Interactions between Insulin lispro protamine and LuSonex Plus
1 drug interaction and 24 additional warnings found for the following 2 drugs:
- insulin lispro protamine
- LuSonex Plus (acetaminophen/guaifenesin/phenylephrine)
Drug interactions
Moderate drug interactions
Moderate:
phenylephrine insulin lispro protamine
Applies to: LuSonex Plus (acetaminophen / guaifenesin / phenylephrine) and insulin lispro protamine
Monitor
The efficacy of insulin and other antidiabetic agents may be diminished by certain drugs, including atypical antipsychotics, corticosteroids, diuretics, estrogens, gonadotropin-releasing hormone agonists, human growth hormone, phenothiazines, progestins, protease inhibitors, sympathomimetic amines, thyroid hormones, L-asparaginase, alpelisib, copanlisib, danazol, diazoxide, isoniazid, megestrol, omacetaxine, phenytoin, sirolimus, tagraxofusp, temsirolimus, as well as pharmacologic dosages of nicotinic acid and adrenocorticotropic agents. These drugs may interfere with blood glucose control because they can cause hyperglycemia, glucose intolerance, new-onset diabetes mellitus, and/or exacerbation of preexisting diabetes.
Management
Caution is advised when drugs that can interfere with glucose metabolism are prescribed to patients with diabetes. Close clinical monitoring of glycemic control is recommended following initiation or discontinuation of these drugs, and the dosages of concomitant antidiabetic agents adjusted as necessary. Patients should be advised to notify their physician if their blood glucose is consistently high or if they experience symptoms of severe hyperglycemia such as excessive thirst and increases in the volume or frequency of urination. Likewise, patients should be observed for hypoglycemia when these drugs are withdrawn from their therapeutic regimen.
References (87)
- Greenstone MA, Shaw AB (1987) "Alternate day corticosteroid causes alternate day hyperglycaemia." Postgrad Med J, 63, p. 761-4
- Pollare T, Lithell H, Berne C (1989) "A comparison of the effects of hydrochlorothiazide and captopril on glucose and lipid metabolism in patients with hypertension." N Engl J Med, 321, p. 868-73
- Carter BL, Small RE, Mandel MD, Starkman MT (1981) "Phenytoin-induced hyperglycemia." Am J Hosp Pharm, 38, p. 1508-12
- Al-Rubeaan K, Ryan EA (1991) "Phenytoin-induced insulin insensitivity." Diabet Med, 8, p. 968-70
- Chaudhuri ML, Catania J (1988) "A comparison of the effects of bumetanide (Burinex) and frusemide on carbohydrate metabolism in the elderly." Br J Clin Pract, 42, p. 427-9
- Goldman JA, Neri A, Ovadia J, Eckerling B, Vries A, de (1969) "Effect of chlorothiazide on intravenous glucose tolerance in pregnancy." Am J Obstet Gynecol, 105, p. 556-60
- Miller NR, Moses H (1978) "Transient oculomotor nerve palsy. Association with thiazide-induced glucose intolerance." JAMA, 240, p. 1887-8
- Kansal PC, Buse J, Buse MG (1969) "Thiazide diuretics and control of diabetes mellitus." South Med J, 62, p. 1372-9
- Andersen OO, Persson I (1968) "Carbohydrate metabolism during treatment with chlorthalidone and ethacrynic acid." Br Med J, 2, p. 798-801
- Curtis J, Horrigan F, Ahearn D, Varney R, Sandler SG (1972) "Chlorthalidone-induced hyperosmolar hyperglycemic nonketotic coma." JAMA, 220, p. 1592-3
