Excess Serious Adverse Events with Concurrent Warfarin and Sulfonylurea Use

Many adverse drug events are attributable to warfarin and to oral antidiabetes drugs. Whether warfarin potentiates the hypoglycemic effects of antidiabetes drugs — and in particular, sulfonylureas — is unclear. In this retrospective cohort study, researchers determined whether warfarin use was associated with excess risk for serious hypoglycemic events in 470,000 Medicare beneficiaries with type 2 diabetes who were treated with oral sulfonylureas (glipizide or glimepiride) from 2006 through 2011.

About 15% of sulfonylurea recipients filled prescriptions for warfarin. In multivariable analysis, emergency department (ED) visits or hospital admissions for hypoglycemia were 22% more likely during concurrent warfarin and sulfonylurea use than dur…