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Can you take Insulin aspart with Landiolol?

1 drug interaction and 31 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

insulin aspart landiolol

Applies to: insulin aspart and landiolol

Landiolol may interfere with blood glucose control thus increasing or reducing the effectiveness of insulin aspart and other diabetic medications.

Beta-blockers such as landiolol may increase the risk, severity, and/or duration of hypoglycemia (low blood sugar) in patients receiving insulin aspart and certain other antidiabetic medications.

In addition, beta-blockers may mask some of the symptoms of hypoglycemia such as tremor, palpitations and rapid heartbeat, making it more difficult to recognize an oncoming episode. Other symptoms of hypoglycemia such as headache, dizziness, drowsiness, nervousness, confusion, nausea, hunger, weakness, and perspiration are not affected.

Hyperglycemia (elevated blood sugar levels) may also occur with some beta-blockers.

You may need a dose adjustment of your diabetic medications during and after treatment with landiolol. You may also need to monitor your blood glucose levels more frequently, especially if you are prone to developing hypoglycemia.

Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Food/lifestyle interactions

Moderate food/lifestyle interactions

Moderate:

insulin aspart Food/Lifestyle

Applies to: insulin aspart

Alcohol may affect blood glucose levels in patients with diabetes. Both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) may occur, depending on how much and how often you drink.

You should avoid using alcohol if your diabetes is not well controlled or if you have:

  • high triglycerides
  • neuropathy (nerve damage)
  • pancreatitis

Moderate alcohol consumption generally does not affect blood glucose levels if your diabetes is under control. However, it may be best to limit 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 your normal meal plan.

Avoid drinking alcohol on an empty stomach or following exercise, as it may increase the risk of hypoglycemia.

It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Disease interactions

30 potential interactions Applies to: 27 conditions, including Allergies, Heart Failure, Asthma, COPD, and Hypokalemia.

Acidosis

Moderate:

landiolol

Landiolol has a moderate potential interaction with Acidosis.

Hyperkalemic renal tubular acidosis may occur in patients with metabolic acidosis receiving landiolol; beta-blockers have been reported to cause this condition. Acidosis in general may be associated with reduced cardiac contractility.

Adrenal Insufficiency

Major:

insulin aspart

Insulin aspart has a major potential interaction with Adrenal Insufficiency.

The use of insulin is contraindicated during episodes of hypoglycemia. 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 but not limited to those who are debilitated or malnourished, those with renal or hepatic impairment, those with defective counterregulatory mechanisms (e.g., autonomic neuropathy and adrenal or pituitary insufficiency), and those with reduced awareness of hypoglycemia. Symptomatic awareness of hypoglycemia may be reduced in patients with longstanding diabetes, diabetic nerve disease, recurrent hypoglycemia, or concomitant medications that block the sympathetic nervous system (e.g., beta-blockers). Changes to any glucose-lowering medications, meal pattern, or physical activity may also increase risk of hypoglycemia. Increased frequency of glucose monitoring is recommended in patients at higher risk for hypoglycemia.

Allergies

Moderate:

landiolol

Landiolol has a moderate potential interaction with Allergies.

When using beta-blockers (like landiolol), patients at risk of anaphylactic reactions may be more reactive to allergen exposure (accidental, diagnostic, or therapeutic). Patients using beta-blockers may be unresponsive to the usual doses of epinephrine used to treat anaphylactic or anaphylactoid reactions.

Anorexia/Feeding Problems

Major:

insulin aspart

Insulin aspart has a major potential interaction with Anorexia/Feeding Problems.

The use of insulin is contraindicated during episodes of hypoglycemia. 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 but not limited to those who are debilitated or malnourished, those with renal or hepatic impairment, those with defective counterregulatory mechanisms (e.g., autonomic neuropathy and adrenal or pituitary insufficiency), and those with reduced awareness of hypoglycemia. Symptomatic awareness of hypoglycemia may be reduced in patients with longstanding diabetes, diabetic nerve disease, recurrent hypoglycemia, or concomitant medications that block the sympathetic nervous system (e.g., beta-blockers). Changes to any glucose-lowering medications, meal pattern, or physical activity may also increase risk of hypoglycemia. Increased frequency of glucose monitoring is recommended in patients at higher risk for hypoglycemia.