- Chowdhury FR, Bleicher SJ (1970) "Chlorthalidone--induced hypokalemia and abnormal carbohydrate metabolism." Horm Metab Res, 2, p. 13-6
- Diamond MT (1972) "Hyperglycemic hyperosmolar coma associated with hydrochlorothiazide and pancreatitis." N Y State J Med, 72, p. 1741-2
- Jones IG, Pickens PT (1967) "Diabetes mellitus following oral diuretics." Practitioner, 199, p. 209-10
- Black DM, Filak AT (1989) "Hyperglycemia with non-insulin-dependent diabetes following intraarticular steroid injection." J Fam Pract, 28, p. 462-3
- Gunnarsson R, Lundgren G, Magnusson G, Ost L, Groth CG (1980) "Steroid diabetes--a sign of overtreatment with steroids in the renal graft recipient?" Scand J Urol Nephrol Suppl, 54, p. 135-8
- Murphy MB, Kohner E, Lewis PJ, Schumer B, Dollery CT (1982) "Glucose intolerance in hypertensive patients treated with diuretics: a fourteen-year follow-up." Lancet, 2, p. 1293-5
- Seltzer HS, Allen EW (1969) "Hyperglycemia and inhibition of insulin secretion during administration of diazoxide and trichlormethiazide in man." Diabetes, 18, p. 19-28
- Jori A, Carrara MC (1966) "On the mechanism of the hyperglycaemic effect of chlorpromazine." J Pharm Pharmacol, 18, p. 623-4
- Erle G, Basso M, Federspil G, Sicolo N, Scandellari C (1977) "Effect of chlorpromazine on blood glucose and plasma insulin in man." Eur J Clin Pharmacol, 11, p. 15-8
- (2002) "Product Information. Thorazine (chlorpromazine)." SmithKline Beecham
- (2002) "Product Information. Diabinese (chlorpropamide)." Pfizer U.S. Pharmaceuticals
- (2002) "Product Information. Glucotrol (glipizide)." Pfizer U.S. Pharmaceuticals
- "Product Information. Diabeta (glyburide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
- (2002) "Product Information. Synthroid (levothyroxine)." Abbott Pharmaceutical
- (2001) "Product Information. Carafate (sucralfate)." Hoechst Marion Roussel
- Stambaugh JE, Tucker DC (1974) "Effect of diphenylhydantoin on glucose tolerance in patients with hypoglycemia." Diabetes, 23, p. 679-83
- Malherbe C, Burrill KC, Levin SR, Karam JH, Forsham PH (1972) "Effect of diphenylhydantoin on insulin secretion in man." N Engl J Med, 286, p. 339-42
- Javier Z, Gershberg H, Hulse M (1968) "Ovulatory suppressants, estrogens, and carbohydrate metabolism." Metabolism, 17, p. 443-56
- Sotaniemi E, Kontturi M, Larmi T (1973) "Effect of diethylstilbestrol on blood glucose of prostatic cancer patients." Invest Urol, 10, p. 438-41
- Bell DS (1993) "Insulin resistance. An often unrecognized problem accompanying chronic medical disorders." Postgrad Med, 93, 99-103,
- Berlin I (1993) "Prazosin, diuretics, and glucose intolerance." Ann Intern Med, 119, p. 860
- Rowe P, Mather H (1985) "Hyperosmolar non-ketotic diabetes mellitus associated with metolazone." Br Med J, 291, p. 25-6
- Haiba NA, el-Habashy MA, Said SA, Darwish EA, Abdel-Sayed WS, Nayel SE (1989) "Clinical evaluation of two monthly injectable contraceptives and their effects on some metabolic parameters." Contraception, 39, p. 619-32
- Virutamasen P, Wongsrichanalai C, Tangkeo P, Nitichai Y, Rienprayoon D (1986) "Metabolic effects of depot-medroxyprogesterone acetate in long-term users: a cross-sectional study." Int J Gynaecol Obstet, 24, p. 291-6
- Dimitriadis G, Tegos C, Golfinopoulou L, Roboti C, Raptis S (1993) "Furosemide-induced hyperglycaemia - the implication of glycolytic kinases." Horm Metab Res, 25, p. 557-9
