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Drug Interactions between Lantus and lisinopril

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

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Moderate

lisinopril insulin glargine

Applies to: lisinopril and Lantus (insulin glargine)

MONITOR: The hypoglycemic effect of insulin may be potentiated by certain drugs, including ACE inhibitors, angiotensin receptor blockers (ARBs), 4-aminoquinolines, amylin analogs, anabolic steroids, fibrates, monoamine oxidase inhibitors (MAOIs, including linezolid), salicylates, selective serotonin reuptake inhibitors (SSRIs), sulfonamides, disopyramide, propoxyphene, quinidine, quinine, and ginseng. These drugs may increase the risk of hypoglycemia by enhancing insulin sensitivity (ACE inhibitors, ARBs, fibrates, ginseng); stimulating insulin secretion (salicylates, disopyramide, pentoxifylline, propoxyphene, quinidine, quinine, MAOIs, ginseng); decreasing insulin clearance and resistance (4-aminoquinolines); increasing peripheral glucose utilization (SSRIs, insulin-like growth factor); inhibiting gluconeogenesis (SSRIs, MAOIs, insulin-like growth factor); slowing the rate of gastric emptying (amylin analogs); and/or suppressing postprandial glucagon secretion (amylin analogs). Clinical hypoglycemia has been reported during use of some of these agents alone or with insulin and/or insulin secretagogues. Use of SSRIs has also been associated with loss of awareness of hypoglycemia in isolated cases.

MANAGEMENT: Close monitoring for the development of hypoglycemia is recommended if these drugs are coadministered with insulin, particularly in patients with advanced age and/or renal impairment. The insulin dosage may require adjustment if an interaction is suspected. Patients should be apprised of the signs and symptoms of hypoglycemia (e.g., headache, dizziness, drowsiness, nausea, hunger, tremor, weakness, sweating, palpitations), how to treat it, and to contact their physician if it occurs. Patients should be observed for loss of glycemic control when these drugs are withdrawn.