Asthma

Moderate:

landiolol

Landiolol has a moderate potential interaction with Asthma.

Patients with reactive airways disease should generally not receive beta-blockers (like landiolol). Because of the relative beta-1 selectivity and titratability, landiolol may be titrated to the lowest possible effective dose. If bronchospasm occurs, the infusion should be stopped immediately; a beta-2 stimulating agent may be administered with appropriate monitoring of ventricular rates.

Autonomic Neuropathy

Major:

insulin aspart

Insulin aspart has a major potential interaction with Autonomic Neuropathy.

The use of insulin is contraindicated during episodes of hypoglycemia. 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 but not limited to those who are debilitated or malnourished, those with renal or hepatic impairment, those with defective counterregulatory mechanisms (e.g., autonomic neuropathy and adrenal or pituitary insufficiency), and those with reduced awareness of hypoglycemia. Symptomatic awareness of hypoglycemia may be reduced in patients with longstanding diabetes, diabetic nerve disease, recurrent hypoglycemia, or concomitant medications that block the sympathetic nervous system (e.g., beta-blockers). Changes to any glucose-lowering medications, meal pattern, or physical activity may also increase risk of hypoglycemia. Increased frequency of glucose monitoring is recommended in patients at higher risk for hypoglycemia.

Cardiogenic Shock

Major:

landiolol

Landiolol has a major potential interaction with Cardiogenic Shock.

Landiolol is contraindicated in patients with cardiogenic shock as it may precipitate further cardiovascular collapse and cause cardiac arrest.

COPD

Moderate:

landiolol

Landiolol has a moderate potential interaction with COPD.

Patients with reactive airways disease should generally not receive beta-blockers (like landiolol). Because of the relative beta-1 selectivity and titratability, landiolol may be titrated to the lowest possible effective dose. If bronchospasm occurs, the infusion should be stopped immediately; a beta-2 stimulating agent may be administered with appropriate monitoring of ventricular rates.

Dehydration

Moderate:

landiolol

Landiolol has a moderate potential interaction with Dehydration.

Patients with hemodynamic compromise, hypovolemia, or on interacting medications are at increased risk of hypotension while taking landiolol. Blood pressure should be monitored closely, especially if pretreatment blood pressure was low. Landiolol should be reduced or stopped for hypotension; the blood pressure effect should wane within 30 minutes.

Diabetes Mellitus

Moderate:

landiolol

Landiolol has a moderate potential interaction with Diabetes Mellitus.

Landiolol may prevent early warning signs of hypoglycemia (e.g., tachycardia) and increase the risk for severe/prolonged hypoglycemia at any time during treatment, especially in patients with diabetes mellitus or patients who are fasting (e.g., surgery, not eating regularly, or are vomiting). Patients receiving landiolol should be monitored for signs/symptoms of hypoglycemia.

Heart Block

Major:

landiolol

Landiolol has a major potential interaction with Heart Block.

Landiolol is contraindicated in patients with severe sinus bradycardia, sick sinus syndrome, or heart block greater than first degree. Patients with first-degree atrioventricular block, sinus node dysfunction, or conduction disorders are at increased risk of bradycardia (including sinus pause, heart block, severe bradycardia, and cardiac arrest). Heart rate and rhythm should be monitored in patients receiving landiolol. If bradyarrhythmia occurs, landiolol should be reduced or stopped.

Heart Failure

Major:

landiolol

Landiolol has a major potential interaction with Heart Failure.

Landiolol is contraindicated in patients with decompensated heart failure. Beta-blockers (like landiolol) can depress myocardial contractility and may precipitate heart failure and cardiogenic shock. At first sign/symptom of impending cardiac failure, landiolol should be stopped and supportive therapy should be started.