- Goldman JA, Ovadia JL (1969) "The effect of estrogen on intravenous glucose tolerance in woman." Am J Obstet Gynecol, 103, p. 172-8
- Hannaford PC, Kay CR (1989) "Oral contraceptives and diabetes mellitus." BMJ, 299, p. 1315-6
- Spellacy WN, Ellingson AB, Tsibris JC (1989) "The effects of two triphasic oral contraceptives on carbohydrate metabolism in women during 1 year of use." Fertil Steril, 51, p. 71-4
- Ludvik B, Clodi M, Kautzky-Willer A, Capek M, Hartter E, Pacini G, Prager R (1993) "Effect of dexamethasone on insulin sensitivity, islet amyloid polypeptide and insulin secretion in humans." Diabetologia, 36, p. 84-7
- Domenet JG (1968) "Diabetogenic effect of oral diuretics." Br Med J, 3, p. 188
- Coni NK, Gordon PW, Mukherjee AP, Read PR (1974) "The effect of frusemide and ethacrynic acid on carbohydrate metabolism." Age Ageing, 3, p. 85-90
- Schmitz O, Hermansen K, Nielsen OH, Christensen CK, Arnfred J, Hansen HE, Mogensen CE, Orskov H, Beck-Nielsen H (1986) "Insulin action in insulin-dependent diabetics after short-term thiazide therapy." Diabetes Care, 9, p. 631-6
- Blayac JP, Ribes G, Buys D, Puech R, Loubatieres-Mariani MM (1981) "Effects of a new benzothiadiazine derivative, LN 5330, on insulin secretion." Arch Int Pharmacodyn Ther, 253, p. 154-63
- Elmfeldt D, Berglund G, Wedel H, Wilhelmsen L (1983) "Incidence and importance of metabolic side-effects during antihypertensive therapy." Acta Med Scand Suppl, 672, p. 79-83
- Winchester JF, Kellett RJ, Boddy K, Boyle P, Dargie HJ, Mahaffey ME, Ward DM, Kennedy AC (1980) "Metolazone and bendroflumethiazide in hypertension: physiologic and metabolic observations." Clin Pharmacol Ther, 28, p. 611-8
- Petri M, Cumber P, Grimes L, Treby D, Bryant R, Rawlins D, Ising H (1986) "The metabolic effects of thiazide therapy in the elderly: a population study." Age Ageing, 15, p. 151-5
- (2001) "Product Information. Glucophage (metformin)." Bristol-Myers Squibb
- Harper R, Ennis CN, Heaney AP, Sheridan B, Gormley M, Atkinson AB, Johnston GD, Bell PM (1995) "A comparison of the effects of low- and conventional-dose thiazide diuretic on insulin action in hypertensive patients with NIDDM." Diabetologia, 38, p. 853-9
- (2001) "Product Information. Precose (acarbose)." Bayer
- (2001) "Product Information. Norvir (ritonavir)." Abbott Pharmaceutical
- (2001) "Product Information. Amaryl (glimepiride)." Hoechst Marion Roussel
- Charan VD, Desai N, Singh AP, Choudhry VP (1993) "Diabetes mellitus and pancreatitis as a complication of L- asparaginase therapy." Indian Pediatr, 30, p. 809-10
- Seifer DB, Freedman LN, Cavender JR, Baker RA (1990) "Insulin-dependent diabetes mellitus associated with danazol." Am J Obstet Gynecol, 162, p. 474-5
- (2001) "Product Information. Crixivan (indinavir)." Merck & Co., Inc
- Pickkers P, Schachter M, Hughes AD, Feher MD, Sever PS (1996) "Thiazide-induced hyperglycaemia: a role for calcium-activated potassium channels?" Diabetologia, 39, p. 861-4
- (2001) "Product Information. Viracept (nelfinavir)." Agouron Pharma Inc
- Dube MP, Johnson DL, Currier JS, Leedom JM (1997) "Protease inhibitor-associated hyperglycaemia." Lancet, 350, p. 713-4
- (2001) "Product Information. Oncaspar (pegaspargase)." Rhone Poulenc Rorer
- (2001) "Product Information. Prandin (repaglinide)." Novo Nordisk Pharmaceuticals Inc
