Drug pairing may raise blood sugar, putting type 2 diabetics at risk

The antidepressant Paxil and cholesterol-lowering drug Pravachol are commonly prescribed in conjunction with one another, but a new study indicates that the combination may lead to dangerous increases in blood sugar in all patients, particularly those with type 2 diabetes.

Due to the fact that medications are given Food and Drug Administration (FDA) approval independently, it is not always possible for doctors to predict the effects combinations of drugs may cause. The research team, which was made up of scientists from the Stanford University School of Medicine, Vanderbilt University and Harvard Medical School, said that neither drug on its own causes hyperglycemic symptoms, making their findings unexpected.

For the study, the researchers reviewed data from the FDA's Adverse Event Reporting Database. They checked for reports of symptoms of hyperglycemia in patients who were taking various combinations of medications. They reported in the journal Clinical Pharmacology and Therapeutics that a high percentage of patients taking Paxil and Pravachol experienced these symptoms.

The team then examined the medical records of 104 patients who had diabetes and were being treated with the drugs. The data showed that these individuals experienced dramatic blood sugar increases after starting the combination treatment. The records of non-diabetic patients taking the two drugs also showed blood sugar increases.

Further testing of the drug pairing in laboratory mice revealed that after several weeks, the test subjects became insulin resistant and showed symptoms associated with pre-diabetes.

The researchers said that their review of the FDA's data indicated that anywhere from 500,000 to 1 million people may be taking a combination of Paxil and Pravachol, making this a significant public health issue. They suggested that the regulatory agency review its policy for tracking potentially dangerous combinations.

In the case of the Paxil-Pravachol pairing, changing treatment guidelines could keep people from suffering the symptoms of type 2 diabetes and reduce their risk of developing the condition.