Drug Interaction Report

Glimepiride 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.

Glimepiride 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.

Glimepiride 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.

Glimepiride 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.

Glimepiride has a moderate potential interaction with Dehydration.

Treatment with sulfonylureas may cause hyponatremia, in patients who are on other medications or have medical conditions known to cause hyponatremia or increase release of antidiuretic hormone. The syndrome of inappropriate antidiuretic hormone (SIADH) secretion has been reported with certain sulfonylureas and these drugs may augment the peripheral (antidiuretic) action of ADH and/or increase release of ADH. Caution should be used when treating patients with hyponatremia or at greater risk of developing hyponatremia such as elderly patients, patients taking diuretics or those who are volume-depleted.

The tirzepatide in Mounjaro has a moderate potential interaction with Dehydration.

Tirzepatide has been associated with gastrointestinal adverse reactions (including nausea, vomiting, diarrhea); such events may lead to dehydration, which could cause acute kidney injury if severe. There have been postmarketing reports of acute kidney injury and worsening of chronic renal failure (which may sometimes require hemodialysis) in patients treated with glucagon-like peptide-1 (GLP-1) receptor agonists; some of these events were reported in patients without known underlying renal disease, and most of the reported cases occurred in patients who experienced nausea, vomiting, diarrhea, or dehydration. Renal function should be monitored when starting or escalating doses of tirzepatide in patients with renal dysfunction reporting severe gastrointestinal adverse reactions. No dose adjustment is recommended for patients with renal dysfunction.

The tirzepatide in Mounjaro has a moderate potential interaction with Diabetic Retinopathy.

Tirzepatide has not been studied in patients with nonproliferative diabetic retinopathy requiring acute therapy, proliferative diabetic retinopathy, or diabetic macular edema; caution is recommended in these patients. Rapid improvement in glucose control has been associated with a temporary worsening of diabetic retinopathy. Patients with history of diabetic retinopathy should be monitored for progression of diabetic retinopathy.

The tirzepatide in Mounjaro has a moderate potential interaction with Diarrhea.

Tirzepatide has been associated with gastrointestinal adverse reactions (including nausea, vomiting, diarrhea); such events may lead to dehydration, which could cause acute kidney injury if severe. There have been postmarketing reports of acute kidney injury and worsening of chronic renal failure (which may sometimes require hemodialysis) in patients treated with glucagon-like peptide-1 (GLP-1) receptor agonists; some of these events were reported in patients without known underlying renal disease, and most of the reported cases occurred in patients who experienced nausea, vomiting, diarrhea, or dehydration. Renal function should be monitored when starting or escalating doses of tirzepatide in patients with renal dysfunction reporting severe gastrointestinal adverse reactions. No dose adjustment is recommended for patients with renal dysfunction.

Glimepiride has a moderate potential interaction with G-6-PD Deficiency.

Sulfonylureas can cause hemolytic anemia in patients with glucose 6-phosphate dehydrogenase (G6PD) deficiency. Therapy with these agents should be used with caution in patients with G6PD deficiency and consider the use of a non-sulfonylurea alternative. There have been postmarketing reports of hemolytic anemia in patients receiving these drugs who did not have known G6PD deficiency.

The tirzepatide in Mounjaro has a moderate potential interaction with Gastroparesis.

Use of tirzepatide has been associated with gastrointestinal adverse reactions (sometimes severe). Because tirzepatide has not been studied in patients with severe gastrointestinal disease (including severe gastroparesis), it is not recommended in these patients.

Glimepiride 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.

Glimepiride has a moderate potential interaction with Hyponatremia.

Treatment with sulfonylureas may cause hyponatremia, in patients who are on other medications or have medical conditions known to cause hyponatremia or increase release of antidiuretic hormone. The syndrome of inappropriate antidiuretic hormone (SIADH) secretion has been reported with certain sulfonylureas and these drugs may augment the peripheral (antidiuretic) action of ADH and/or increase release of ADH. Caution should be used when treating patients with hyponatremia or at greater risk of developing hyponatremia such as elderly patients, patients taking diuretics or those who are volume-depleted.

Glimepiride has a major potential interaction with Liver Disease.

Sulfonylureas are metabolized in the liver, and their metabolites (some with pharmacologic activity) are excreted in the urine and feces. Patients with impaired liver and/or renal function treated with sulfonylureas may be exposed to higher serum drug concentrations, which can increase the potential for severe hypoglycemic episodes induced by these agents. In the presence of hepatic impairment, gluconeogenic capacity may also be diminished, further compounding the risk. Therapy with sulfonylureas should be administered cautiously in patients with liver and/or renal disease. Reduced dosages and longer intervals between dosage adjustments may be required. Hypoglycemia, if it occurs during treatment, may be prolonged in these patients because of slowed metabolism and/or excretion of the drugs.

