Sulfonylureas and Metformin Were Not Associated With an Increased Rate of Serious Bleeding in Warfarin Users: A Self-Controlled Case Series Study.

Abstract

Drug interactions between warfarin and sulfonylureas are suggested by pharmacokinetic information and prior studies. However, clinical evidence on the association of such interactions and the risk of bleeding is lacking. Using healthcare claims data from 5 US Medicaid programs from 1999-2011 and a self-controlled case series design with warfarin as an object drug, we calculated confounder-adjusted rate ratios (RRs) for concomitant use of sulfonylureas and metformin for 3 outcomes separately: (i) serious bleeding as a composite outcome of gastrointestinal bleeding (GIB) and nontraumatic intracranial hemorrhage (ICH); (ii) GIB; and (iii) ICH. In 6,463 warfarin users experiencing serious bleeding, an increased rate of serious bleeding was not associated with concomitant use of glimepiride (RR: 0.93; 95% confidence interval (CI) 0.75-1.15), glipizide (RR: 0.97; 95% CI 0.84-1.13), glyburide (RR: 0.89; 95% CI 0.76-1.06), or metformin (RR: 0.85; 95% CI 0.76-0.96), nor was the occurrence of the component outcomes of GIB or ICH. These results suggest that use of sulfonylureas or metformin was not associated with an increased rate of serious bleeding in warfarin users.

• Authors: Young Hee Nam, Xu Han, Colleen M Brensinger, Warren B Bilker, Charles E Leonard, Sean Hennessy
• Journal: Clinical pharmacology and therapeutics (Clin Pharmacol Ther) Vol. 108 Issue 5 Pg. 1010-1017 (11 2020) ISSN: 1532-6535 [Electronic] United States
• PMID: 32392373 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: © 2020 The Authors. Clinical Pharmacology & Therapeutics © 2020 American Society for Clinical Pharmacology and Therapeutics.

Chemical References

• Anticoagulants
• Hypoglycemic Agents
• Sulfonylurea Compounds
• Warfarin
• Metformin

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Anticoagulants (adverse effects, pharmacokinetics)
• Drug Interactions
• Female
• Hemorrhage (chemically induced)
• Humans
• Hypoglycemic Agents (adverse effects, therapeutic use)
• Male
• Medicaid
• Metformin (adverse effects, therapeutic use)
• Middle Aged
• Risk Assessment
• Risk Factors
• Sulfonylurea Compounds (adverse effects, therapeutic use)
• United States
• Warfarin (adverse effects, pharmacokinetics)
• Young Adult