ModerateAntiplatelet agents (low dose) / NSAIDs (analgesic dose)×Oral hypoglycemic agents. Sulfonylureas
Updated · Methodology
Mechanism
High aspirin doses displace glibenclamide from albumin binding and suppress hepatic gluconeogenesis. Hypoglycaemia risk at aspirin doses above 3 g/day.
Symptoms
Sweating, tremor, hunger, tachycardia, confusion. Severe cases: seizures and coma. Symptoms appear 1–2 days after starting high aspirin doses.
Management
Cardioprotective aspirin doses (75–100 mg) are acceptable without adjustment. At high doses, monitor glucose 4 times daily in the first week; reduce glibenclamide if needed.
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Sources
- FDA: Warfarin sodium tablet (Amneal Pharmaceuticals LLC) – Prescribing Information (2017)– ; DailyMed setid 558b7a0d-5490-4c1b-802e-3ab3f1efe760