References

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  17. Murakami K, Nambu S, Koh H, Kobayashi M, Shigeta Y "Clofibrate enhances the affinity of insulin receptors in non-insulin dependent diabetes mellitus." Br J Clin Pharmacol 17 (1984): 89-91
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  30. Slade IH, and Iosefa RN "Fatal hypoglycemic coma from the use of tolbutamide in elderly patients: report of two cases." J Am Geriatr Soc 15 (1967): 948-50
  31. Cattaneo AG, Caviezel F, Pozza G "Pharmacological interaction between tolbutamide and acetylsalicylic acid: study on insulin secretion in man." Int J Clin Pharmacol Ther Toxicol 28 (1990): 229-34
  32. Christensen LK, Hansen JM, Kristensen M "Sulphaphenazole-induced hypoglycemic attacks in tolbutamide-treated diabetics." Lancet 2 (1963): 1298-301
  33. Turtle JR, Burgess JA "Hypoglycemic action of fenfluramine in diabetes mellitus." Diabetes 22 (1973): 858-67
  34. Ferriere M, Lachkar H, Richard JL, Bringer J, Orsetti A, Mirouze J "Captopril and insulin sensitivity." Ann Intern Med 102 (1985): 134-5
  35. Johnson JA, Kappel JE, Sharif MN "Hypoglycemia secondary to trimethoprim/sulfamethoxazole administration in a renal transplant patient." Ann Pharmacother 27 (1993): 304-6
  36. Almirall J, Montoliu J, Torras A, Revert L "Propoxyphene-induced hypoglycemia in a patient with chronic renal failure." Nephron 53 (1989): 273-5
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  38. Phillips AF, Matty PJ, Porte PJ, Raye JR "Inhibition of glucose-induced insulin secretion by indomethacin and sodium salicylate in the fetal lamb." Am J Obstet Gynecol 148 (1984): 481-7
  39. Baron SH "Salicylates as hypoglycemic agents." Diabetes Care 5 (1982): 64-71
  40. Prince RL, Larkins RG, Alford FP "The effect of acetylsalicylic acid on plasma glucose and the response of glucose regulatory hormones to intravenous glucose and arginine in insulin treated diabetics and normal subjects." Metabolism 30 (1981): 293-8
  41. Ferrari C, Fressati S, Romussi M, et al. "Effects of short-term clofibrate administration on glucose tolerance and insulin secretion in patients with chemical diabetes or hypertriglyceridemia." Metabolism 26 (1977): 129-39
  42. Storlien LH, Thorburn AW, Smythe GA, Jenkins AB, Chisholm DJ, Kraegen EW "Effect of d-fenfluramine on basal glucose turnover and fat-feeding-induced insulin resistance in rats." Diabetes 38 (1989): 499-503
  43. Pestell RG, Crock PA, Ward GM, Alford FP, Best JD "Fenfluramine increases insulin action in patients with NIDDM." Diabetes Care 12 (1989): 252-8
  44. Harrison LC, King-Roach A, Martin FI, Melick RA "The effect of fenfluramine on insulin binding and on basal and insulin-stimulated oxidation of 1-C-glucose by human adipose tissue." Postgrad Med J 51 Suppl 1 (1975): 110-4
  45. Feldman JM, Chapman B "Monoamine oxidase inhibitors: nature of their interaction with rabbit pancreatic islets to alter insulin secretion." Diabetologia 11 (1975): 487-94
  46. Aleyassine H, Gardiner RJ "Dual action of antidepressant drugs (MAO inhibitors) on insulin release." Endocrinology 96 (1975): 702-10
  47. Aleyassine H, Lee SH "Inhibition of insulin release by substrates and inhibitors of monoamine oxidase." Am J Physiol 222 (1972): 565-9
  48. Cooper AJ, Ashcroft G "Potentiation of insulin hypoglycaemia by M.A.O.I. antidepressant drugs." Lancet 1 (1966): 407-9
  49. Herings RMC, Deboer A, Stricker BHC, Leufkens HGM, Porsius A "Hypoglycaemia associated with use of inhibitors of angiotensin converting enzyme." Lancet 345 (1995): 1195-8
  50. Ahmad S "Drug interaction induces hypoglycemia." J Fam Pract 40 (1995): 540-1
  51. Feher MD, Amiel S "ACE inhibitors and hypoglycaemia." Lancet 346 (1995): 125-6
  52. Paolisso G, Balbi V, Gambardella A, Varricchio G, Tortoriello R, Saccomanno F, Amato L, Varricchio M "Lisinopril administration improves insulin action in aged patients with hypertension." J Hum Hypertens 9 (1995): 541-6
  53. Darcy PF, Griffin JP "Interactions with drugs used in the treatment of depressive illness." Adverse Drug React Toxicol Rev 14 (1995): 211-31
  54. Kubacka RT, Antla EJ, Juhl RP, Welshman IR "Effects of aspirin and ibuprofen on the pharmacokinetics and pharmacodynamics of glyburide in healthy subjects." Ann Pharmacother 30 (1996): 20-6
  55. Deeg MA, Lipkin EW "Hypoglycemia associated with the use of fluoxetine." West J Med 164 (1996): 262-3
  56. Hellman B "Potentiating effects of drugs on the binding of glibenclamide to pancreatic beta cells." Metabolism 23 (1974): 839-46
  57. Hekimsoy Z, Biberoglu S, Comlekci A, Tarhan O, Mermut C, Biberoglu K "Trimethoprim/sulfamethoxazole-induced hypoglycemia in a malnourished patient with severe infection." Eur J Endocrinol 136 (1997): 3046
  58. Iida H, Morita T, Suzuki E, Iwasawa K, Toyooka T, Nakajima T "Hypoglycemia induced by interaction between clarithromycin and disopyramide." Jpn Heart J 40 (1999): 91-6
  59. Morris AD, Newton RW, Boyle DI, et al. "ACE inhibitor use is associated with hospitalization for severe hypoglycemia in patients with diabetes." Diabetes Care 20 (1997): 1363-7
  60. Abad S, Moachon L, Blanche P, Bavoux F, Sicard D, Salmon-Ceron D "Possible interaction between glicazide, fluconazole and sulfamethoxazole resulting in severe hypoglycaemia." Br J Clin Pharmacol 52 (2001): 456-7
  61. "Product Information. Humalog (insulin lispro)." Lilly, Eli and Company (2002):
  62. "Product Information. Humulin 70/30 (insulin isophane-insulin regular)." Lilly, Eli and Company (2002):
  63. Pollak PT, Mukherjee SD, Fraser AD "Sertraline-induced hypoglycemia." Ann Pharmacother 35 (2001): 1371-4
  64. Hundal RS, Petersen KF, Mayerson AB, et al. "Mechanism by which high-dose aspirin improves glucose metabolism in type 2 diabetes." J Clin Invest 109 (2002): 1321-6
  65. "Product Information. Apidra (insulin glulisine)." Aventis Pharmaceuticals (2004):
  66. Fogari R, Zoppi A, Corradi L, Pierangelo L, Mugellini A, Lusardi P "Comparative effects of lisinopril and losartan on insulin sensitivity in the treatment of non diabetic hypertension." Br J Clin Pharmacol 46 (1998): 467-71
  67. Vuorinen-Markkola H, Yki-Jarvinen H "Antihypertensive therapy with enalapril improves glucose storage and insulin sensitivity in hypertensive patients with non-insulin-dependent diabetes mellitus." Metabolism 44 (1995): 85-9
  68. "Product Information. Increlex (mecasermin)." Tercica Inc (2005):
  69. Vuksan V, Sievenpiper JL, Koo VY, et al. "American ginseng (Panax quinquefolius L) reduces postprandial glycemia in nondiabetic subjects and subjects with type 2 diabetes mellitus." Arch Intern Med 160 (2000): 1009-13
  70. Vuksan V, Stavro MP, Sievenpiper JL, et al. "Similar postprandial glycemic reductions with escalation of dose and administration time of American ginseng in type 2 diabetes." Diabetes Care 23 (2000): 1221-6
  71. Sievenpiper JL, Arnason JT, Leiter LA, Vuksan V "Variable effects of American ginseng: a batch of American ginseng (Panax quinquefolius L.) with a depressed ginsenoside profile does not affect postprandial glycemia." Eur J Clin Nutr 57 (2003): 243-8
  72. Ben Salem C, Fathallah N, Hmouda H, Bouraoui K "Drug-induced hypoglycaemia: an update." Drug Saf 34 (2011): 21-45
  73. "Product Information. Afrezza (insulin inhalation, rapid acting)." MannKind Corporation (2014):
  74. "Product Information. Ryzodeg 70/30 FlexTouch (insulin aspart-insulin degludec)." Novo Nordisk Pharmaceuticals Inc (2015):
  75. "Product Information. Tresiba FlexTouch (insulin degludec)." Novo Nordisk Pharmaceuticals Inc (2015):
  76. World Health Organization "WHO Public Assessment Reports (WHOPARs) https://extranet.who.int/pqweb/medicines/prequalification-reports/whopars" (2020):
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Drug and food interactions

