Interactions between Nateglinide and Soliqua
3 drug interactions and 27 additional warnings found for the following 2 drugs:
- nateglinide
- Soliqua (insulin glargine/lixisenatide)
Drug interactions
Moderate drug interactions
Moderate:
insulin glargine nateglinide
Applies to: Soliqua (insulin glargine / lixisenatide) and nateglinide
Monitor
The hypoglycemic effect of insulin may be potentiated by other antidiabetic drugs. The proposed mechanism is additive hypoglycemic effects.
Management
Insulins may be used together, and insulin may be prescribed with non-insulin antidiabetic agents. However, close monitoring for hypoglycemia is recommended, particularly when therapy is initiated, discontinued, or adjusted, and in patients at increased risk such as older adults or those with renal impairment. Dose reduction of insulin and/or the concomitant antidiabetic agent may be necessary. Patients should be counseled on the signs and symptoms of hypoglycemia, including headache, dizziness, drowsiness, nausea, hunger, tremor, weakness, sweating, and palpitations; how to treat low blood glucose; and when to contact their healthcare provider.
References (8)
- (2024) "Product Information. Awiqli FlexTouch (insulin icodec)." Novo Nordisk Canada Inc
- (2026) "Product Information. Awiqli FlexTouch (insulin icodec)." Novo Nordisk Pharmaceuticals Inc
- (2025) "Product Information. Kirsty (insulin aspart)." Biocon Biologics Inc., DM 4
- (2023) "Product Information. Insulin Aspart Protamine-Insulin Aspart FlexPen (insulin aspart-insulin aspart protamine)." Novo Nordisk Pharmaceuticals Inc, DM 8
- (2022) "Product Information. Insulin Degludec (insulin degludec)." Novo Nordisk Pharmaceuticals Inc, DM 2
- (2022) "Product Information. Levemir (insulin detemir)." Novo Nordisk Pharmaceuticals Inc, DM 30
- (2025) "Product Information. Insulin Glargine Max Solostar Pen (insulin glargine)." Winthrop US, DM 7
- (2025) "Product Information. Awiqli (insulin icodec)." Novo Nordisk Pharmaceuticals Pty Ltd, VV-LAB-102355 v9.0
Moderate:
insulin glargine lixisenatide
Applies to: Soliqua (insulin glargine / lixisenatide) and Soliqua (insulin glargine / lixisenatide)
Adjust dose
Coadministration of a glucagon-like peptide-1 (GLP-1) receptor agonist or dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptor agonist with insulin may potentiate the risk of hypoglycemia. GLP-1 receptor agonists and dual GLP-1 and GIP receptor agonists lower blood glucose by stimulating insulin secretion and lowering glucagon secretion. An increased incidence of hypoglycemia has been observed in patients treated with a combination of basal insulin and GLP-1 or dual GLP-1 and GIP receptor agonists. Additionally, patients with diabetic retinopathy who received treatment with basal insulin and subcutaneous semaglutide in one clinical trial had an increased risk of developing diabetic retinopathy complications. Rapid improvement in glucose control has been associated with a temporary worsening of diabetic retinopathy, but other mechanisms cannot be excluded. The safety and efficacy of GLP-1 or dual GLP-1 and GIP receptor agonists in combination with non-basal insulin have not been established.
Management
When a GLP-1 receptor agonist or dual GLP-1 and GIP receptor agonist is used as add-on therapy to basal insulin, a lower dosage of insulin may be required. Some clinical trials have reduced the basal insulin dose by 20% in patients with a baseline hemoglobin A1c <= 8% when a GLP-1 or dual GLP-1 and GIP receptor agonist was initiated. Because diabetic ketoacidosis has been reported in insulin-dependent patients after rapid discontinuation or dose reduction of insulin, a stepwise approach to insulin dose reduction is recommended and blood glucose levels should be closely monitored. Patients should receive guidance on the recognition and management of hypoglycemia as well as precautions to take to avoid hypoglycemia, particularly while driving or operating hazardous machinery. Those with diabetic retinopathy should also be monitored for progression of the condition or complications. A rapid improvement in glucose control has been associated with a temporary worsening of diabetic retinopathy.
