Monitor Closely (1)shark cartilage increases effects of insulin detemir by pharmacodynamic synergism. Changes in glucose tolerance occur more commonly in patients receiving 50 mcg or more of ethinyl estradiol (or equivalent) per day in combined oral contraceptives (COCs), which are not commonly used in practice since the marketing of lower dose COCs, patches, injections and rings. Use Caution/Monitor. Concomitant use may cause an increased blood glucose-lowering effect with risk of hypoglycemia. nortriptyline increases effects of insulin detemir by pharmacodynamic synergism. It appears that the effects of thiazide diuretics on glycemic control are dose-related and low doses can be instituted without deleterious effects on glycemic control. Corticosteroids stimulate hepatic glucose production and inhibit peripheral glucose uptake into muscle and fatty tissues, producing insulin resistance. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. Monitor Closely (1)isocarboxazid increases effects of insulin detemir by unknown mechanism. management in the general population. Halogenated Anesthetics: (Major) Avoid coadministration of halogenated anesthetics and hydroxychloroquine due to the risk of increased QT prolongation. cortisone decreases effects of insulin detemir by pharmacodynamic antagonism. The presence or absence of a concomitant progestin may influence the significance of any hormonal effect on glucose homeostasis. Sympathetic blockade with phentolamine causes immediate and
Ondansetron: (Major) Concomitant use of hydroxychloroquine and ondansetron increases the risk of QT/QTc prolongation and torsade de pointes (TdP). In: Proceedings of the WSAVA/FECAVA/BSAVA congress; 1215 April 2012; Birmingham, UK. Quetiapine: (Moderate) Monitor blood glucose during concomitant atypical antipsychotic and insulin use. Medscape Education, Personalized Management for the Diabetes Patient in Primary Care, encoded search term (insulin detemir (Levemir)) and insulin detemir (Levemir), Novo Rejects USInsulin Price Hikes Report, Has 'Nothing to Hide', Expensive Insulins, Pen Devices Dominate Diabetes Care in US, Novo Nordisk Recalls Insulin Product Samples in US, Medscape Endocrinologist Wealth & Debt Report 2021, FDA Approves First-Ever Agent to Delay Type 1 Diabetes Onset. Concomitant use of insulin and ARBs may require insulin dosage adjustment and increased glucose monitoring. Published studies using insulin lispro during pregnancy have not reported an association between insulin lispro and the induction of major birth defects, miscarriage or adverse maternal or fetal outcomes. (Minor) Phenothiazines, especially chlorpromazine, may increase blood glucose concentrations. Diabetes mellitus type 1 is caused by insulin deficiency while diabetes mellitus type 2 is caused by a combination of insulin deficiency and resistance. Non selective beta blockers delay recovery of normoglycemia after insulin induced hypoglycemia; however, they also inhibit insulin secretion, so long term beta blocker Tx may result in reduced glucose tolerance. You may give other people a serious infection, or get a serious infection from them. Sympathomimetics, through stimulation of alpha- and beta- receptors, increase hepatic glucose production and glycogenolysis and inhibit insulin secretion.
Glucophage PDR.net is to be used only as a reference aid. Hyperglycemia has been reported as well and is possibly due to beta-2 receptor blockade in the beta cells of the pancreas. Estrogens can decrease the hypoglycemic effects of antidiabetic agents by impairing glucose tolerance. Use Caution/Monitor. clozapine, insulin detemir. Monitor blood glucose and HbA1C when these drugs are used together. Clinical studies for the treatment of anaphylaxis have
Also, adrenergic medications may decrease glucose uptake by muscle cells. Fluphenazine: (Minor) Phenothiazines, especially chlorpromazine, may increase blood glucose concentrations. Concomitant use may cause an increased blood glucose-lowering effect with risk of hypoglycemia. Insulin induced hypoglycemia may induce hypertension during non selective beta blocker Tx. Alert patients to contact their healthcare provider if they experience new or worsening depression, suicidal thoughts, or mood or behavioral changes. Monoamine oxidase inhibitors: (Moderate) Monitor blood glucose during concomitant insulin and monoamine oxidase inhibitor (MAOI) use; an insulin dose adjustment may be necessary. Corticosteroids stimulate hepatic glucose production and inhibit peripheral glucose uptake into muscle and fatty tissues, producing insulin resistance. Risk factors for impaired glucose tolerance due to corticosteroids include the corticosteroid dose and duration of treatment. NOTE: Insulin lispro 100 units/mL may also be administered by continuous subcutaneous infusion using an insulin pump. Either increases effects of the other by pharmacodynamic synergism. During partial remission phase, total combined daily insulin requirement is often less than 0.5 units/kg/day. [61729] [61732] [65120] [65121] [65139] [65140] [65141] [65142] [65143], Hydroxychloroquine is administered orally. In the United States, 57.9% of patients with diabetes have 1 or more diabetes-related complications and 14.3% have 3 or more. Use Caution/Monitor. An overview of Mercks latest news, events and financials. Telithromycin: (Major) Concomitant use of telithromycin and hydroxychloroquine increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Consider taking steps to minimize the risk for QT/QTc interval prolongation and TdP, such as electrolyte monitoring and repletion and ECG monitoring, if concomitant use is necessary. Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate: (Moderate) Monitor blood glucose during concomitant insulin and salicylate use.
