Drug-induced hypoglycemia: a disproportionality analysis of the FAERS database

Expert Opin Drug Saf. 2024 Aug;23(8):1061-1067. doi: 10.1080/14740338.2023.2278700. Epub 2023 Nov 9.

Abstract

Background: Hypoglycemia is an adverse event (AE) that cannot be ignored in clinical practice. This study aimed to identify the most common and top drugs associated with the risk of hypoglycemia based on the United States Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database.

Research design and methods: We used OpenVigil 2.1 pharmacovigilance analytics platform to query FAERS database and data from 2004 to 2023 were retrieved. The Medical Dictionary for Regulatory Activities (MedDRA) was used to identify hypoglycemia cases, and DrugBank database was used to determine drug generic names.

Results: A total of 11,155,106 AEs reports were identified, of which 28,443 (0.25%) were related to hypoglycemia. Metformin (6926 cases) was associated with most cases of hypoglycemia. According to the disproportionality analysis, the top five drugs with the highest ROR and PRR were penamecillin, nikethamide, sotagliflozin, norethandrolone, glimepiride/pioglitazone. Nineteen of the top 50 drugs did not have hypoglycemia indicated in the package insert.

Conclusions: By analyzing the FAERS database, we listed drugs with a strong hypoglycemic signal for which the label does not provide a reminder. Notably, the potential hypoglycemia risks are of great importance and should be closely monitored in medical practice.

Keywords: FAERS; Hypoglycemia; disproportionality analysis; pharmacovigilance.

MeSH terms

  • Adolescent
  • Adult
  • Adverse Drug Reaction Reporting Systems* / statistics & numerical data
  • Aged
  • Child
  • Child, Preschool
  • Databases, Factual*
  • Drug Labeling
  • Female
  • Humans
  • Hypoglycemia* / chemically induced
  • Hypoglycemia* / epidemiology
  • Hypoglycemic Agents* / administration & dosage
  • Hypoglycemic Agents* / adverse effects
  • Male
  • Middle Aged
  • Pharmacovigilance*
  • United States / epidemiology
  • United States Food and Drug Administration*
  • Young Adult

Substances

  • Hypoglycemic Agents