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©The Author(s) 2024.
World J Diabetes. May 15, 2024; 15(5): 853-866
Published online May 15, 2024. doi: 10.4239/wjd.v15.i5.853
Published online May 15, 2024. doi: 10.4239/wjd.v15.i5.853
Anti-DM drug | Anti-TB drug | Interaction effects | Expected clinical effects |
Biguanides | |||
Metformin | Rifampin (RIF, INN, rifampicin) | RIF induces upregulation of metformin effects | Promotes glucose-lowering effect of metformin[98] |
Sulfonylurea group | |||
Tolbutamide | Rifampin (INN, rifampicin) | RIF promotes the CYP2C9 and reduces in tolbutamide plasma conc | Hyperglycemia and diminished anti-TB efficacy over time[18,84] |
Glyburide (INN, glibenclamide) | Rifampin (INN, rifampicin) | RIF promotes the CYP2C9 and reduces 39% glyburide conc | Hyperglycemia and diminished anti-TB efficacy over time[134] |
Glyburide (INN, glibenclamide) | Rifapentine | Rifapentine induces CYP3A4 and CYP2C8/9 expressions and reduces glyburide plasma conc | Hyperglycemia[81,135] |
Glyburide (INN, glibenclamide) | Bedaquiline | Glyburide inhibits CYP3A4 in liver | [85,136] |
Glyburide (INN, glibenclamide) | Delamanid | Glyburide inhibits CYP3A4 in liver | [85,136] |
Gliclazide | Rifampin (INN, rifampicin) | RIF decreases plasma conc. of gliclazide by 70% by inducing CYP2C9 | Hyperglycemia and diminished anti-TB efficacy over time[18,137] |
Gliclazide | Rifapentine | Rifapentine induces CYP3A4 and CYP2C8/9 and decreases gliclazide | Hyperglycemia[81] |
Gliclazide | Bedaquiline | M2 of bedaquiline inhibits effects on CYP3A4 and CYP2C8 | Hypoglycemic episodes[85] |
Gliclazide | Delamanid | No crossing interaction | [85] |
Glimepiride | Rifampin (INN, rifampicin) | RIF promotes the expression of CYP2C9 reducing in 34% of glimepiride conc | Hyperglycemia and diminished anti-TB efficacy over time[138] |
Glipizide | Rifampin (INN, rifampicin) | RIF promotes CYP2C9 and reduces 22% of glipizide conc | Hyperglycemia and diminished anti-TB efficacy over time[134] |
Gliquidone | Rifapentine | Rifapentine induces CYP3A4 and CYP2C8/9 and decreases gliquidone | Hyperglycemia[81] |
Gliquidone | Bedaquiline | M2 of bedaquiline inhibits CYP3A4 effects | Hypoglycemic episodes[85] |
Gliquidone | Delamanid | Delamanid induces CYP3A4 and decreases gliquidone level | [85] |
Meglitinide analogues | |||
Repaglinide | Rifampin (INN, rifampicin) | RIF promotes CYP3A4 and reduces repaglinide conc. 57% | Hyperglycemia and diminished anti-TB efficacy over time[18,138-140] |
Repaglinide | Rifapentine | Rifapentine induces CYP3A4 and CYP2C8 and decreases repaglinide level | Hyperglycemia[81] |
Repaglinide | Bedaquiline | Interindividual variability | Variable hypoglycemic episodes[85,141] |
Repaglinide | Delamanid | Interindividual variability | Variable hypoglycemic episodes[85,141] |
Nateglinide | Rifampin (INN, rifampicin) | RIF promotes CYP3A4 and CYP2C9 and reduces nateglinide conc by 24%. | Hyperglycemia and diminished anti-TB efficacy over time[84] |
Nateglinide | Rifapentine | Rifapentine induces CYP3A4 and CYP2C9 and decreases nateglinide level | Hyperglycemia[81] |
Nateglinide | Bedaquiline | M2 of bedaquiline inhibits effects on CYP3A4 | Hypoglycemic episodes[85] |
Nateglinide | Delamanid | Coadministration of delamanid with nateglinide reduces exposure to delamanid | TB reactivation[85,142] |
Thiazolidinediones | |||
Rosiglitazone | Rifampin (INN, rifampicin) | RIF promotes CYP2C8 and reduces of rosiglitazone conc by 65% | Hyperglycemia and diminished anti-TB efficacy over time[18,92] |
Rosiglitazone | Rifapentine | Rifapentine induces CYP3A4 and CYP2C9 and decreases rosiglitazone level | Hyperglycemia[81] |
Rosiglitazone | Bedaquiline | M2 of bedaquiline inhibits effects on CYP2A8 | Hypoglycemic episodes[85] |
Rosiglitazone | Delamanid | No crossing | [116] |
Pioglitazone | Rifampin (INN, rifampicin) | RIF promotes CYP2C8 and reduces pioglitazone conc by 65% | Hyperglycemia and diminished anti-TB efficacy over time[20,62,143] |
Pioglitazone | Rifapentine | Rifapentine induces CYP3A4 and CYP2C8 and decreases pioglitazone level | Hyperglycemia[81] |
Pioglitazone | Bedaquiline | In combination with bedaquiline, pioglitazone may cause severe acute rhabdomyolysis | Dose-independent myalgia[85,144] |
Pioglitazone | Delamanid | Inhibitory effects on CYP3A4 | Hypoglycemic episodes[85] |
Dipeptidyl peptidase IV inhibitors | |||
Sitagliptin | Rifapentine | Rifapentine induces CYP3A4 and CYP2C8 and decreases sitagliptin level | Hyperglycemia[81] |
Sitagliptin | Bedaquiline | M2 of bedaquiline inhibits effects on CYP3A4 and CYP2A8 | Hypoglycemic episodes[85] |
Sitagliptin | Delamanid | Inhibitory effects on CYP3A4 | Hypoglycemic episodes[85] |
Saxagliptin | Rifapentine | Rifapentine induces CYP3A4 and decreases saxagliptin level | Hyperglycemia[81] |
Saxagliptin | Bedaquiline | M2 of bedaquiline inhibits effects on CYP3A4 | Hypoglycemic episodes[85] |
Saxagliptin | Delamanid | Inhibitory effects on CYP3A4 | Hypoglycemic episodes[85] |
Insulin | No effect anticipated | No studies published[85] | |
Isoniazid | In DM patients | Isoniazid in combination with rifampicin causes hepatotoxicity TB-DM patients (50%) | Low Anti-TB efficacy[34,84,128,129] |
Isoniazid | HIV-positive patient with type 2 DM | Prophylaxis of TB | Hyperglycaemia induced by isoniazid[20,145] |
Pyrazinamide | In DM patients | DM patients with higher levels of xanthine oxidase causes low therapeutic targets for pyrazinamide | TB resistance[20,86,88] |
Ethambutol | In DM patients | Neuritis optica in patients with complicated diabetes. Reduced kidney function in TB-DM patients | Enhances side effects[20,89] |
- Citation: Al-Bari MAA, Peake N, Eid N. Tuberculosis-diabetes comorbidities: Mechanistic insights for clinical considerations and treatment challenges. World J Diabetes 2024; 15(5): 853-866
- URL: https://www.wjgnet.com/1948-9358/full/v15/i5/853.htm
- DOI: https://dx.doi.org/10.4239/wjd.v15.i5.853