Clarithromycin, Levemir and hypos?

Bluemarine Josephine · Oct 4, 2016

Good day my beautiful friends, I hope that you are very well.

About a week ago, I was diagnosed with a developing tonsillitis and my GP prescribed an antibiotic substance called “Clarithromycin”. (Had never heard of it before.)

So there I am, first two days of Clarithromycin, 500 mg in the morning and 500 mg in the evening (12 hours apart).

Third day onwards I started having nocturnal hypos… I was snacking every two hours, following the DAFNE rules of 10-15 grams carbs and all I could manage was to maintain a mildly hypo level… (But, I am always careful to not overtreat.) On the next day, I started having hypos during the day as well.

To make a long story short, I had to reduce my basal insulin by 2 units and I am still debating with myself if I should reduce it even further.

Has anyone of you ever had any experience with Clarithromycin? Is there a possibility that this substance interferes with Levemir? (I am asking because I am trying to understand if my hypos are due to the antibiotic or if I should look for other reasons but, other than the change of weather there is nothing else I could think of at the moment – and, still, colder weather would mean I should raise my insulin intake…)

Thanks ever so much!
Have a lovely day
Josephine

ChristinePG · Oct 5, 2016

Bluemarine Josephine said:
Good day my beautiful friends, I hope that you are very well.

About a week ago, I was diagnosed with a developing tonsillitis and my GP prescribed an antibiotic substance called “Clarithromycin”. (Had never heard of it before.)

So there I am, first two days of Clarithromycin, 500 mg in the morning and 500 mg in the evening (12 hours apart).

Third day onwards I started having nocturnal hypos… I was snacking every two hours, following the DAFNE rules of 10-15 grams carbs and all I could manage was to maintain a mildly hypo level… (But, I am always careful to not overtreat.) On the next day, I started having hypos during the day as well.

To make a long story short, I had to reduce my basal insulin by 2 units and I am still debating with myself if I should reduce it even further.

Has anyone of you ever had any experience with Clarithromycin? Is there a possibility that this substance interferes with Levemir? (I am asking because I am trying to understand if my hypos are due to the antibiotic or if I should look for other reasons but, other than the change of weather there is nothing else I could think of at the moment – and, still, colder weather would mean I should raise my insulin intake…)

Thanks ever so much!
Have a lovely day
Josephine

If you don't want to see your doctor why not ask a pharmacist - they are very knowledgeable.

Tony337 · Oct 7, 2016

Hi new member here...
I have a tendency to check drugs out on the WWW and i checked yours and the only effect the drug can have is if you are on simvastatins?
Even then its not clear on the effect.
I enjoy a good working relationship with my GP surgery so i would phone up and get an alternative antibiotic to be on the safe side.

Good luck

Tony

Bluemarine Josephine · Oct 18, 2016

Good day my beautiful friends,
I hope you are all very well today!
Thank you for your replies.

Here is my update:
I call my diabetes nurse to ask if Clarithromycin could potentially affect blood sugar.
She replies “no, it shouldn’t…”
I ask my pharmacist. She replies that she is clueless about diabetes.

Seven days later, I am, at the GP waiting room for a routine appointment regarding my tonsillitis. The waiting is rather long and I have nothing with me to read so, I take out of my bag the Clarithromycin box and, out of boredom, I start reading the paper inside the box. There is a section which says “ Clarithromycin may increase the effect of the following medicines”:

There is a list of medicines and then, at some point, my eyes focus on this:
“Insulin and other medicines for the treatment of diabetes.”

What??

Immediately the idea comes to my mind… If I am not a doctor/nurse and took the time to read this then, the person who is actually prescribing this hasn’t read it?
I would still take clarithromycin if I had to but, I would like for the specialist to warn me “monitor closely your blood sugar levels because this substance can potentially create (even rare) hypoglycemic episodes”

For once more, I feel that the only people I can rely on are my diabetic friends through our forum.
Evidently, the professionals are proven to be, once more, absolutely clueless…

Regards
Josephine.

traceyart · Mar 23, 2017

I have been taking this for 3 days and have had 4 hypos in that time.
I am usually well in control but just googled clarithromycin and insulin and read this!
It's a bit scary going to sleep, knowing you'll be awake in a few hours with low blood sugar!

himtoo · Mar 23, 2017

traceyart said:
I have been taking this for 3 days and have had 4 hypos in that time.
I am usually well in control but just googled clarithromycin and insulin and read this!
It's a bit scary going to sleep, knowing you'll be awake in a few hours with low blood sugar!