Hyperthyroidism

Moderate:

landiolol

Landiolol has a moderate potential interaction with Hyperthyroidism.

When landiolol is used in patients with hyperthyroidism, certain clinical signs (e.g., tachycardia) of hyperthyroidism may be masked by beta-adrenergic blockade. Abrupt withdrawal of beta-blockers may precipitate a thyroid storm. Patients should be monitored for signs of thyrotoxicosis when withdrawing landiolol therapy.

Hypoglycemia

Major:

insulin aspart

Insulin aspart has a major potential interaction with Hypoglycemia.

The use of insulin is contraindicated during episodes of hypoglycemia. 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 but not limited to those who are debilitated or malnourished, those with renal or hepatic impairment, those with defective counterregulatory mechanisms (e.g., autonomic neuropathy and adrenal or pituitary insufficiency), and those with reduced awareness of hypoglycemia. Symptomatic awareness of hypoglycemia may be reduced in patients with longstanding diabetes, diabetic nerve disease, recurrent hypoglycemia, or concomitant medications that block the sympathetic nervous system (e.g., beta-blockers). Changes to any glucose-lowering medications, meal pattern, or physical activity may also increase risk of hypoglycemia. Increased frequency of glucose monitoring is recommended in patients at higher risk for hypoglycemia.

Moderate:

landiolol

Landiolol has a moderate potential interaction with Hypoglycemia.

Landiolol may prevent early warning signs of hypoglycemia (e.g., tachycardia) and increase the risk for severe/prolonged hypoglycemia at any time during treatment, especially in patients with diabetes mellitus or patients who are fasting (e.g., surgery, not eating regularly, or are vomiting). Patients receiving landiolol should be monitored for signs/symptoms of hypoglycemia.

Hypokalemia

Moderate:

insulin aspart

Insulin aspart has a moderate potential interaction with Hypokalemia.

Hypokalemia may commonly occur during treatment with insulin. Use with caution and monitor potassium levels 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).

Hypotension

Moderate:

landiolol

Landiolol has a moderate potential interaction with Hypotension.

Patients with hemodynamic compromise, hypovolemia, or on interacting medications are at increased risk of hypotension while taking landiolol. Blood pressure should be monitored closely, especially if pretreatment blood pressure was low. Landiolol should be reduced or stopped for hypotension; the blood pressure effect should wane within 30 minutes.

Ischemic Heart Disease

Moderate:

landiolol

Landiolol has a moderate potential interaction with Ischemic Heart Disease.

Patients should be observed for signs of myocardial ischemia when discontinuing landiolol. Severe exacerbations of angina, myocardial infarction, and ventricular arrhythmias have been reported in patients with coronary artery disease following abrupt discontinuation of beta-blocker therapy.

Liver Disease

Moderate:

insulin aspart

Insulin aspart has a moderate potential interaction with 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.

Moderate:

landiolol

Landiolol has a moderate potential interaction with Liver Disease.

The effect of moderate or severe liver dysfunction (Child-Pugh B or C) on landiolol pharmacokinetics is unknown; use of landiolol should be avoided in patients with moderate or severe liver dysfunction. In patients with mild liver dysfunction (Child-Pugh A), more conservative dose titration is recommended.

Malnourishment

Major:

insulin aspart

Insulin aspart has a major potential interaction with Malnourishment.

The use of insulin is contraindicated during episodes of hypoglycemia. 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 but not limited to those who are debilitated or malnourished, those with renal or hepatic impairment, those with defective counterregulatory mechanisms (e.g., autonomic neuropathy and adrenal or pituitary insufficiency), and those with reduced awareness of hypoglycemia. Symptomatic awareness of hypoglycemia may be reduced in patients with longstanding diabetes, diabetic nerve disease, recurrent hypoglycemia, or concomitant medications that block the sympathetic nervous system (e.g., beta-blockers). Changes to any glucose-lowering medications, meal pattern, or physical activity may also increase risk of hypoglycemia. Increased frequency of glucose monitoring is recommended in patients at higher risk for hypoglycemia.

