Interplay of Statins, Clopidogrel, and Repaglinide: Unraveling the Nexus of Hypoglycemia and Myopathy in a Geriatric Type 2 Diabetes Patient: A Case Report
Background: The management of cardiovascular diseases often includes the use of statins, which, while reducing cardiovascular risk, can interact with other medications leading to significant adverse effects. This case report explores the complex interactions between atorvastatin, clopidogrel, and...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-10-01
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| Series: | Journal of Diabetology |
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| Online Access: | https://journals.lww.com/jodb/fulltext/2024/15040/interplay_of_statins,_clopidogrel,_and.16.aspx |
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| author | Shambo S Samajdar Shatavisa Mukherjee Bansi Saboo Nandini Chatterjee Jyotirmoy Pal Shashank Joshi |
| author_facet | Shambo S Samajdar Shatavisa Mukherjee Bansi Saboo Nandini Chatterjee Jyotirmoy Pal Shashank Joshi |
| author_sort | Shambo S Samajdar |
| collection | DOAJ |
| description | Background:
The management of cardiovascular diseases often includes the use of statins, which, while reducing cardiovascular risk, can interact with other medications leading to significant adverse effects. This case report explores the complex interactions between atorvastatin, clopidogrel, and repaglinide, which precipitated severe hypoglycemia and myopathy in a patient with multiple comorbidities.
Case Presentation:
We describe a 68-year-old female with a history of type 2 diabetes mellitus, hypertension, and ischemic heart disease, who developed severe hypoglycemia and myopathy following the adjustment of her statin therapy post-cardiac diagnosis. Her treatment regimen was modified to include an increased dose of atorvastatin and the introduction of clopidogrel, shortly after which she presented with hypoglycemia and symptoms of myopathy. Investigations revealed significantly elevated muscle injury markers and magnetic resonance imaging findings consistent with myositis.
Discussion:
The pharmacokinetic interactions between clopidogrel with repaglinide and repaglinide with atorvastatin exacerbated by the increased dose of atorvastatin, likely led to the observed clinical manifestations. This case highlights the critical need for careful monitoring of drug interactions, especially in patients with polypharmacy. Adjustments in drug dosages and consideration of alternative medications with fewer interaction risks are essential components of managing similar cases.
Conclusion:
This case underscores the importance of vigilant therapeutic management and individualized patient care in the context of complex drug regimens. Understanding and anticipating drug interactions can prevent significant adverse effects and improve patient outcomes in a population at high risk of polypharmacy complications. |
| format | Article |
| id | doaj-art-4fd970fc45304d179d1a90db09cd72cf |
| institution | Kabale University |
| issn | 2078-7685 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Diabetology |
| spelling | doaj-art-4fd970fc45304d179d1a90db09cd72cf2024-12-15T07:15:02ZengWolters Kluwer Medknow PublicationsJournal of Diabetology2078-76852024-10-0115443743910.4103/jod.jod_111_24Interplay of Statins, Clopidogrel, and Repaglinide: Unraveling the Nexus of Hypoglycemia and Myopathy in a Geriatric Type 2 Diabetes Patient: A Case ReportShambo S SamajdarShatavisa MukherjeeBansi SabooNandini ChatterjeeJyotirmoy PalShashank JoshiBackground: The management of cardiovascular diseases often includes the use of statins, which, while reducing cardiovascular risk, can interact with other medications leading to significant adverse effects. This case report explores the complex interactions between atorvastatin, clopidogrel, and repaglinide, which precipitated severe hypoglycemia and myopathy in a patient with multiple comorbidities. Case Presentation: We describe a 68-year-old female with a history of type 2 diabetes mellitus, hypertension, and ischemic heart disease, who developed severe hypoglycemia and myopathy following the adjustment of her statin therapy post-cardiac diagnosis. Her treatment regimen was modified to include an increased dose of atorvastatin and the introduction of clopidogrel, shortly after which she presented with hypoglycemia and symptoms of myopathy. Investigations revealed significantly elevated muscle injury markers and magnetic resonance imaging findings consistent with myositis. Discussion: The pharmacokinetic interactions between clopidogrel with repaglinide and repaglinide with atorvastatin exacerbated by the increased dose of atorvastatin, likely led to the observed clinical manifestations. This case highlights the critical need for careful monitoring of drug interactions, especially in patients with polypharmacy. Adjustments in drug dosages and consideration of alternative medications with fewer interaction risks are essential components of managing similar cases. Conclusion: This case underscores the importance of vigilant therapeutic management and individualized patient care in the context of complex drug regimens. Understanding and anticipating drug interactions can prevent significant adverse effects and improve patient outcomes in a population at high risk of polypharmacy complications.https://journals.lww.com/jodb/fulltext/2024/15040/interplay_of_statins,_clopidogrel,_and.16.aspxclinical pharmacology; clopidogrel; drug interactions; geriatric medicine; hypoglycemia; myopathy; repaglinide; statins |
| spellingShingle | Shambo S Samajdar Shatavisa Mukherjee Bansi Saboo Nandini Chatterjee Jyotirmoy Pal Shashank Joshi Interplay of Statins, Clopidogrel, and Repaglinide: Unraveling the Nexus of Hypoglycemia and Myopathy in a Geriatric Type 2 Diabetes Patient: A Case Report Journal of Diabetology clinical pharmacology; clopidogrel; drug interactions; geriatric medicine; hypoglycemia; myopathy; repaglinide; statins |
| title | Interplay of Statins, Clopidogrel, and Repaglinide: Unraveling the Nexus of Hypoglycemia and Myopathy in a Geriatric Type 2 Diabetes Patient: A Case Report |
| title_full | Interplay of Statins, Clopidogrel, and Repaglinide: Unraveling the Nexus of Hypoglycemia and Myopathy in a Geriatric Type 2 Diabetes Patient: A Case Report |
| title_fullStr | Interplay of Statins, Clopidogrel, and Repaglinide: Unraveling the Nexus of Hypoglycemia and Myopathy in a Geriatric Type 2 Diabetes Patient: A Case Report |
| title_full_unstemmed | Interplay of Statins, Clopidogrel, and Repaglinide: Unraveling the Nexus of Hypoglycemia and Myopathy in a Geriatric Type 2 Diabetes Patient: A Case Report |
| title_short | Interplay of Statins, Clopidogrel, and Repaglinide: Unraveling the Nexus of Hypoglycemia and Myopathy in a Geriatric Type 2 Diabetes Patient: A Case Report |
| title_sort | interplay of statins clopidogrel and repaglinide unraveling the nexus of hypoglycemia and myopathy in a geriatric type 2 diabetes patient a case report |
| topic | clinical pharmacology; clopidogrel; drug interactions; geriatric medicine; hypoglycemia; myopathy; repaglinide; statins |
| url | https://journals.lww.com/jodb/fulltext/2024/15040/interplay_of_statins,_clopidogrel,_and.16.aspx |
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