Hi @traceyart
welcome to the forum !!
I have found variation in BG's when on an antibiotic, I would just suggest that you test more often over the next few days.
Possibly a small snack at bedtime would help as well.

isjoberg · Mar 24, 2017

traceyart said:
I have been taking this for 3 days and have had 4 hypos in that time.
I am usually well in control but just googled clarithromycin and insulin and read this!
It's a bit scary going to sleep, knowing you'll be awake in a few hours with low blood sugar!

Clarithromycin has a warning in the packaging, can cause severe hypos (although this is a study done on type two). I took it for a week and didn't give bolus basically at all and ate to my levels as it was far easier than adjusting (for me anyway) and my levels were actually the best they've been for a while! I'm a little paranoid so I always read the leaflets in full which is why I saw this and took the time to figure out best form of attack, but true it's a little concerning that at no point someone mentioned to myself or to you about the potential effects for diabetics

Bluemarinejosephine · Mar 24, 2017

traceyart said:
I have been taking this for 3 days and have had 4 hypos in that time.
I am usually well in control but just googled clarithromycin and insulin and read this!
It's a bit scary going to sleep, knowing you'll be awake in a few hours with low blood sugar!

Hello and thank you for your input.

In fact, during the period that I was on clarithromycin for my tonsillitis (which was for about 7-10 days) I had to reduce my evening Levemir and I was debating with myself if I should reduce it even more.) After finishing my clarithromycin prescription, it took about 4-5 days and then my bg levels started to rise which signaled me that most probably clarithromycin was out of my system and I, therefore, raised my Levemir gradually (1 unit every 4-5 days). Until it gave me a good steady state again.

If you read the leaflet inside the box you will see that Clarithromycin can interact with insulin and diabetes- related oral medication causing hypoglycemias. I would still take clarithromycin if I had too but, I would like them to warn me so as to feel prepared.

I agree with Himtoo. Keep monitoring your levels closely, treat before you reach a hypoglycemic stage (as a precaution), reduce your insulin if you have too and treat before bedtime and also during the night (I was waking up every 2-3 hours to check my bg and, to my surprise I had to treat).

I hope this helps
Regards
Josephine

Mumpotts_ · Jul 21, 2017

Prescribed Clarithromycin 250 twice daily on Monday 17 of July. Took one at 6pm and Levemir 12 units at 10 pm. 8 am on Tuesday I was in an ambulance on way to hospital. My monitor couldn't register any glucose! Everyone said there was no interaction except my daughter who is a Registered Nurse
Low fasting BM all week and this morning at 4 am, once again unrecordable.
Clarithromycin disposed of!
Very scary that the medical profession deny any interaction and blame me for doing "something wrong"
As a nurse and type 1 for over 30 years I disagree..

isjoberg · Jul 21, 2017

Mumpotts_ said:
Prescribed Clarithromycin 250 twice daily on Monday 17 of July. Took one at 6pm and Levemir 12 units at 10 pm. 8 am on Tuesday I was in an ambulance on way to hospital. My monitor couldn't register any glucose! Everyone said there was no interaction except my daughter who is a Registered Nurse
Low fasting BM all week and this morning at 4 am, once again unrecordable.
Clarithromycin disposed of!
Very scary that the medical profession deny any interaction and blame me for doing "something wrong"
As a nurse and type 1 for over 30 years I disagree..

When I was on that - didn't bolus all week once I had figured out the effect on my bg!

DVMC123 · Jan 9, 2018

Bluemarine Josephine said:
Good day my beautiful friends, I hope that you are very well.

About a week ago, I was diagnosed with a developing tonsillitis and my GP prescribed an antibiotic substance called “Clarithromycin”. (Had never heard of it before.)

So there I am, first two days of Clarithromycin, 500 mg in the morning and 500 mg in the evening (12 hours apart).

Third day onwards I started having nocturnal hypos… I was snacking every two hours, following the DAFNE rules of 10-15 grams carbs and all I could manage was to maintain a mildly hypo level… (But, I am always careful to not overtreat.) On the next day, I started having hypos during the day as well.

To make a long story short, I had to reduce my basal insulin by 2 units and I am still debating with myself if I should reduce it even further.

Has anyone of you ever had any experience with Clarithromycin? Is there a possibility that this substance interferes with Levemir? (I am asking because I am trying to understand if my hypos are due to the antibiotic or if I should look for other reasons but, other than the change of weather there is nothing else I could think of at the moment – and, still, colder weather would mean I should raise my insulin intake…)

Thanks ever so much!
Have a lovely day
Josephine

I was prescribed Clarithromicin 500mg twice a day last week for laryngitis, I am on day 5 out of 7 and the nocturnal hypos have been getting worse. I had a scary one last night which I struggled to take enough carbs to counteract the effect. I am on Levemir 20 units am and the same pm, on the off chance I googled whether there is an interaction and found these posts on this site and similar elsewhere.