References (16)
- (2010) "Product Information. Victoza (liraglutide)." Novo Nordisk Pharmaceuticals Inc
- (2014) "Product Information. Tanzeum (albiglutide)." GlaxoSmithKline
- (2014) "Product Information. Trulicity (dulaglutide)." Eli Lilly and Company
- (2016) "Product Information. Adlyxin (lixisenatide)." sanofi-aventis
- (2022) "Product Information. Ozempic (1 mg dose) (semaglutide)." Novo Nordisk Pharmaceuticals Inc
- (2022) "Product Information. Mounjaro (tirzepatide)." Lilly, Eli and Company
- (2022) "Product Information. Wegovy (2.4 mg dose) (semaglutide)." Novo Nordisk Pharmaceuticals Inc, SUPPL-3
- (2023) "Product Information. Bydureon BCise (exenatide)." AstraZeneca UK Ltd
- (2022) "Product Information. Byetta Prefilled Pen (exenatide)." Astra-Zeneca Pharmaceuticals
- (2014) "Product Information. Eperzan (albiglutide)." GlaxoSmithKline UK Ltd
- (2023) "Product Information. Trulicity (dulaglutide)." Eli Lilly and Company Ltd
- (2022) "Product Information. Saxenda (liraglutide)." Novo Nordisk Ltd
- (2022) "Product Information. Victoza (liraglutide)." Novo Nordisk Ltd
- (2022) "Product Information. Lyxumia (lixisenatide)." Sanofi
- (2023) "Product Information. Ozempic (semaglutide)." Novo Nordisk Ltd
- (2026) "Product Information. Awiqli FlexTouch (insulin icodec)." Novo Nordisk Pharmaceuticals Inc
Moderate:
nateglinide lixisenatide
Applies to: nateglinide and Soliqua (insulin glargine / lixisenatide)
Adjust dose
Coadministration of a glucagon-like peptide-1 (GLP-1) receptor agonist or dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptor agonist with an insulin secretagogue (e.g., sulfonylurea, meglitinide) may potentiate the risk of hypoglycemia. GLP-1 receptor agonists and dual GLP-1 and GIP receptor agonists lower blood glucose by stimulating insulin secretion and lowering glucagon secretion.
Management
A lower dosage of the insulin secretagogue may be required when used in combination with a GLP-1 receptor agonist or a dual GLP-1 and GIP receptor agonist. Blood glucose should be monitored closely, and patients should be counseled to recognize the symptoms of hypoglycemia such as headache, dizziness, drowsiness, nervousness, confusion, tremor, hunger, weakness, perspiration, palpitation, and tachycardia. If hypoglycemia occurs, patients should initiate appropriate remedial therapy immediately and contact their physician. Patients should also be advised to take precautions to avoid hypoglycemia while driving or operating hazardous machinery.
References (7)
- (2005) "Product Information. Byetta (exenatide)." Amylin Pharmaceuticals Inc
- (2010) "Product Information. Victoza (liraglutide)." Novo Nordisk Pharmaceuticals Inc
- (2014) "Product Information. Tanzeum (albiglutide)." GlaxoSmithKline
- (2014) "Product Information. Trulicity (dulaglutide)." Eli Lilly and Company
- (2016) "Product Information. Adlyxin (lixisenatide)." sanofi-aventis
- (2022) "Product Information. Ozempic (1 mg dose) (semaglutide)." Novo Nordisk Pharmaceuticals Inc
- (2022) "Product Information. Mounjaro (tirzepatide)." Lilly, Eli and Company
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
insulin glargine Food/Lifestyle
Applies to: Soliqua (insulin glargine / lixisenatide)
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:
nateglinide Food/Lifestyle
Applies to: nateglinide
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:
lixisenatide Food/Lifestyle
Applies to: Soliqua (insulin glargine / lixisenatide)
Adjust dosing interval
Lixisenatide slows gastric emptying, which may impact the absorption of concomitantly administered oral medications. The interaction has been studied with various medications, which demonstrated primarily an effect on the rate rather than the overall extent of absorption. Acetaminophen: When acetaminophen 1000 mg was administered 1 hour and 4 hours after lixisenatide 10 mcg injection, acetaminophen peak plasma concentration (Cmax) was decreased by 29% and 31%, respectively; and median time to peak plasma concentration (Tmax) was delayed by 2 hours and 1.75 hours, respectively. The Cmax and Tmax of acetaminophen were not significantly altered when acetaminophen was given one hour before lixisenatide injection, and systemic exposure (AUC) was not affected whether administered before or after lixisenatide administration. Based on these results, no dose adjustment for acetaminophen is required; however, it may be advisable to take acetaminophen at least one hour before lixisenatide if a rapid onset of action is required. Oral Contraceptives: When an oral contraceptive containing ethinyl estradiol 0.03 mg and levonorgestrel 0.15 mg was administered 1 hour and 4 hours after lixisenatide 10 mcg