HIGHLIGHTS OF PRESCRIBING INFORMATION Use Admelog or Humalog 100 units/mL only to prepare infusions. Ivosidenib: (Major) Avoid coadministration of ivosidenib and hydroxychloroquine due to the risk of increased QT prolongation. New onset diabetes mellitus, exacerbation of diabetes mellitus, and hyperglycemia due to insulin resistance have been reported with use of anti-retroviral protease inhibitors. Monitor Closely (1)perindopril increases effects of insulin detemir by pharmacodynamic synergism. Insulin dosage adjustment and increased glucose monitoring may be required. oxymetholone increases effects of insulin detemir by pharmacodynamic synergism. Minor (1)agrimony increases effects of insulin detemir by pharmacodynamic synergism. Omeprazole; Sodium Bicarbonate: (Major) Hydroxychloroquine absorption may be reduced by antacids as has been observed with the structurally similar chloroquine. Monitor for loss of glycemic control when sympathomimetics are administered to patients taking insulin. Monitor blood glucose and HbA1C when these drugs are used together. Changes in glucose tolerance occur more commonly in patients receiving 50 mcg or more of ethinyl estradiol (or equivalent) per day in combined oral contraceptives (COCs), which are not commonly used in practice since the marketing of lower dose COCs, patches, injections and rings. Epinephrine overdosage can also cause transient Insulin lispro has a duration of action of roughly 3 to 5 hours, which is shorter than regular insulin. Risk of hypoglycemia. Pharmacokinetic and Pharmacodynamic Study of Caninsulin in Cats with Diabetes Mellitus. Exenatide: (Moderate) The risk of hypoglycemia is increased when exenatide is used in combination with insulins. When rosiglitazone was added to insulin therapy, the incidence of hypoglycemia was higher with 8 mg/day of rosiglitazone (67%) compared to 4 mg/day (53%). Martin GJ, Rand JS. PRECAUTIONS]. Use Caution/Monitor. Patients who are taking antidiabetic agents should monitor for worsening glycemic control when a phenothiazine is instituted. Comment: Combination may result in thrombocytopenia (rare). For treatment of cold symptoms, nasal decongestants may be preferable for short term, limited use (1 to 3 days) as an alternative to systemic decongestants in patients taking medications for diabetes. Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ: (Moderate) Monitor patients receiving insulin closely for changes in diabetic control when thiazide diuretics are instituted or discontinued; dosage adjustments may be required. The likelihood of QTc prolongation may increase with increasing dose of the drug; therefore, the recommended dose should not be exceeded especially in patients with renal or hepatic impairment where the Cmax and AUC are slightly higher. subcutaneous, or intravenous dose (on a mg/m basis at maternal subcutaneous dose
If heart failure develops in a patient receiving insulin and a thiazoladinedione, manage the patient according to standards of care, and discontinue or consider reducing the dose of the thiazoladinedione. fosamprenavir decreases effects of insulin detemir by Other (see comment). Also, adrenergic medications may decrease glucose uptake by muscle cells. Also, adrenergic medications may decrease glucose uptake by muscle cells. Sympathomimetics, through stimulation of alpha- and beta- receptors, increase hepatic glucose production and glycogenolysis and inhibit insulin secretion. Epinephrine usually inhibits spontaneous or oxytocin
If cardiotoxicity is suspected or demonstrated by tissue biopsy, prompt discontinuation of hydroxychloroquine may prevent life-threatening cardiac complications. Most Monitor for loss of glycemic control when sympathomimetics are administered to patients taking insulin. Comment: Fenfluramine enhances glucose uptake in peripheral tissue, increasing risk of hypoglycemia. Use Caution/Monitor. For treatment of cold symptoms, nasal decongestants may be preferable for short term, limited use (1 to 3 days) as an alternative to systemic decongestants in patients taking medications for diabetes. Minor (1)isoniazid decreases effects of insulin detemir by unspecified interaction mechanism. Risk factors for impaired glucose tolerance due to corticosteroids include the corticosteroid dose and duration of treatment. Use Caution/Monitor. Minor (1)devil's claw increases effects of insulin detemir by pharmacodynamic synergism. rosiglitazone, insulin detemir. The cessation of nicotine therapy or tobacco smoking may result in a decrease in blood glucose. Concomitant use of insulin and somatostatin analogs may require insulin dosage adjustment and increased glucose monitoring. Use Caution/Monitor. Rituximab: (Moderate) The concomitant use of rituximab with other disease modifying anti-rheumatic drugs (DMARDs), such as hydroxychloroquine, may result in an increased risk of infection. Concomitant use may cause an increased blood glucose-lowering