Moderate

lisinopril food

Applies to: lisinopril

GENERALLY AVOID: Moderate-to-high dietary intake of potassium can cause hyperkalemia in some patients who are using angiotensin converting enzyme (ACE) inhibitors. In some cases, affected patients were using a potassium-rich salt substitute. ACE inhibitors can promote hyperkalemia through inhibition of the renin-aldosterone-angiotensin (RAA) system.

MANAGEMENT: It is recommended that patients who are taking ACE inhibitors be advised to avoid moderately high or high potassium dietary intake. Particular attention should be paid to the potassium content of salt substitutes.

References

  1. "Product Information. Vasotec (enalapril)." Merck & Co., Inc PROD (2002):
  2. Good CB, McDermott L "Diet and serum potassium in patients on ACE inhibitors." JAMA 274 (1995): 538
  3. Ray K, Dorman S, Watson R "Severe hyperkalaemia due to the concomitant use of salt substitutes and ACE inhibitors in hypertension: a potentially life threatening interaction." J Hum Hypertens 13 (1999): 717-20

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Moderate

insulin glargine food

Applies to: Lantus (insulin glargine)

GENERALLY AVOID: Alcohol may cause hypoglycemia or hyperglycemia in patients with diabetes. Hypoglycemia most frequently occurs during acute consumption of alcohol. Even modest amounts can lower blood sugar significantly, especially when the alcohol is ingested on an empty stomach or following exercise. The mechanism involves inhibition of both gluconeogenesis as well as the counter-regulatory response to hypoglycemia. Episodes of hypoglycemia may last for 8 to 12 hours after ethanol ingestion. By contrast, chronic alcohol abuse can cause impaired glucose tolerance and hyperglycemia. Moderate alcohol consumption generally does not affect blood glucose levels in patients with well controlled diabetes. A disulfiram-like reaction (e.g., flushing, headache, and nausea) to alcohol has been reported frequently with the use of chlorpropamide and very rarely with other sulfonylureas.

