March 3, 2026Open Access

Maintenance hemodialysis patient who developed prolonged severe hypoglycemia due to concomitant use of repaglinide and clopidogrel： A case report

Key Points

Severe hypoglycemia was observed in a hemodialysis patient after initiating clopidogrel.
The patient experienced prolonged low blood sugar ten days post-surgery due to drug interaction with repaglinide.

Structured PICO

Population

1 patient with end-stage renal failure due to diabetic kidney disease on maintenance hemodialysis, managed with repaglinide, who underwent transcatheter aortic valve implantation (TAVI)

Intervention

Clopidogrel added for thrombosis prevention post-TAVI while on repaglinide

Outcome

Prolonged severe hypoglycemiasafety

Concomitant use of clopidogrel and repaglinide can cause severe, prolonged hypoglycemia in dialysis patients due to CYP2C8 inhibition.

Abstract

レパグリニドは短時間作用型のインスリン分泌促進薬であり，糖尿病透析患者においては投与可能な経口血糖降下薬の選択肢が少ないことからしばしば処方されるが，クロピドグレルによるcyp2c8の阻害がレパグリニドの血中濃度を上げることが報告されている．本稿では糖尿病性腎臓病による末期腎不全で維持血液透析を受け，レパグリニドを含めた経口血糖降下薬で血糖管理をされていた患者が，経カテーテル大動脈弁植込み術後に血栓予防のためクロピドグレルが投与され，10日後に遷延性の重症低血糖を呈した事例を報告する．本症例においてはレパグリニドとクロピトグレルの相互作用で低血糖が生じた可能性が高く，併用の際には低血糖の発現に十分注意する必要がある．

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Discussion

Authors

Akiyo Inoue

Nobuyuki Takahashi

Kinuko Dote

Journals

Nihon Toseki Igakkai Zasshi

Actions

Institutions

Kansai Medical University

References and Citations

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Maintenance hemodialysis patient who developed prolonged severe hypoglycemia due to concomitant use of repaglinide and clopidogrel： A case report

Key Points

Structured PICO

Abstract

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Discussion

Authors

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Actions

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References and Citations

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