Glimepiride 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.

The tirzepatide in Mounjaro has a major potential interaction with Multiple Endocrine Neoplasia Type II.

Tirzepatide is contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) and in patients with multiple endocrine neoplasia syndrome type 2. Patients with elevated serum calcitonin or thyroid nodules noted on physical examination or neck imaging should be further evaluated. Patients should be counseled regarding the potential risk for MTC with the use of tirzepatide and should be informed of symptoms of thyroid tumors.

The tirzepatide in Mounjaro has a moderate potential interaction with Pancreatitis.

Acute pancreatitis (including fatal and nonfatal hemorrhagic or necrotizing pancreatitis) has been observed in patients treated with glucagon-like peptide-1 (GLP-1) receptor agonists; acute pancreatitis has been reported in patients treated with tirzepatide in clinical trials. Tirzepatide has not been studied in patients with history of pancreatitis; it is unknown if such patients are at higher risk of developing pancreatitis on tirzepatide. After initiation of tirzepatide, patients should be observed carefully for signs/symptoms of pancreatitis (including persistent severe abdominal pain [sometimes radiating to the back], with or without vomiting); if pancreatitis is suspected, tirzepatide should be discontinued and appropriate management should be started.

Glimepiride 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.

Glimepiride has a major potential interaction with Renal Dysfunction.

Sulfonylureas are metabolized in the liver, and their metabolites (some with pharmacologic activity) are excreted in the urine and feces. Patients with impaired liver and/or renal function treated with sulfonylureas may be exposed to higher serum drug concentrations, which can increase the potential for severe hypoglycemic episodes induced by these agents. In the presence of hepatic impairment, gluconeogenic capacity may also be diminished, further compounding the risk. Therapy with sulfonylureas should be administered cautiously in patients with liver and/or renal disease. Reduced dosages and longer intervals between dosage adjustments may be required. Hypoglycemia, if it occurs during treatment, may be prolonged in these patients because of slowed metabolism and/or excretion of the drugs.

The tirzepatide in Mounjaro has a moderate potential interaction with Renal Dysfunction.

Tirzepatide has been associated with gastrointestinal adverse reactions (including nausea, vomiting, diarrhea); such events may lead to dehydration, which could cause acute kidney injury if severe. There have been postmarketing reports of acute kidney injury and worsening of chronic renal failure (which may sometimes require hemodialysis) in patients treated with glucagon-like peptide-1 (GLP-1) receptor agonists; some of these events were reported in patients without known underlying renal disease, and most of the reported cases occurred in patients who experienced nausea, vomiting, diarrhea, or dehydration. Renal function should be monitored when starting or escalating doses of tirzepatide in patients with renal dysfunction reporting severe gastrointestinal adverse reactions. No dose adjustment is recommended for patients with renal dysfunction.

Glimepiride has a moderate potential interaction with SIADH.

Treatment with sulfonylureas may cause hyponatremia, in patients who are on other medications or have medical conditions known to cause hyponatremia or increase release of antidiuretic hormone. The syndrome of inappropriate antidiuretic hormone (SIADH) secretion has been reported with certain sulfonylureas and these drugs may augment the peripheral (antidiuretic) action of ADH and/or increase release of ADH. Caution should be used when treating patients with hyponatremia or at greater risk of developing hyponatremia such as elderly patients, patients taking diuretics or those who are volume-depleted.

The tirzepatide in Mounjaro has a major potential interaction with Thyroid Tumor.

Tirzepatide is contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) and in patients with multiple endocrine neoplasia syndrome type 2. Patients with elevated serum calcitonin or thyroid nodules noted on physical examination or neck imaging should be further evaluated. Patients should be counseled regarding the potential risk for MTC with the use of tirzepatide and should be informed of symptoms of thyroid tumors.

The tirzepatide in Mounjaro has a moderate potential interaction with Vomiting.

Tirzepatide has been associated with gastrointestinal adverse reactions (including nausea, vomiting, diarrhea); such events may lead to dehydration, which could cause acute kidney injury if severe. There have been postmarketing reports of acute kidney injury and worsening of chronic renal failure (which may sometimes require hemodialysis) in patients treated with glucagon-like peptide-1 (GLP-1) receptor agonists; some of these events were reported in patients without known underlying renal disease, and most of the reported cases occurred in patients who experienced nausea, vomiting, diarrhea, or dehydration. Renal function should be monitored when starting or escalating doses of tirzepatide in patients with renal dysfunction reporting severe gastrointestinal adverse reactions. No dose adjustment is recommended for patients with renal dysfunction.