Drug General Information (ID: DDIRLEXUMJ)
  Drug Name Norfloxacin Drug Info Sitagliptin Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Antibiotics Antidiabetic Agents
  Structure

 Mechanism of Norfloxacin-Sitagliptin Interaction (Severity Level: Moderate)
     Increased risk of hypoglycemia Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Norfloxacin Sitagliptin
      Mechanism 1 Hypoglycemic effects Antidiabetic agent
      Key Mechanism Factor 1
Factor Name Hypoglycemia
Factor Description Hypoglycemia is a condition in which your blood sugar (glucose) level is below the standard range. It causes irregular or rapid heartbeat, pale skin, numbness of the lips, tongue or cheeks, and sweating.
      Mechanism Description
  • Increased risk of hypoglycemia by the combination of Norfloxacin and Sitagliptin 
     Antagonize the effect of antidiabetic agents Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Norfloxacin Sitagliptin
      Mechanism 2 Hyperglycemia Antidiabetic agent
      Key Mechanism Factor 2
Factor Name Antidiabetic agents
Factor Description The hypoglycemic effect of antidiabetes may be reduced, leading to higher blood glucose, increased blood glucose fluctuations, and the possibility of hyperglycemic complications
      Mechanism Description
  • Antagonize the effect of Sitagliptin when combined with Norfloxacin 
      Mechanism 3 Hyperglycemic effects Antidiabetic agent
      Key Mechanism Factor 3
Factor Name Antidiabetic agents
Factor Description The hypoglycemic effect of antidiabetes may be reduced, leading to higher blood glucose, increased blood glucose fluctuations, and the possibility of hyperglycemic complications
      Mechanism Description
  • Antagonize the effect of Sitagliptin when combined with Norfloxacin 

Recommended Action
      Management Blood glucose should be closely monitored whenever quinolones are prescribed to diabetic patients, especially if they are elderly, have renal impairment, or are severely ill. Patients should be apprised of the increased risk of dysglycemia and be particularly alert to potential signs and symptoms of hypoglycemia such as headache, dizziness, drowsiness, nervousness, confusion, tremor, hunger, weakness, perspiration, palpitation, and tachycardia. If hypoglycemia occurs, patients should initiate appropriate remedial therapy immediately, discontinue the quinolone, and contact their physician. alternative antibiotics may need to be considered.

References
1 Gavin JR 3rd, Kubin R, Choudhri S, et al "Moxifloxacin and glucose homeostasis: a pooled-analysis of the evidence from clinical and postmarketing studies." Drug Saf 27 (2004): 671-86. [PMID: 15230648]
2 Kelesidis T, Canseco E "Quinolone-induced hypoglycemia: a life-threatening but potentially reversible side effect." Am J Med 123 (2010): e5-6. [PMID: 20103009]
3 Yip C, Lee AJ "Gatifloxacin-induced hyperglycemia: a case report and summary of the current literature." Clin Ther 28 (2006): 1857-66. [PMID: 17213006]