlipidemic, the incidence of severe hypoglycemia was 5.8/100 person-years. Adjusted hazard ratios (HRs) for sulfonylurea+statins were consistent with no association. Most overall HRs for sulfonylurea+fibrate were elevated, with sulfonylurea-specific adjusted HRs as large as 1.50 (95% confidence interval (CI): 1.24-1.81) for glyburide+gemfibrozil, 1.37 (95% CI: 1.11-1.69) for glipizide+gemfibrozil, and 1.63 (95% CI: 1.29-2.06) for glimepiride+fenofibrate. Concomitant therapy with a sulfonylurea and fibrate is associated with an often delayed increased rate of severe hypoglycemia.en-USPublisher PolicyCohort studiesDrug interactionsFibric acidsHydroxymethylglutaryl-CoA reductase inhibitorsHypoglycemiaMedicaidPharmacoepidemiologyPropensity scoreSulfonylurea compoundsArticle