Right this minute after eating a ton of jelly babies and two slices of toast I am actually still worried about going to sleep. No warnings from my GP no warnings on the packet. This is a dangerous disgrace!

michael_n · Jan 9, 2018

I had this happen to me too. I had to reduce my usual 36u of Levemir to around 18 and also halve my NovoRapid doses.

NewTD2 · Jan 9, 2018

It sounds absolutely irresponsible of your GP/doctor to be prescribing an antibiotic without reading instructions and providing any advice or warning about dealing with hypoglycaemia.

If this happened in the USA, you could have sued your doctor!

jade930524 · Jan 27, 2018

I had this with this antibiotic, even tested it out by eating a lot of Milkybar and taking no insulin.. the result - still had a morning hypo.

Had to go back and ask for a different one and the GP made me feel like an idiot even after i told her about my little experiment she proceeded, telling me its more likely to be my fault. 2nd day on different antibiotic and no routine morning hypo's... go figure.

Since then I've been avoiding ones ending in 'mycin' as i understand they're part of a family of antibiotics and i've been fine.

Lorriecoghlan · Jul 24, 2018

Bluemarine Josephine said:
Good day my beautiful friends, I hope that you are very well.

About a week ago, I was diagnosed with a developing tonsillitis and my GP prescribed an antibiotic substance called “Clarithromycin”. (Had never heard of it before.)

So there I am, first two days of Clarithromycin, 500 mg in the morning and 500 mg in the evening (12 hours apart).

Third day onwards I started having nocturnal hypos… I was snacking every two hours, following the DAFNE rules of 10-15 grams carbs and all I could manage was to maintain a mildly hypo level… (But, I am always careful to not overtreat.) On the next day, I started having hypos during the day as well.

To make a long story short, I had to reduce my basal insulin by 2 units and I am still debating with myself if I should reduce it even further.

Has anyone of you ever had any experience with Clarithromycin? Is there a possibility that this substance interferes with Levemir? (I am asking because I am trying to understand if my hypos are due to the antibiotic or if I should look for other reasons but, other than the change of weather there is nothing else I could think of at the moment – and, still, colder weather would mean I should raise my insulin intake…)

Thanks ever so much!
Have a lovely day
Josephine

Has anyone on basaglar ever had any hypos while taking clarithromycine niacin 500 mg?

Lorriecoghlan · Jul 24, 2018

Lorriecoghlan said:
Has anyone on basaglar ever had any hypos while taking clarithromycine niacin 500 mg?

Sorry clarithromycine biaxin

Andy V · Aug 20, 2024

Hi
I'm currently on Clarithromycin. GP said watch BG's but didn;t say which way they might go, so thought maybe they'd be elevated. Am on Day two, lots of Skittles eaten, jam on toast. Quite surprised there's something that can drop not causes raises in BG. Only have a 3.5 day course so gonna weather it out for now.
That said I'm extremely grateful to everyone who took the time to share and confirm.

All the best
Andy

Paulaah · Aug 20, 2024

Hi.

I had the same experience with Erythromycin, for sure. But I was on it for 3 months ( a few times for Rosacea), so had to change background and ratios each time.

Paulaah · Aug 20, 2024

Paulaah said:
Hi.

I had the same experience with Erythromycin, for sure. But I was on it for 3 months ( a few times for Rosacea), so had to change background and ratios each time.

P.s I looked it up at the time and it said it had “stomach emptying qualities”, which heightened insulin sensitivity. I think sometimes it can be prescribed in low doses to reduce insulin resistance from what I remember. I’m sure somebody will jump in if that’s not right. I’m going by memory.

Taighnamona · Aug 20, 2024

I was recently on Clarithromycin 500 twice a day and my gp warned me as she was prescribing it that it would likely lower my blood glucose. There wasn’t an alternative so I kept an eye on my sensor and lowered my basal and had a bed time digestive. I think other antibiotics may have similar effects.
For me the gut and intestinal disturbances were more upsetting despite swallowing probiotics and peppermint oil capsules. As the week progressed all these effects eased.
As peeps have noted it is listed as a side effect. Scary that some health professionals may not be aware though.

Clarithromycin, Levemir and hypos?

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