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Nonsteroidal anti-inflammatory drugs (standard or coxibs) - prescribing issues - Management
What should I do for a person who requires a sulphonylurea and an NSAID?
- Concomitant use of a sulphonylurea and a nonsteroidal anti-inflammatory drug (NSAID) may result in hypoglycaemia.
- People using a sulphonylurea and azapropazone are at increased risk of hypoglycaemia. Therefore, if possible, stop the azapropazone and use another NSAID, or:
- Monitor blood glucose levels closely, and
- Consider reducing the dose of the sulphonylurea.
- Other NSAIDs do not normally increase the risk of hypoglycaemia when used together with a sulphonylurea, but isolated cases of hypoglycaemia have been reported, with the effect of the sulphonylurea being enhanced in people given:
- Fenclofenac with chlorpropamide and metformin.
- Diflunisal with glibenclamide.
- Naproxen with glibenclamide and metformin.
- Indobufen with glipizide.
- Piroxicam with glibenclamide.
Basis for recommendation
- These recommendations are based on information in an authoritative reference manual and the British National Formulary [Baxter, 2006; BNF 55, 2008].
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