injection, ethinyl estradiol Cmax was decreased by 52% and 39%, respectively, while levonorgestrel Cmax was decreased by 46% and 20%, respectively. Median Tmax values were delayed by 1 to 3 hours, but overall exposure (AUC) and mean terminal half-life (T1/2) of ethinyl estradiol and levonorgestrel were not significantly altered. Administration of the oral contraceptive 1 hour before or 11 hours after lixisenatide had no effect on any of the measured pharmacokinetic parameters of either ethinyl estradiol or levonorgestrel. Based on these results, no dose adjustment for oral contraceptives is required; however, some authorities recommend that oral contraceptives be administered at least 1 hour before or 11 hours after lixisenatide. Atorvastatin: When atorvastatin 40 mg and lixisenatide 20 mcg were coadministered in the morning for 6 days, atorvastatin Cmax was decreased by 31% and Tmax was delayed by 3.25 hours, but AUC was not affected. When atorvastatin was administered in the evening and lixisenatide in the morning, the AUC and Cmax of atorvastatin were increased by 27% and 66%, respectively, but there was no change in Tmax. Based on these results, no dose adjustment for atorvastatin is required; however, some authorities recommend that atorvastatin be administered at least 1 hour before lixisenatide. Warfarin: When warfarin 25 mg was coadministered with repeated dosing of lixisenatide 20 mcg, warfarin Cmax was decreased by 19% and Tmax was delayed by 7 hours, but there were no effects on AUC or International Normalized Ratio (INR). Based on these results, no dose adjustment for warfarin is required; however, closer monitoring of INR may be appropriate following initiation or discontinuation of lixisenatide treatment. Digoxin: When digoxin 0.25 mg and lixisenatide 20 mcg were coadministered at steady state, digoxin Cmax was decreased by 26% and Tmax was delayed by 1.5 hours, but AUC was not affected. Based on these results, no dose adjustment for digoxin is required. Ramipril: When ramipril 5 mg and lixisenatide 20 mcg were coadministered for 6 days, ramipril Cmax was decreased by 63% and AUC was increased by 21%, while Cmax and AUC of the active metabolite (ramiprilat) were not affected. The Tmax values of ramipril and ramiprilat were delayed by approximately 2.5 hours. Based on these results, no dose adjustment for ramipril is required.
Management
Caution is advised during concomitant use of lixisenatide with oral medications that have a narrow therapeutic index or that require careful clinical monitoring. These medications should be administered on a consistent schedule relative to lixisenatide, and blood levels and/or pharmacologic effects should be closely monitored. In addition, if they are to be administered with food, patients should be advised to take them with a meal or snack when lixisenatide is not administered. Oral medications that are particularly dependent on threshold concentrations for efficacy, such as antibiotics, or medications for which a delay in effect is undesirable, such as acetaminophen, should be administered at least 1 hour before lixisenatide. Gastro-resistant formulations containing substances sensitive to stomach degradation should be administered 1 hour before or 4 hours after lixisenatide. Patients taking oral contraceptives should be advised to take them at least 1 hour before or 11 hours after lixisenatide.
References (1)
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
Disease interactions
24 potential interactions Applies to: 17 conditions, including Hypokalemia, Diabetes, Type 1, Gastroparesis, Anaphylaxis, and Gallstones.
Adrenal Insufficiency
Moderate:
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.
Moderate:
Soliqua
The insulin glargine in Soliqua 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:
Soliqua
The lixisenatide in Soliqua has a major potential interaction with Alcoholism.
Acute pancreatitis, including fatal and non- fatal hemorrhagic or necrotizing pancreatitis, has been reported postmarketing in patients treated with lixisenatide. Some patients had risk factors such as cholelithiasis and alcohol abuse. Patients should be observed carefully for any symptoms of pancreatitis including persistent abdominal pain, sometimes radiating to the back, that may or may not be accompanied by vomiting. If pancreatitis is suspected, lixisenatide should be discontinued and appropriate management should be established. If pancreatitis is confirmed, lixisenatide should not be restarted. Lixisenatide is not recommended for patients with history of pancreatitis.
Anaphylaxis
Major:
Soliqua
The lixisenatide in Soliqua has a major potential interaction with Anaphylaxis.