MANAGEMENT: Patients with diabetes should avoid consuming alcohol if their blood glucose is not well controlled, or if they have hypertriglyceridemia, neuropathy, or pancreatitis. Patients with well controlled diabetes should limit their alcohol intake to one drink daily for women and two drinks daily for men (1 drink = 5 oz wine, 12 oz beer, or 1.5 oz distilled spirits) in conjunction with their normal meal plan. Alcohol should not be consumed on an empty stomach or following exercise.

References

  1. Jerntorp P, Almer LO "Chlorpropamide-alcohol flushing in relation to macroangiopathy and peripheral neuropathy in non-insulin dependent diabetes." Acta Med Scand 656 (1981): 33-6
  2. Jerntorp P, Almer LO, Holin H, et al. "Plasma chlorpropamide: a critical factor in chlorpropamide-alcohol flush." Eur J Clin Pharmacol 24 (1983): 237-42
  3. Barnett AH, Spiliopoulos AJ, Pyke DA, et al. "Metabolic studies in chlorpropamide-alcohol flush positive and negative type 2 (non-insulin dependent) diabetic patients with and without retinopathy." Diabetologia 24 (1983): 213-5
  4. Hartling SG, Faber OK, Wegmann ML, Wahlin-Boll E, Melander A "Interaction of ethanol and glipizide in humans." Diabetes Care 10 (1987): 683-6
  5. "Product Information. Diabinese (chlorpropamide)." Pfizer U.S. Pharmaceuticals PROD (2002):
  6. "Product Information. Glucotrol (glipizide)." Pfizer U.S. Pharmaceuticals PROD (2002):
  7. "Product Information. Diabeta (glyburide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  8. Skillman TG, Feldman JM "The pharmacology of sulfonylureas." Am J Med 70 (1981): 361-72
  9. "Position Statement: evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes related complications. American Diabetes Association." Diabetes Care 25(Suppl 1) (2002): S50-S60
  10. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
View all 10 references

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Moderate

lisinopril food

Applies to: lisinopril

MONITOR: Many psychotherapeutic and CNS-active agents (e.g., anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics, opioids, alcohol, muscle relaxants) exhibit hypotensive effects, especially during initiation of therapy and dose escalation. Coadministration with antihypertensives and other hypotensive agents, in particular vasodilators and alpha-blockers, may result in additive effects on blood pressure and orthostasis.

MANAGEMENT: Caution and close monitoring for development of hypotension is advised during coadministration of these agents. Some authorities recommend avoiding alcohol in patients receiving vasodilating antihypertensive drugs. Patients should be advised to avoid rising abruptly from a sitting or recumbent position and to notify their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia.

References

  1. Sternbach H "Fluoxetine-associated potentiation of calcium-channel blockers." J Clin Psychopharmacol 11 (1991): 390-1
  2. Shook TL, Kirshenbaum JM, Hundley RF, Shorey JM, Lamas GA "Ethanol intoxication complicating intravenous nitroglycerin therapy." Ann Intern Med 101 (1984): 498-9
  3. Feder R "Bradycardia and syncope induced by fluoxetine." J Clin Psychiatry 52 (1991): 139
  4. Ellison JM, Milofsky JE, Ely E "Fluoxetine-induced bradycardia and syncope in two patients." J Clin Psychiatry 51 (1990): 385-6
  5. Rodriguez de la Torre B, Dreher J, Malevany I, et al. "Serum levels and cardiovascular effects of tricyclic antidepressants and selective serotonin reuptake inhibitors in depressed patients." Ther Drug Monit 23 (2001): 435-40
  6. Cerner Multum, Inc. "Australian Product Information." O 0
  7. Pacher P, Kecskemeti V "Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns?" Curr Pharm Des 10 (2004): 2463-75
  8. Andrews C, Pinner G "Postural hypotension induced by paroxetine." BMJ 316 (1998): 595
View all 8 references

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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.

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