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Previous studies have suggested a potential relationship between angiotensin\u2010converting enzyme inhibitors (ACEIs) used with sulfonylureas and serious hypoglycemia, and widely used drug compendia warn of this potential drug\u2010drug interaction. We investigated the association between serious hypoglycemia and concomitant use of ACEIs in patients receiving insulin secretagogues, using the self\u2010controlled case series design and Medicaid claims data from 5 US states linked to Medicare claims from 1999\u20132011. The exposure of interest was active prescription for ACEIs during insulin secretagogue or metformin (negative control object drug) episodes. The outcome was hospital presentation for serious hypoglycemia, identified by discharge diagnosis codes in inpatient and emergency department claims (positive predictive value ~\u00a078\u201389%). We calculated confounder\u2010adjusted rate ratios (RRs) and 95% confidence internals (CIs) of outcome occurrence during ACEI\u2010exposed vs. ACEI\u2010unexposed time using conditional Poisson regression. The RRs for ACEIs were not statistically elevated during observation time of glipizide (RR, 1.06; CI, 0.98\u20131.15), glyburide (RR, 1.05; CI, 0.96\u20131.15), repaglinide (RR, 1.15; CI, 0.94\u20131.41), or metformin (RR, 1.02; CI, 0.97\u20131.06); but was modestly elevated with glimepiride (RR, 1.23; CI, 1.11\u20131.37) and modestly reduced with nateglinide (RR, 0.73; CI, 0.56\u20130.96). The overall pattern of results do not suggest that ACEIs used with insulin secretagogues were associated with increased rates of serious hypoglycemia, with the possible exception of glimepiride.<\/jats:p>","DOI":"10.1002\/cpt.2377","type":"journal-article","created":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T08:35:53Z","timestamp":1627374953000},"page":"218-226","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Angiotensin\u2010Converting Enzyme Inhibitors Used Concomitantly with Insulin Secretagogues and the Risk of Serious Hypoglycemia"],"prefix":"10.1111","volume":"111","author":[{"given":"Young","family":"Hee Nam","sequence":"first","affiliation":[{"name":"Department of Population Medicine Harvard Medical School &amp; Harvard Pilgrim Health Care Institute Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen M.","family":"Brensinger","sequence":"additional","affiliation":[{"name":"Center for Pharmacoepidemiology Research and Training Center for Clinical Epidemiology and Biostatistics, and Department of Biostatistics, Epidemiology and Informatics Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warren B.","family":"Bilker","sequence":"additional","affiliation":[{"name":"Center for Pharmacoepidemiology Research and Training Center for Clinical Epidemiology and Biostatistics, and Department of Biostatistics, Epidemiology and Informatics Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James H.","family":"Flory","sequence":"additional","affiliation":[{"name":"Endocrinology Service Department of Subspecialty Medicine Memorial Sloan Kettering Cancer Center New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles E.","family":"Leonard","sequence":"additional","affiliation":[{"name":"Center for Pharmacoepidemiology Research and Training Center for Clinical Epidemiology and Biostatistics, and Department of Biostatistics, Epidemiology and Informatics Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Hennessy","sequence":"additional","affiliation":[{"name":"Center for Pharmacoepidemiology Research and Training Center for Clinical Epidemiology and Biostatistics, and Department of Biostatistics, Epidemiology and Informatics Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,23]]},"reference":[{"key":"e_1_2_12_1_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.16201"},{"key":"e_1_2_12_2_1","unstructured":"U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion.National Action Plan for Adverse Drug Event Prevention.2014. 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