Myasthenia Gravis

Moderate:

landiolol

Landiolol has a moderate potential interaction with Myasthenia Gravis.

Beta-adrenergic receptor blocking agents (aka beta-blockers) may potentiate muscle weakness consistent with certain myasthenic symptoms such as diplopia, ptosis, and generalized weakness. Several beta-blockers have been associated rarely with aggravation of muscle weakness in patients with preexisting myasthenia gravis or myasthenic symptoms. Use cautiously in patients with myasthenia gravis.

Panhypopituitarism

Major:

insulin aspart

Insulin aspart has a major potential interaction with Panhypopituitarism.

The use of insulin is contraindicated during episodes of hypoglycemia. 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 but not limited to those who are debilitated or malnourished, those with renal or hepatic impairment, those with defective counterregulatory mechanisms (e.g., autonomic neuropathy and adrenal or pituitary insufficiency), and those with reduced awareness of hypoglycemia. Symptomatic awareness of hypoglycemia may be reduced in patients with longstanding diabetes, diabetic nerve disease, recurrent hypoglycemia, or concomitant medications that block the sympathetic nervous system (e.g., beta-blockers). Changes to any glucose-lowering medications, meal pattern, or physical activity may also increase risk of hypoglycemia. Increased frequency of glucose monitoring is recommended in patients at higher risk for hypoglycemia.

Peripheral Arterial Disease

Moderate:

landiolol

Landiolol has a moderate potential interaction with Peripheral Arterial Disease.

Landiolol may exacerbate peripheral circulatory disorders (e.g., Raynaud's disease/syndrome) and peripheral occlusive vascular disease.

Pheochromocytoma

Moderate:

landiolol

Landiolol has a moderate potential interaction with Pheochromocytoma.

Administration of beta-blockers alone in the setting of pheochromocytoma has been associated with a paradoxical increase in blood pressure due to the attenuation of beta receptor-mediated vasodilatation in skeletal muscle. In patients with pheochromocytoma, an alpha-blocking agent should be initiated prior to the use of any beta-blocking agent. Caution should be taken in the administration of these agents to patients suspected of having pheochromocytoma.

Prinzmetal's Angina

Moderate:

landiolol

Landiolol has a moderate potential interaction with Prinzmetal's Angina.

Landiolol may exacerbate anginal attacks in patients with Prinzmetal angina due to unopposed alpha receptor-mediated coronary artery vasoconstriction.

Pulmonary Arterial Hypertension

Major:

landiolol

Landiolol has a major potential interaction with Pulmonary Arterial Hypertension.

Landiolol is contraindicated in patients with pulmonary hypertension as it may precipitate cardiorespiratory decompensation.

Renal Dysfunction

Moderate:

insulin aspart

Insulin aspart has a moderate potential interaction with Renal Dysfunction.

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.

Moderate:

landiolol

Landiolol has a moderate potential interaction with Renal Dysfunction.

Landiolol can cause increases in serum potassium and hyperkalemia; the risk is increased in patients with risk factors such as renal dysfunction. Potentially life-threatening hyperkalemia has been reported in hemodialysis patients administered IV beta-blockers. Serum electrolytes should be monitored during landiolol therapy. The effect of renal dysfunction on landiolol pharmacokinetics is unknown.

Sinus Node Dysfunction

Major:

landiolol

Landiolol has a major potential interaction with Sinus Node Dysfunction.

Landiolol is contraindicated in patients with severe sinus bradycardia, sick sinus syndrome, or heart block greater than first degree. Patients with first-degree atrioventricular block, sinus node dysfunction, or conduction disorders are at increased risk of bradycardia (including sinus pause, heart block, severe bradycardia, and cardiac arrest). Heart rate and rhythm should be monitored in patients receiving landiolol. If bradyarrhythmia occurs, landiolol should be reduced or stopped.

More resources

insulin aspart

A total of 458 drugs are known to interact with insulin aspart.

landiolol

A total of 467 drugs are known to interact with landiolol.

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.