- (2001) "Product Information. Elspar (asparaginase)." Merck & Co., Inc
- (2022) "Product Information. Hyperstat (diazoxide)." Apothecon Inc
- (2001) "Product Information. Megace (megestrol)." Bristol-Myers Squibb
- Walli R, Demant T (1998) "Impaired glucose tolerance and protease inhibitors." Ann Intern Med, 129, p. 837-8
- (2001) "Product Information. Agenerase (amprenavir)." Glaxo Wellcome
- Mauss S, Wolf E, Jaeger H (1999) "Impaired glucose tolerance in HIV-positive patients receiving and those not receiving protease inhibitors." Ann Intern Med, 130, p. 162-3
- Kaufman MB, Simionatto C (1999) "A review of protease inhibitor-induced hyperglycemia." Pharmacotherapy, 19, p. 114-7
- (2001) "Product Information. Tolinase (tolazamide)." Pharmacia and Upjohn
- (2001) "Product Information. Orinase (tolbutamide)." Pharmacia and Upjohn
- (2001) "Product Information. Dymelor (acetohexamide)." Lilly, Eli and Company
- Wehring H, Alexander B, Perry PJ (2000) "Diabetes mellitus associated with clozapine therapy." Pharmacotherapy, 20, p. 844-7
- Tsiodras S, Mantzoros C, Hammer S, Samore M (2000) "Effects of protease inhibitors on hyperglycemia, hyperlipidemia, and lipodystrophy - A 5-year cohort study." Arch Intern Med, 160, p. 2050-6
- (2001) "Product Information. Fortovase (saquinavir)." Roche Laboratories
- (2001) "Product Information. Starlix (nateglinide)." Novartis Pharmaceuticals
- Hardy H, Esch LD, Morse GD (2001) "Glucose disorders associated with HIV and its drug therapy." Ann Pharmacother, 35, p. 343-51
- Leary WP, Reyes AJ (1984) "Drug interactions with diuretics." S Afr Med J, 65, p. 455-61
- (2022) "Product Information. NovoLOG Mix 70/30 (insulin aspart-insulin aspart protamine)." Novo Nordisk Pharmaceuticals Inc
- (2003) "Product Information. Reyataz (atazanavir)." Bristol-Myers Squibb
- (2003) "Product Information. Lexiva (fosamprenavir)." GlaxoSmithKline
- (2004) "Product Information. Apidra (insulin glulisine)." Aventis Pharmaceuticals
- (2006) "Product Information. Prezista (darunavir)." Ortho Biotech Inc
- (2006) "Product Information. Zolinza (vorinostat)." Merck & Co., Inc
- (2007) "Product Information. Torisel (temsirolimus)." Wyeth-Ayerst Laboratories
- (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka America Pharmaceutical, Inc.
- (2019) "Product Information. Elzonris (tagraxofusp)." Stemline Therapeutics
- (2019) "Product Information. Piqray (alpelisib)." Novartis Pharmaceuticals
- Drazilova S, Gazda J, Janicko M, Jarcuska P (2018) "Chronic Hepatitis C Association with Diabetes Mellitus and Cardiovascular Risk in the Era of DAA Therapy" Can J Gastroenterol Hepatol, 1, p. 1-11
- (2026) "Product Information. Awiqli FlexTouch (insulin icodec)." Novo Nordisk Pharmaceuticals Inc
Food/lifestyle interactions
Major food/lifestyle interactions
Major:
acetaminophen Food/Lifestyle
Applies to: LuSonex Plus (acetaminophen / guaifenesin / phenylephrine)
Generally avoid
Chronic, excessive consumption of alcohol may increase the risk of acetaminophen-induced hepatotoxicity, which has included rare cases of fatal hepatitis and frank hepatic failure requiring liver transplantation. The proposed mechanism is induction of hepatic microsomal enzymes during chronic alcohol use, which may result in accelerated metabolism of acetaminophen and increased production of potentially hepatotoxic metabolites.