The use of lixisenatide may result in cross-sensitivity in patients with a history of anaphylaxis reaction or angioedema to another GLP-1 receptor agonist. These patients should be informed of the risk of anaphylaxis when using lixisenatide. Close monitoring is recommended when prescribing lixisenatide to these patients.
Angioedema
Major:
Soliqua
The lixisenatide in Soliqua has a major potential interaction with Angioedema.
The use of lixisenatide may result in cross-sensitivity in patients with a history of anaphylaxis reaction or angioedema to another GLP-1 receptor agonist. These patients should be informed of the risk of anaphylaxis when using lixisenatide. Close monitoring is recommended when prescribing lixisenatide to these patients.
Anorexia/Feeding Problems
Moderate:
nateglinide
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.
Moderate:
Soliqua
The insulin glargine in Soliqua 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:
nateglinide
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.
Moderate:
Soliqua
The insulin glargine in Soliqua 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.
Cardiovascular Conditions and Disorders
Major:
nateglinide
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.
Diabetes, Type 1
Major:
nateglinide
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.
Diabetic Ketoacidosis
Major:
nateglinide
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.
Gallstones
Major:
Soliqua
The lixisenatide in Soliqua has a major potential interaction with Gallstones.
Acute pancreatitis, including fatal and non- fatal hemorrhagic or necrotizing pancreatitis, has been reported postmarketing in patients treated with lixisenatide. Some patients had risk factors such as cholelithiasis and alcohol abuse. Patients should be observed carefully for any symptoms of pancreatitis including persistent abdominal pain, sometimes radiating to the back, that may or may not be accompanied by vomiting. If pancreatitis is suspected, lixisenatide should be discontinued and appropriate management should be established. If pancreatitis is confirmed, lixisenatide should not be restarted. Lixisenatide is not recommended for patients with history of pancreatitis.
Gastroparesis
Major:
Soliqua
The lixisenatide in Soliqua has a major potential interaction with Gastroparesis.
Lixisenatide slows gastric emptying and patients with preexisting gastroparesis were excluded from clinical trials. Lixisenatide should not be used in patients with severe gastroparesis.
Hypokalemia
Moderate:
Soliqua
The insulin glargine in Soliqua 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
Moderate:
nateglinide
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.
Moderate:
Soliqua
The insulin glargine in Soliqua 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
Moderate:
nateglinide
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.
Moderate:
Soliqua
The insulin glargine in Soliqua 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.
Pancreatitis
Major:
Soliqua
The lixisenatide in Soliqua has a major potential interaction with Pancreatitis.
Acute pancreatitis, including fatal and non- fatal hemorrhagic or necrotizing pancreatitis, has been reported postmarketing in patients treated with lixisenatide. Some patients had risk factors such as cholelithiasis and alcohol abuse. Patients should be observed carefully for any symptoms of pancreatitis including persistent abdominal pain, sometimes radiating to the back, that may or may not be accompanied by vomiting. If pancreatitis is suspected, lixisenatide should be discontinued and appropriate management should be established. If pancreatitis is confirmed, lixisenatide should not be restarted. Lixisenatide is not recommended for patients with history of pancreatitis.
Panhypopituitarism
Moderate:
nateglinide
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.
Moderate:
Soliqua
The insulin glargine in Soliqua 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.
Renal Dysfunction
Moderate:
Soliqua
The lixisenatide in Soliqua has a moderate potential interaction with Renal Dysfunction.
Acute kidney injury and worsening of chronic renal failure which sometimes required hemodialysis has been reported postmarketing in patients treated with lixisenatide. Renal function should be closely monitored when initiating or escalating doses. Lixisenatide is not recommended for patients with end stage renal disease. Patients with mild and moderate renal impairment need close monitoring but no dose adjustment. There is limited experience in patients with severe renal impairment but drug exposure showed to be higher, so close monitoring is recommended for changes in renal function or gastrointestinal adverse reactions.
Moderate:
Soliqua
The insulin glargine in Soliqua 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
nateglinide
A total of 519 drugs are known to interact with nateglinide.
- Nateglinide is in the drug class meglitinides.
- Nateglinide is used to treat Type 2 Diabetes.
Soliqua
A total of 479 drugs are known to interact with Soliqua.
- Soliqua is in the drug class antidiabetic combinations.
- Soliqua is used to treat Type 2 Diabetes.
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.