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Drug Interactions between exenatide and trace elements

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

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Interactions between your drugs

Moderate

chromic chloride hexahydrate exenatide

Applies to: trace elements and exenatide

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 (9)
  1. Bratman S, Kroll D. (2000) "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
  2. Mertz W (1998) "Interaction of chromium with insulin: a progress report." Nutr Rev, 56, p. 174-7
  3. Fox GN, Sabovic Z (1998) "Chromium picolinate supplementation for diabetes mellitus." J Fam Pract, 46, p. 83-6
  4. Anderson RA (1998) "Chromium, glucose intolerance and diabetes." J Am Coll Nutr, 17, p. 548-55
  5. Anderson RA, cheng N, Bryden NA, et al. (1997) "Elevated intakes of supplemental chromium improve glucose and insulin variables in individuals with type 2 diabetes." Diabetes, 46, p. 1786-91
  6. Abraham AS, Brooks BA, Eylath U (1992) "The effects of chromiium supplementation on serum glucose and lipids in patients with and without non-insulin-dependent diabetes." Metabolism, 41, p. 768-71
  7. Althuis MD, Jordan NE, Ludington EA, Wittes JT (2002) "Glucose and insulin responses to dietary chromium supplements: a meta-analysis." Am J Clin Nutr, 76, p. 148-55
  8. Gunton JE, Cheung NW, Hitchman R, et al. (2005) "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, p. 712-3
  9. Martin J, Wang ZQ, Zhang XH, et al. (2006) "Chromium picolinate supplementation attenuates body weight gain and increases insulin sensitivity in subjects with type 2 diabetes." Diabetes Care, 29, p. 1826-32

Drug and food interactions

Moderate

exenatide food

Applies to: exenatide

ADJUST DOSING INTERVAL: Exenatide slows gastric emptying and may reduce the extent and rate of absorption of concomitantly administered oral medications. When acetaminophen 1000 mg was administered simultaneously with exenatide 10 mcg and also one hour, 2 hours, and 4 hours after exenatide injection, acetaminophen systemic exposure (AUC) was decreased by 21%, 23%, 24%, and 14%, respectively; peak plasma concentration (Cmax) was decreased by 37%, 56%, 54%, and 41%, respectively; and time to peak plasma concentration (Tmax) was increased from 0.6 hours in the control period to 0.9 hours, 4.2 hours, 3.3 hours, and 1.6 hours, respectively. These values were not significantly changed when acetaminophen was given one hour before exenatide injection.

MANAGEMENT: Concomitantly administered oral medications that are dependent on threshold concentrations for efficacy (e.g., antibiotics, contraceptives) or that require rapid gastrointestinal absorption (e.g., hypnotics, pain medications) should be administered at least 1 hour before exenatide. If such medications are to be administered with food, patients should be advised to take them with a meal or snack when exenatide is not administered.

References (1)
  1. (2005) "Product Information. Byetta (exenatide)." Amylin Pharmaceuticals Inc

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

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