Management
In general, chronic alcoholics should avoid regular or excessive use of acetaminophen. Alternative analgesic/antipyretic therapy may be appropriate in patients who consume three or more alcoholic drinks per day.
References (1)
- (2022) "Product Information. Acetaminophen (acetaminophen)." Camber Pharmaceuticals, Inc
Moderate food/lifestyle interactions
Moderate:
insulin lispro protamine Food/Lifestyle
Applies to: insulin lispro protamine
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 (11)
- Jerntorp P, Almer LO (1981) "Chlorpropamide-alcohol flushing in relation to macroangiopathy and peripheral neuropathy in non-insulin dependent diabetes." Acta Med Scand, 656, p. 33-6
- Jerntorp P, Almer LO, Holin H, et al. (1983) "Plasma chlorpropamide: a critical factor in chlorpropamide-alcohol flush." Eur J Clin Pharmacol, 24, p. 237-42
- Barnett AH, Spiliopoulos AJ, Pyke DA, et al. (1983) "Metabolic studies in chlorpropamide-alcohol flush positive and negative type 2 (non-insulin dependent) diabetic patients with and without retinopathy." Diabetologia, 24, p. 213-5
- Hartling SG, Faber OK, Wegmann ML, Wahlin-Boll E, Melander A (1987) "Interaction of ethanol and glipizide in humans." Diabetes Care, 10, p. 683-6
- (2002) "Product Information. Diabinese (chlorpropamide)." Pfizer U.S. Pharmaceuticals
- (2002) "Product Information. Glucotrol (glipizide)." Pfizer U.S. Pharmaceuticals
- "Product Information. Diabeta (glyburide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
- Skillman TG, Feldman JM (1981) "The pharmacology of sulfonylureas." Am J Med, 70, p. 361-72
- (2002) "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), S50-S60
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- (2026) "Product Information. Awiqli FlexTouch (insulin icodec)." Novo Nordisk Pharmaceuticals Inc
Moderate:
phenylephrine Caffeine
Applies to: LuSonex Plus (acetaminophen / guaifenesin / phenylephrine)
Monitor
Coadministration of two or more sympathomimetic or noradrenergic agents may increase the risk of nervousness, irritability, tachycardia, and/or increased blood pressure. Central nervous system (CNS) stimulants, particularly amphetamines, can potentiate the adrenergic response to vasopressors and other sympathomimetic and/or noradrenergic agents, including norepinephrine transporter inhibitors. Additive increases in blood pressure and heart rate may occur due to enhanced peripheral sympathetic activity.
Management
Caution is advised if two or more sympathomimetic or noradrenergic agents are coadministered. Pulse and blood pressure should be closely monitored. Consultation with individual product labeling, as well as relevant institutional protocols, may be advisable for further guidance.
References (20)
- Rosenblatt JE, Lake CR, van Kammen DP, Ziegler MG, Bunney WE Jr (1979) "Interactions of amphetamine, pimozide, and lithium on plasma norepineophrine and dopamine-beta-hydroxylase in schizophrenic patients." Psychiatry Res, 1, p. 45-52
- Cavanaugh JH, Griffith JD, Oates JA (1970) "Effect of amphetamine on the pressor response to tyramine: formation of p-hydroxynorephedrine from amphetamine in man." Clin Pharmacol Ther, 11, p. 656
- (2001) "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc
- (2001) "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals
- (2001) "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals
- (2001) "Product Information. Focalin (dexmethylphenidate)." Mikart Inc
- (2024) "Product Information. Ephedrine (ephedrine)." Hameln Pharma Ltd
- (2023) "Product Information. Ephedrine Hydrochloride (ephedrine)." Wockhardt UK Ltd
- (2026) "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company
- (2025) "Product Information. Atomoxetine (atomoxetine)." Zentiva Pharma UK Ltd
- (2026) "Product Information. Atomoxetine (Apo) (atomoxetine)." Arrotex Pharmaceuticals Pty Ltd
- Angita Pharma, Inc (2026) AG-ATOMOXETINE Product Monograph (Health Canada) https://pdf.hres.ca/dpd_pm/00059014.PDF
- (2026) "Product Information. Boots Decongestant (Pseudoephedrine) (pseudoephedrine)." The Boots Company Plc
