There is an interaction between metformin and chromium picolinate that suggests chromium may potentiate the hypoglycemic effect of metformin and patients should be monitored carefully.
metformin and chromium picolinate (Moderate Drug-Drug)
MONITOR: Pharmacologic dosages of chromium (200 mcg/day or more for adults) may potentiate the hypoglycemic effect of insulin and oral 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 and/or oral antidiabetic agents due to the potential for additive risk of hypoglycemia. Patients should be monitored for changes in diabetic medication requirements.
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