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Drug Interactions between Cr-GTF and SymlinPen 120

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

chromium picolinate pramlintide

Applies to: Cr-GTF (chromium picolinate) and SymlinPen 120 (pramlintide)

MONITOR: Pharmacologic dosages of chromium (200 mcg/day or more for adults) may help improve diabetic control and reduce the requirements for insulin and other antidiabetic agents. Chromium appears to play a role in normal insulin function and glucose utilization, and some investigators have suggested that it increases insulin sensitivity and glucose tolerance and decreases blood glucose levels in certain diabetics, possibly those with low chromium levels. However, others have not corroborated these findings, and a few have even reported a negative effect on glucose tolerance and blood levels.

MANAGEMENT: Until further data are available, therapy with pharmacologic dosages of chromium should be administered cautiously in patients receiving insulin or other antidiabetic agents. Patients should be monitored for changes in diabetic medication requirements.

References

  1. Bratman S, Kroll D. "The Natural Health Bible: From the Most Trusted Alternative Health Site in the World--Your A-Z Guide to over 300 Conditions, Herbs, Vitamins, and Supplements." Roseville, CA: Prima Health (2000):
  2. Mertz W "Interaction of chromium with insulin: a progress report." Nutr Rev 56 (1998): 174-7
  3. Fox GN, Sabovic Z "Chromium picolinate supplementation for diabetes mellitus." J Fam Pract 46 (1998): 83-6
  4. Anderson RA "Chromium, glucose intolerance and diabetes." J Am Coll Nutr 17 (1998): 548-55
  5. Anderson RA, cheng N, Bryden NA, et al. "Elevated intakes of supplemental chromium improve glucose and insulin variables in individuals with type 2 diabetes." Diabetes 46 (1997): 1786-91
  6. Abraham AS, Brooks BA, Eylath U "The effects of chromiium supplementation on serum glucose and lipids in patients with and without non-insulin-dependent diabetes." Metabolism 41 (1992): 768-71
  7. Althuis MD, Jordan NE, Ludington EA, Wittes JT "Glucose and insulin responses to dietary chromium supplements: a meta-analysis." Am J Clin Nutr 76 (2002): 148-55
  8. Gunton JE, Cheung NW, Hitchman R, et al. "Chromium supplementation does not improve glucose tolerance, insulin sensitivity, or lipid profile: a randomized, placebo-controlled, double-blind trial of supplementation in subjects with impaired glucose tolerance." Diabetes Care 28 (2005): 712-3
  9. Martin J, Wang ZQ, Zhang XH, et al. "Chromium picolinate supplementation attenuates body weight gain and increases insulin sensitivity in subjects with type 2 diabetes." Diabetes Care 29 (2006): 1826-32
View all 9 references

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Drug and food interactions

Moderate

pramlintide food

Applies to: SymlinPen 120 (pramlintide)

ADJUST DOSING INTERVAL: Pramlintide slows gastric emptying and may delay the absorption of concomitantly administered oral medications. In a pharmacokinetic study of 24 patients with type 2 diabetes, coadministration with pramlintide (120 mcg) decreased the peak plasma concentration (Cmax) of acetaminophen (1000 mg) by 29% and increased its time to peak plasma concentration (Tmax) based on the time of acetaminophen administration relative to pramlintide injection. Pramlintide significantly increased acetaminophen Tmax (range 48 to 72 minutes) when acetaminophen was administered simultaneously with or up to 2 hours following pramlintide injection, but it had negligible effect when acetaminophen was administered 1 to 2 hours before pramlintide injection.

MANAGEMENT: When rapid onset of a concomitantly administered oral medication is critical to its effectiveness, the medication should be administered at least 1 hour before or 2 hours after pramlintide injection.

References

  1. "Product Information. Symlin (pramlintide)." Amphastar Pharmaceuticals Inc (2005):

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.