- (2023) "Product Information. Sinus and Nasal Decongestant (Trust) (pseudoephedrine)." Noumed Pharmaceuticals Pty Ltd
- (2019) "Product Information. Ephedrine (ephedrine)." Pfizer Australia Pty Ltd
- (2024) "Product Information. EPHEDrine Sulfate (ePHEDrine)." Amneal Pharmaceuticals LLC
- (2024) "Product Information. Lemsip Cough Max for Mucus Cough and Cold (guaifenesin/paracetamol/phenylephrine)." Reckitt Benckiser Healthcare (UK) Ltd
- emc (2026) Product information: sudafed plus blocked nose 1mg/50mg/ml nasal spray. https://www.medicines.org.uk/emc/product/14256/smpc?utm_source=chatgpt.com
- (2023) "Product Information. EPHEDrine Sulfate (ePHEDrine)." Baxter Corporation
- Neo Health (OTC) Pty Ltd (2026) Product information: pseudoephedrine hydrochloride-paracetamol capsules. https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2024-PI-02603-1&d=20260804172310101&d=20260827172310101
Disease interactions
21 potential interactions Applies to: 19 conditions, including Benign Prostatic Hyperplasia, Hypokalemia, Hyperthyroidism, Diabetes Mellitus, and Adrenal Insufficiency.
Adrenal Insufficiency
Moderate:
insulin lispro protamine
Insulin lispro protamine has a moderate potential interaction with Adrenal Insufficiency.
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.
Alcoholism
Major:
LuSonex Plus
The acetaminophen in LuSonex Plus has a major potential interaction with Alcoholism.
Chronic alcohol abusers may be at increased risk of hepatotoxicity during treatment with acetaminophen (APAP). Severe liver injury, including cases of acute liver failure resulting in liver transplant and death, has been reported in patients using acetaminophen. Therapy with acetaminophen should be administered cautiously, if at all, in patients who consume three or more alcoholic drinks a day. In general, patients should avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure. They should also be advised to seek medical attention if they experience signs and symptoms of liver injury such as fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, and jaundice.
Anorexia/Feeding Problems
Moderate:
insulin lispro protamine
Insulin lispro protamine has a moderate potential interaction with 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.
Autonomic Neuropathy
Moderate:
insulin lispro protamine
Insulin lispro protamine has a moderate potential interaction with Autonomic Neuropathy.
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.
Benign Prostatic Hyperplasia
Moderate:
LuSonex Plus
The phenylephrine in LuSonex Plus has a moderate potential interaction with Benign Prostatic Hyperplasia.
Sympathomimetic agents may cause or worsen urinary difficulty in patients with prostate enlargement due to smooth muscle contraction in the bladder neck via stimulation of alpha-1 adrenergic receptors. Therapy with sympathomimetic agents should be administered cautiously in patients with hypertrophy or neoplasm of the prostate.
Cardiovascular Conditions and Disorders
Major:
LuSonex Plus
The phenylephrine in LuSonex Plus has a major potential interaction with Cardiovascular Conditions and Disorders.
Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.
Cerebrovascular Insufficiency
Major:
LuSonex Plus
The phenylephrine in LuSonex Plus has a major potential interaction with Cerebrovascular Insufficiency.
Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.
Dehydration
Major:
LuSonex Plus
The acetaminophen in LuSonex Plus has a major potential interaction with Dehydration.
Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease. Patients with hepatic impairment may be at increased risk of toxicity. Severe liver injury, including cases of acute liver failure and death, have been reported in patients using this drug. Clinical monitoring of hepatic function is recommended. Caution is advised if using acetaminophen in patients with chronic malnutrition or severe hypovolemia. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.
Diabetes Mellitus
Moderate:
LuSonex Plus
The phenylephrine in LuSonex Plus has a moderate potential interaction with Diabetes Mellitus.
