ABSTRACT

Background: Tuberculosis remains a foremost cause of morbidity and mortality in developing countries. Diabetes mellitus boosts the risk of active tuberculosis. DM management in patients with TB is also problematic. TB drug rifampicin increases the consent of most oral antidiabetic drugs that are generally used in low-income to middle-income countries, sulfonylureas are metabolized in the liver by CYPP450 enzymes, from which rifampicin is a virtuous inducer. To overcome the properties of rifampicin in dealing with and maintaining glycaemic control, metformin has been recommended as a better choice over other oral hypoglycaemic agents for the reason that it is not metabolized in the liver. Moreover, metformin is the primary choice antidiabetic according to type 2 DM treatment strategies. There is very inadequate data on the concomitant use of metformin and rifampicin and the essential for dose modifications in patients with TB-DM. In healthy volunteers, rifampicin produced altered oral hypoglycaemic agents’ absorption kinetics, foremost to higher exposure levels and improved glucose- lowering action. Hence there is a prerequisite to comprehend the effect of Oral hypoglycaemic agents when co-administered with rifampicin. Method: The study is shown in the pulmonologist department. The study participants were included based on the study principles. The data is collected after obtaining the informed consent. Demographic data, clinical history, diagnosis, and investigations were documented in a pre-formed questionnaire. The subjects who are being treated with oral hypoglycaemic drugs and rifampicin were analysed for thehypoglycaemic effect by unvarying blood glucose evaluations. The details of the management of these hypoglycaemic events with the required modification of the metformin are recorded. Result: The drug interaction of Rifampicin with oral hypoglycaemic drugs is the foremost objective of our study. A total of 50 subjects were contained in our study and they were divided into groups based on the oral hypoglycaemic drugs that were prescribed. This study was performed for 6 months and their levels of RBS were detected every time they revisited for their ATT adjustment up to 5 times. In the 50 patients, it is observed that the 9 patients on metformin show drip in their RBS upon their 2nd visit after starting their ATT. The rest of the test groups show elevation in RBS from their 2nd visit and the dose of their oral hypoglycaemic is adjusted based on the rise or lowering of their RBS levels. Conclusion: The study was led on the drug interaction of Rifampicin with oral hypoglycaemic drugs, it is concluded in the study that Rifampicin relates with oral hypoglycaemic drugs and reduces the efficacy of the oral hypoglycaemic drugs. It is also detected that the efficacy of metformin is increased as it reduced the RBS level when ATT was started. Keywords: Tuberculosis, Diabetes mellitus, Hypoglycaemic agents, Rifampicin, Oral hypoglycaemic agents
Publication date: 01/02/2026

https://ijbpas.com/pdf/2026/February/MS_IJBPAS_2026_8907.pdf

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https://doi.org/10.31032/IJBPAS/2026/15.2.8907