effect with risk of hypoglycemia. Blood glucose concentrations should be checked every hour. because of its location, size, and available blood flow. Ranolazine: (Major) Avoid coadministration of ranolazine and hydroxychloroquine due to an increased risk of QT prolongation. The presence or absence of a concomitant progestin may influence the significance of any hormonal effect on glucose homeostasis. Also, adrenergic medications may decrease glucose uptake by muscle cells. Corticosteroids stimulate hepatic glucose production and inhibit peripheral glucose uptake into muscle and fatty tissues, producing insulin resistance. Constituents in garlic might have some antidiabetic activity, and may increase serum insulin levels and increase glycogen storage in the liver. The presence or absence of a concomitant progestin may influence the significance of any hormonal effect on glucose homeostasis. Vetsulin(porcine insulin zinc suspension) is the first FDA-approved veterinary product for the management of canine and feline diabetes mellitus. Hypotension associated with septic shock is a medical
Comment: Closely monitor blood glucose when treated with antidiabetic agents. Concomitant use of insulin and somatostatin analogs may require insulin dosage adjustment and increased glucose monitoring. For treatment of cold symptoms, nasal decongestants may be preferable for short term, limited use (1 to 3 days) as an alternative to systemic decongestants in patients taking medications for diabetes. Concomitant use may cause an increased blood glucose-lowering effect with risk of hypoglycemia. Use Caution/Monitor. The oxycodone immediate-release formulation is FDA-approved for the management of acute or chronic moderate to severe pain, for which other treatments do not suffice, and for which the use of opioid medication is appropriate. Guaifenesin; Pseudoephedrine: (Moderate) Sympathomimetic agents tend to increase blood glucose concentrations when administered systemically. doses approximately 15 times the maximum recommended intramuscular, subcutaneous,
10977. Concomitant use may cause an increased blood glucose-lowering effect with risk of hypoglycemia. If use together is necessary, obtain an ECG at baseline to assess initial QT interval and determine frequency of subsequent ECG monitoring, avoid any non-essential QT prolonging drugs, and correct electrolyte imbalances. There are risks to the mother and fetus associated with untreated or increased maternal disease activity from malaria, rheumatoid arthritis, and systemic lupus erythematosus (SLE) during pregnancy that should be considered. Avoid concomitant use if possible, especially in patients with additional risk factors for TdP. Some pharmacokinetic studies have shown increased circulating levels of insulin in patients with hepatic or renal failure. sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of insulin detemir by Other (see comment). All patients achieved the targeted glucose range at some point during the 6-hour assessment phase. 1 INDICATIONS AND USAGE . 172 0 obj
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1 INDICATIONS AND USAGE. Avoid concomitant use if possible, especially in patients with additional risk factors for TdP. Minor/Significance Unknown. For treatment of cold symptoms, nasal decongestants may be preferable for short term, limited use (1 to 3 days) as an alternative to systemic decongestants in patients taking medications for diabetes. Minor (1)mesterolone increases effects of insulin detemir by pharmacodynamic synergism. Use Caution/Monitor. As of 2018, the most common procedure is to take a functioning heart, with or without both lungs, from a recently deceased organ donor (brain death is the Minor/Significance Unknown. pasireotide increases effects of insulin detemir by unspecified interaction mechanism. tissues. HOW TO USE: Read the Patient Information Leaflet provided by your pharmacist before you start using this medication and each time you get a refill. Patients who are taking antidiabetic agents should monitor for worsening glycemic control when a phenothiazine is instituted. Tolazamide: (Moderate) Monitor blood glucose during concomitant sulfonylurea and hydroxychloroquine use; a sulfonylurea dose adjustment may be necessary. Most 4th ed. Codeine; Phenylephrine; Promethazine: (Major) Concomitant use of hydroxychloroquine and promethazine increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Monitor blood glucose and glycemic control and adjust therapy as clinically indicated. iloperidone, insulin detemir. