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Insulin degludec / liraglutide Disease Interactions

There are 8 disease interactions with insulin degludec / liraglutide:

Major

Glp-1 Receptor Agonists (Includes Insulin degludec/liraglutide) ↔ Pancreatitis

Severe Potential Hazard, Moderate plausibility

Applies to: Pancreatitis

The use of GLP-1 receptor agonists has been associated with rare reports of acute pancreatitis. Other antidiabetic therapies should be considered in patients with a previous history of pancreatitis, although it is not known if they are at increased risk. Patients receiving treatment with GLP-1 receptor agonists should be observed carefully for signs and symptoms of pancreatitis. If this diagnosis is suspected, the treatment should be discontinued immediately and appropriate management should be initiated. Treatment with GLP-1 receptor agonists should be permanently discontinued if pancreatitis is confirmed.

Major

Glp-1 Receptor Agonists (Includes Insulin degludec/liraglutide) ↔ Thyroid Carcinoma

Severe Potential Hazard, Moderate plausibility

Applies to: Multiple Endocrine Neoplasia Type II

GLP-1 receptor agonist antidiabetic drugs are contraindicated in patients with a personal or family history of medullary thyroid carcinoma and in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN2). Carcinogenicity studies in rodents and limited postmarketing data suggest that GLP-1 inhibitors may cause a dose-related and treatment duration-related increase in risk of thyroid C-cell tumors, although a causal relationship has not been established.

Major

Liraglutide (Includes Insulin degludec/liraglutide) ↔ Depression

Severe Potential Hazard, Moderate plausibility

Applies to: Depression

Therapy with liraglutide should be administered cautiously in patients with depression or any mood or behavior disorder because of the potential for suicidal thoughts or behavior. The drug should be avoided in patients with a history of suicidal attempts or active suicidal ideation.

Moderate

Glp-1 Receptor Agonists (Includes Insulin degludec/liraglutide) ↔ Renal Dysfunction

Moderate Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

There have been reports of acute renal failure and worsening of chronic renal failure sometimes requiring hemodialysis in patients treated with GLP-1 receptor inhibitors. Some of these events occurred in patients without known underlying renal disease. These drugs should be used with caution in patients with renal impairment, especially during treatment initiation or dose escalation. Patients should be monitored, especially if they report severe gastrointestinal reactions such as nausea, vomiting, diarrhea, or dehydration. The frequency of gastrointestinal events is increased as renal function declines. There is limited clinical experience with most of these drugs in patients with severe renal impairment.

Moderate

Insulin (Includes Insulin degludec/liraglutide) ↔ Renal/Liver Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction, Liver Disease

Insulin requirements may be diminished in patients with renal or hepatic impairment due to reduced insulin metabolism and, in the latter case, also to reduced capacity for gluconeogenesis. Lower initial dosages may be appropriate, with careful monitoring of plasma glucose levels and dosing adjustments.

References

  1. "Product Information. Novolog (insulin aspart)" Novo Nordisk Pharmaceuticals Inc, Princeton, NJ.
  2. "Product Information. Lantus (insulin glargine)" Aventis Pharmaceuticals, Swiftwater, PA.
  3. "Product Information. Humulin BR (insulin)." Lilly, Eli and Company, Indianapolis, IN.
Moderate

Insulin- Hypokalemia

Moderate Potential Hazard, Moderate plausibility

Applies to: Hypokalemia

Hypokalemia may commonly occur during treatment with insulin. Use with caution in patients who may be particularly at risk of developing hypokalemia (e.g., patients using potassium-lowering medications, patients taking medications sensitive to serum potassium concentrations).

Moderate

Insulin/Oral Hypoglycemic Agents (Includes Insulin degludec/liraglutide) ↔ Hypoglycemia

Moderate Potential Hazard, Moderate plausibility

Applies to: Adrenal Insufficiency, Malnourished, Autonomic Neuropathy, Panhypopituitarism, Anorexia/Feeding Problems

Hypoglycemia may commonly occur during treatment with insulin and/or oral hypoglycemic agents. Care should be taken in patients who may be particularly susceptible to the development of hypoglycemic episodes during the use of these drugs, including those who are debilitated or malnourished, those with defective counterregulatory mechanisms (e.g., autonomic neuropathy and adrenal or pituitary insufficiency), and those receiving beta-adrenergic blocking agents.

References

  1. Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, eds. "Harrison's Principles of Internal Medicine. 14th ed." New York, NY: McGraw-Hill Health Professionals Division (1998):
  2. "Product Information. Glucotrol (glipizide)." Pfizer US Pharmaceuticals, New York, NY.
  3. "Product Information. Glucophage (metformin)." Bristol-Myers Squibb, Princeton, NJ.
  4. "Product Information. Novolog (insulin aspart)" Novo Nordisk Pharmaceuticals Inc, Princeton, NJ.
  5. "Product Information. Lantus (insulin glargine)" Aventis Pharmaceuticals, Swiftwater, PA.
  6. "Product Information. Humulin BR (insulin)." Lilly, Eli and Company, Indianapolis, IN.
  7. "Product Information. Diabeta (glyburide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  8. "Product Information. Dymelor (acetohexamide)" Lilly, Eli and Company, Indianapolis, IN.
  9. "Product Information. Starlix (nateglinide)" Novartis Pharmaceuticals, East Hanover, NJ.
  10. "Product Information. Amaryl (glimepiride)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  11. "Product Information. Prandin (repaglinide)." Novo Nordisk Pharmaceuticals Inc, Princeton, NJ.
  12. "Product Information. Micronase (glyburide)." Pharmacia and Upjohn, Kalamazoo, MI.
  13. "Product Information. Tolinase (tolazamide)" Pharmacia and Upjohn, Kalamazoo, MI.
  14. "Multum Information Services, Inc. Expert Review Panel"
  15. "Product Information. Diabinese (chlorpropamide)." Pfizer US Pharmaceuticals, New York, NY.
View all 15 references
Moderate

Liraglutide (Includes Insulin degludec/liraglutide) ↔ Cardiovascular Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Cardiovascular Disease, History - Cerebrovascular Disease

Liraglutide can increase the resting heart rate and it should be used with caution in patients with history of cardiovascular disease and cerebrovascular disease. Heart rate should be monitored regularly, and patients should inform their healthcare providers of any symptoms such as palpitations and racing heartbeat appear while at rest.

insulin degludec / liraglutide drug Interactions

There are 916 drug interactions with insulin degludec / liraglutide

insulin degludec / liraglutide alcohol/food Interactions

There are 2 alcohol/food interactions with insulin degludec / liraglutide

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
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 information available.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2018 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

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