Effect of anti-tuberculosis drugs on the pharmacokinetics and pharmacodynamics of novel antidiabetic drugs: A scoping review - PubMed
3 days ago
- #drug-drug interaction
- #pharmacokinetics
- #diabetes management
- Co-occurrence of tuberculosis (TB) and diabetes mellitus (DM) is a growing global health concern.
- Rifamycin (RIF) significantly reduces plasma exposure of DPP4i (saxagliptin, gemigliptin, evogliptin) and canagliflozin.
- Other SGLT2i (dapagliflozin, empagliflozin, ertugliflozin) are minimally affected by RIF.
- No direct data available for GLP-1 receptor agonists (GLP-1a).
- Adverse events are rare in healthy participants but more frequent in elderly patients with poorly controlled DM.
- Linezolid and dapagliflozin co-administration may lead to severe pancytopenia.
- RIF co-administration with gemigliptin, evogliptin, and canagliflozin requires caution and potential dose adjustments.
- Saxagliptin, dapagliflozin, ertugliflozin, and empagliflozin appear safer alternatives.
- Hematologic monitoring recommended when combining linezolid and dapagliflozin.
- Current evidence is limited by small sample sizes, single-dose designs, and lack of data on GLP-1a or other anti-TB agents.
- A clinical decision algorithm was developed to support co-treatment in TB-DM cases, but further studies are needed.