Sympathomimetic agents may cause increases in blood glucose concentrations. These effects are usually transient and slight but may be significant with dosages higher than those normally recommended. Therapy with sympathomimetic agents should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate.
Glaucoma/Intraocular Hypertension
Moderate:
LuSonex Plus
The phenylephrine in LuSonex Plus has a moderate potential interaction with Glaucoma/Intraocular Hypertension.
Sympathomimetic agents can induce transient mydriasis via stimulation of alpha-1 adrenergic receptors. In patients with anatomically narrow angles or narrow-angle glaucoma, pupillary dilation can provoke an acute attack. In patients with other forms of glaucoma, mydriasis may occasionally increase intraocular pressure. Therapy with sympathomimetic agents should be administered cautiously in patients with or predisposed to glaucoma, particularly narrow-angle glaucoma.
Hyperthyroidism
Major:
LuSonex Plus
The phenylephrine in LuSonex Plus has a major potential interaction with Hyperthyroidism.
Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.
Hypokalemia
Moderate:
insulin lispro protamine
Insulin lispro protamine has a moderate potential interaction with 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).
Liver Disease
Major:
LuSonex Plus
The acetaminophen in LuSonex Plus has a major potential interaction with Liver Disease.
Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease. Patients with hepatic impairment may be at increased risk of toxicity. Severe liver injury, including cases of acute liver failure and death, have been reported in patients using this drug. Clinical monitoring of hepatic function is recommended. Caution is advised if using acetaminophen in patients with chronic malnutrition or severe hypovolemia. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.
Moderate:
insulin lispro protamine
Insulin lispro protamine 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.
Malnourishment
Major:
LuSonex Plus
The acetaminophen in LuSonex Plus has a major potential interaction with Malnourishment.
Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease. Patients with hepatic impairment may be at increased risk of toxicity. Severe liver injury, including cases of acute liver failure and death, have been reported in patients using this drug. Clinical monitoring of hepatic function is recommended. Caution is advised if using acetaminophen in patients with chronic malnutrition or severe hypovolemia. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.
Moderate:
insulin lispro protamine
Insulin lispro protamine has a moderate potential interaction with Malnourishment.
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.
Panhypopituitarism
Moderate:
insulin lispro protamine
Insulin lispro protamine has a moderate potential interaction with Panhypopituitarism.
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.
Phenylketonuria
Moderate:
LuSonex Plus
The acetaminophen in LuSonex Plus has a moderate potential interaction with Phenylketonuria.
Several oral acetaminophen and acetaminophen-combination products, particularly flavored chewable tablets, contain the artificial sweetener, aspartame (NutraSweet). Aspartame is converted to phenylalanine in the gastrointestinal tract following ingestion. Chewable and effervescent formulations of acetaminophen products may also contain phenylalanine. The aspartame/phenylalanine content should be considered when these products are used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics).
Pheochromocytoma
Major:
LuSonex Plus
The phenylephrine in LuSonex Plus has a major potential interaction with Pheochromocytoma.
Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.
Prostate Tumor, Benign
Moderate:
LuSonex Plus
The phenylephrine in LuSonex Plus has a moderate potential interaction with Prostate Tumor, Benign.
Sympathomimetic agents may cause or worsen urinary difficulty in patients with prostate enlargement due to smooth muscle contraction in the bladder neck via stimulation of alpha-1 adrenergic receptors. Therapy with sympathomimetic agents should be administered cautiously in patients with hypertrophy or neoplasm of the prostate.
Renal Dysfunction
Moderate:
insulin lispro protamine
Insulin lispro protamine 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.
More resources
insulin lispro protamine
A total of 457 drugs are known to interact with insulin lispro protamine.
- Insulin lispro protamine is in the drug class insulin.
LuSonex Plus
A total of 721 drugs are known to interact with LuSonex Plus.
- Lusonex plus is in the drug class upper respiratory combinations.
- Lusonex plus is used to treat Cough and Nasal Congestion.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.