Interactions between Leuprolide and Nateglinide

Nateglinide 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.

Nateglinide 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.

Nateglinide 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.

Nateglinide has a major potential interaction with Cardiovascular Conditions and Disorders.

The use of oral hypoglycemic agents may be associated with an increased risk of cardiovascular mortality compared to treatment with diet alone or diet with insulin. This warning is based on the University Group Diabetes Program (UGDP) study, a long-term prospective clinical trial designed to evaluate the effectiveness of glucose-lowering drugs in preventing or delaying vascular complications in patients with non-insulin-dependent diabetes. Patients treated with diet plus a fixed dosage of either tolbutamide (a sulfonylurea) or phenformin (a biguanide) for 5 to 8 years had a cardiovascular mortality rate approximately 2.5 times that of patients treated with diet alone, resulting in discontinuation of both these treatments in the study. Despite controversy regarding interpretation of these results, clinicians and patients should be aware of the potential risk when making treatment decisions for diabetes, particularly in the presence of underlying cardiovascular disease. Data are not available for other sulfonylureas or biguanides, nor for hypoglycemic agents belonging to other classes. However, given the similarities in chemical structure and/or mode of action, the same caution should be applied.

Leuprolide has a moderate potential interaction with Cardiovascular Conditions and Disorders.

Increased risk of developing myocardial infarction, sudden cardiac death and stroke has been reported in association with the use of GnRH agonists such as leuprolide, and triptorelin. Cardiovascular risk factors should be evaluated carefully before treatment initiation. Patients should be monitored for symptoms and signs suggestive of development or cardiovascular disease and should be managed according to current clinical practice.

Nateglinide has a major potential interaction with Diabetes, Type 1.

The use of meglitinides is contraindicated in patients with type I diabetes or for the treatment of diabetic ketoacidosis, with or without coma.

Leuprolide has a moderate potential interaction with Diabetes Mellitus.

Hyperglycemia and an increased risk of developing diabetes have been reported in men receiving GnRH agonists such as leuprolide and triptorelin. Caution is advised in patients with diabetes as treatment with these agents may risk glycemic control. Monitor blood glucose and/or HbA1c periodically in patients receiving treatment.

Nateglinide has a major potential interaction with Diabetic Ketoacidosis.

The use of meglitinides is contraindicated in patients with type I diabetes or for the treatment of diabetic ketoacidosis, with or without coma.

Leuprolide has a moderate potential interaction with Electrolyte Abnormalities.

Androgen deprivation therapy may prolong the QT/QTc interval. Health care providers should consider if benefits of therapy outweigh the potential risks in patients with congenital long QT syndrome, congestive heart failure, electrolyte abnormalities, or taking other drugs that can also prolong the QT interval. Consider periodic monitoring of EKG and electrolytes.

Leuprolide has a moderate potential interaction with Heart Failure.

Androgen deprivation therapy may prolong the QT/QTc interval. Health care providers should consider if benefits of therapy outweigh the potential risks in patients with congenital long QT syndrome, congestive heart failure, electrolyte abnormalities, or taking other drugs that can also prolong the QT interval. Consider periodic monitoring of EKG and electrolytes.

Nateglinide has a moderate potential interaction with Liver Disease.

Nateglinide is primarily metabolized in the liver to both pharmacologically active and inactive substances. Patients with impaired liver function may be exposed to higher concentrations of nateglinide and its associated metabolites. Higher serum drug levels, in addition to diminished gluconeogenic capacity secondary to hepatic insufficiency, may increase the potential for severe hypoglycemic episodes. Therapy with nateglinide should be administered cautiously in patients with liver disease. Dosage adjustments may be necessary in moderate to severe hepatic impairment, although clinical data are lacking.

Leuprolide has a moderate potential interaction with Long QT Syndrome.

Androgen deprivation therapy may prolong the QT/QTc interval. Health care providers should consider if benefits of therapy outweigh the potential risks in patients with congenital long QT syndrome, congestive heart failure, electrolyte abnormalities, or taking other drugs that can also prolong the QT interval. Consider periodic monitoring of EKG and electrolytes.

Nateglinide 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.

Leuprolide has a moderate potential interaction with Osteoporosis.

Decreased bone density has been reported in men who have had orchiectomy or who have been treated with a GnRH agonist analog as leuprolide. It can be anticipated that long periods of medical castration in men will have effects on bone density. Bone density loss may not be reversible. Therapy with leuprolide should be administered cautiously in patients with major risk factors for decreased bone mineral content, such as chronic alcohol and/or tobacco use, a strong family history of osteoporosis, or chronic use of drugs that can reduce bone mass (e.g., anticonvulsants, corticosteroids). Therapy beyond six months with gonadotropin-releasing hormone analogs is not recommended for patients with major risk factors for decreased bone mineral content.

Nateglinide 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.

Leuprolide has a moderate potential interaction with Seizures.

Convulsions have been observed in patients taking leuprolide, including patients who have a history of seizures, epilepsy, or brain disorders, and in those taking medications associated with convulsions. Convulsions have also been reported in patients without any of these conditions. Caution is advised in patients with a history of seizures.