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely. Insulin detemir is usually injected with the evening meal or at bedtime. Lithium: (Moderate) Monitor blood glucose during concomitant insulin and lithium use; an insulin dose adjustment may be necessary. Also, adrenergic medications may decrease glucose uptake by muscle cells. Paliperidone has been associated with QT prolongation; Torsade de pointes (TdP) and ventricular fibrillation have been reported in the setting of overdose. Allow sufficient washout time of drugs affecting GH release before administering macimorelin. This interaction has been observed on treatment with the structurally similar chloroquine and cannot be ruled out for hydroxychloroquine. Consider taking steps to minimize the risk for QT/QTc interval prolongation and TdP, such as electrolyte monitoring and repletion and ECG monitoring, if concomitant use is necessary. (Minor) Progestins can decrease the hypoglycemic effects of antidiabetic agents by impairing glucose tolerance. If use together is necessary, obtain an ECG at baseline to assess initial QT interval and determine frequency of subsequent ECG monitoring, avoid any non-essential QT prolonging drugs, and correct electrolyte imbalances. Initiate droperidol at a low dose and increase the dose as needed to achieve the desired effect. Concomitant use may cause an increased blood glucose-lowering effect with risk of hypoglycemia. Specific dosing recommendations are not available. The amino acid sequence of mecasermin (rh-IGF-1) is approximately 50 percent homologous to insulin and cross binding with either receptor is possible. Levonorgestrel; Ethinyl Estradiol; Ferrous Bisglycinate: (Minor) Patients receiving antidiabetic agents should be periodically monitored for changes in glycemic control when hormone therapy is instituted or discontinued. Diabetic ketoacidosis has occurred in some patients including patients who were not diabetic prior to protease inhibitor treatment. Alfuzosin: (Major) Avoid coadministration of alfuzosin and hydroxychloroquine due to the risk of increased QT prolongation.
valsartan If muscle or nerve toxicity is suspected or demonstrated by tissue biopsy, discontinue hydroxychloroquine therapy. Sorafenib: (Major) Avoid coadministration of hydroxychloroquine and sorafenib due to the risk of increased QT prolongation. Side effects may require a temporary initial dose reduction. Never share pen between patients even if needle is changed, Long-acting insulin; do not use for circumstances that require rapid-acting insulin, Use with caution in patients with decreased insulin requirements, including those with diarrhea, nausea/vomiting, malabsorption, hypothyroidism, renal impairment, or hepatic impairment, Rapid changes in serum glucose may induce symptoms of hypoglycemia, Frequent glucose monitoring and insulin dose reduction may be required with renal or hepatic impairment; not recommended during periods of rapidly declining renal or hepatic function, because of risk for prolonged hypoglycemia, May cause a shift in potassium from extracellular to intracellular space, possibly leading to hypokalemia; caution when coadministered with potassium-lowering drugs or conditions that may decrease potassium, Use with caution in patients with increased insulin requirements, including those with fever, hyperthyroidism, trauma, or infection or who have undergone surgery, Lower dose when used in combination with a GLP-1 receptor agonist to minimize the risk of hypoglycemia, Available data from published studies and postmarketing case reports in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes; in a randomized, clinical trial of pregnant women with type 1 diabetes who were administered this drug once or twice daily, beginning in gestational weeks 8 to 12 or prior to conception, no clear evidence of maternal or fetal risk associated with this drug was observed; there are risks to the mother and fetus associated with poorly controlled diabetes in pregnancy, Hypoglycemia and hyperglycemia occur more frequently during pregnancy in patients with pre-gestational diabetes; poorly controlled diabetes in pregnancy increases maternal risk for diabetic ketoacidosis, preeclampsia, spontaneous abortions, preterm delivery, and delivery complications; poorly controlled diabetes increases fetal risk for major birth defects, stillbirth, and macrosomia-related morbidity, Available data from published literature demonstrate that exogenous human insulin products, are transferred into human milk; there are no published reports of adverse reactions, including hypoglycemia, in breastfed infants exposed to exogenous human insulin products, including this drug, in breastmilk, There are no data on effects of exogenous human insulin products, including insulin detemir, on milk production; the developmental and health benefits of breastfeeding should be considered along with the mothers clinical need for this insulin and any potential adverse effects on the breastfed infant from this drug or from underlying maternal condition. Patients with Parkinson's disease may experience
Either increases effects of the other by pharmacodynamic synergism. signs or symptoms of infection, such as persistent redness, warmth, swelling,
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