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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Aggressive Behavior With Drop In Sugar Levels On Taking ATK4?

My dad aged 68 years and diabetic is diagonised with TB recently through CT scan. He has been prescribed to use ATK4 medicines which he took along with regular medicines including Glypride for sugar. He started the ATK4 medince last Tuesday (15th Nov). After couple of days, he sudenly started behaving aggressively with sugar level dropping to 39 mg/dl. He got admitted immedialy. Also his sodium level has dropped considerably. A doctor then visited told him ATK4 is a bit stronger for his age and asked us to stop this immediately and to switch over to Tab Glevo 500 mg, Benadon and combinex. He also told us liver got damaged because of ATK4. Not his sugar as well as sodium is restored to somewhat normal level for now. He got discharged from hosptial yesterday with advise that his food intake should be good going forward Can you suggest stopping ATK4 is right? Do we need to restart it or TB can be cured with Tab Glevo 500 mg, Benadon and combinex? Also we were asked to stop Glypride for few more days, when do we restart it?
Tue, 24 Nov 2020
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Internal Medicine Specialist 's  Response
Hi,

Combunex is combination of Ethambutol/isoniazid, thus avoiding Rifampicin in AKT4 which is hepatotoxic in few people. Adding Glevo (levofloxacin) is correct apart from it. If you developed liver toxic symptoms again, you need to stop Isoniazide. Trial and error, Ethambutol is least liver toxic, you can continue stoping glyburide and waiting for some time reasonable

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Suneel V. Babu, Internal Medicine Specialist
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What Causes Aggressive Behavior With Drop In Sugar Levels On Taking ATK4?

Hi, Combunex is combination of Ethambutol/isoniazid, thus avoiding Rifampicin in AKT4 which is hepatotoxic in few people. Adding Glevo (levofloxacin) is correct apart from it. If you developed liver toxic symptoms again, you need to stop Isoniazide. Trial and error, Ethambutol is least liver toxic, you can continue stoping glyburide and waiting for some time reasonable Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Suneel V. Babu, Internal Medicine Specialist