August
01-28-2007, 04:37 AM
From diabetesincontrol
Drugs That May Affect Blood Glucose Levels
When we look at drugs that may affect glucose levels, we need to invoke some special rules. There are
medicines that can cause hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar) in diabetic and
in nondiabetic patients. These pharmaceuticals will have an even greater effect on the patient with diabetes
and should either be avoided or used with vigilance and with a consideration of changing the amount of the
diabetes medication used.
Some medications are found to have a possible effect on the patient with diabetes but can be used more freely.
Again, however, vigilance is warranted.
There is also a category of medications that interact with diabetes medications. These medications don’t
actually cause hypoglycemia or hyperglycemia, but rather they interfere with the action of the medicines you
are taking for your diabetes. Whenever you start a new medication, it’s important to understand if it will
affect your blood sugars or interfere with your blood sugar medication. In either case, it is important to
monitor your glucose levels carefully.
Some of the products listed consist of two medications combined in the same pill. These are shown with a plus
sign (+) between the two medications. Only generic names are used in the following lists. Your pharmacist
will be able to tell you the brand names or generic names of medications you use. Due to the aggressive
reporting requirements of the FDA, new contraindication information is constantly becoming available. Check
with your pharmacist on a regular basis. And remember: If you have any questions about how your medicines
can affect your blood sugars, be sure to ask your physician or pharmacist.
Drugs That Can Cause Hyperglycemia
Most likely
Acitretin
Amprenavir
Atenolol + chlorthalidone
Benazepril +
hydrochlorothiazide
Bisoprolol +
hydrochlorothiazide
Bumetanide
Candesartan +
hydrochlorothiazide
Captopril +
hydrochlorothiazide
Chlorothiazide
Chlorthalidone
Corticotropin (ACTH)
Cortisone
Dexamethasone
Enalapril +
hydrochlorothiazide
Ethacrynic acid
Fosinopril +
hydrochlorothiazide
Furosemide
Hydrochlorothiazide
Hydrochlorothiazide +
irbesartan
Hydrochlorothiazide +
lisinopril
Hydrochlorothiazide +
losartan
Hydrochlorothiazide +
metoprolol
Hydrochlorothiazide +
moexipril
Hydrochlorothiazide +
quinapril
Hydrochlorothiazide +
telmisartan
Hydrochlorothiazide +
valsartan
Hydrocortisone
Indapamide
Indinavir
Lopinavir + ritonavir
Megestrol
Metolazone
Nelfinavir
Pentamidine
Ritonavir
Saquinavir
Tacrolimus
Torsemide
Less likely
Abacavir
Abacavir + lamivudine,
zidovudine
Acetazolamide
Albuterol, levalbuterol
Albuterol + ipratropium
Ammonium chloride
Amphotericin B
Amphotericin B lipid
formulations
Arsenic trioxide
Atovaquone
Baclofen
Betamethasone
Betamethasone +
clotrimazole
Betaxolol
Bexarotene
Bicalutamide
Caffeine
Carteolol
Carvedilol
Chlorothiazide
Choline salicylate
Choline salicylate +
magnesium salicylate
Clobetasol
Clozapine
Conjugated estrogens
Conjugated estrogens
+ medroxyprogesterone
Cyclosporine
Daclizumab
Desonide
Desoximetasone
Dextromethorphan +
promethazine
Diazoxide
Encainide
Esterified estrogens, estrone,
estropipate
Esterified estrogens +
methyltestosterone
Estradiol, ethinyl estradiol
Estradiol + norethindrone
Estradiol + norgestimate
Estramustine
Fluoxetine
Flurandrenolide
Formoterol
Gatifloxacin
Gemtuzumab ozogamicin
Interferon alfa-2a
Interferon alfa-2b
Interferon alfa-2b +
ribavirin
Interferon alfa-n1
Irinotecan
Isoniazid
Isotretinoin
Lamivudine
L-asparaginase
Levonorgestrel
Magnesium salicylate
Medroxyprogesterone
Methylprednisolone
Metoprolol
Modafinil
Moxifloxacin
Mycophenolate
Nadolol
Niacin, niacinamide
Nilutamide
Nitric oxide
Norethindrone
Norgestrel
Nystatin
Nystatin + triamcinolone
Octreotide
Pantoprazole
Pegaspargase
Peginterferon alfa-2b
Phenytoin
Pipecuronium
Prednisolone
Prednisone
Progesterone
Ritodrine
Rituximab
Salmeterol
Salsalate
Sodium oxybate
Somatropin
Sotalol
Streptozocin
Triamcinolone
Ursodeoxycholic acid,
ursodiol
Valproic acid, divalproex
sodium
Drugs That Can Cause Hypoglycemia
Most likely
Alcohol
Diazoxide
Dicumarol
Dorzolamide + timolol
Fosphenytoin
Glimepiride
Glipizide
Glyburide
Glyburide + metformin
Penicillamine
Pentamidine
Phenytoin
Quinine
Less likely
Acebutolol
Acetohexamide
Amphotericin B
Amphotericin B lipid
formulations
Aspirin
Aspirin + dipyridamole
Atenolol
Atenolol + chlorthalidone
Betaxolol
Bisoprolol
Bisoprolol +
hydrochlorothiazide
Choline salicylate
Choline salicylate +
magnesium salicylate
Chromium
Clarithromycin
Dalfopristin + quinupristin
Disopyramide
Fluoxetine
Gatifloxacin
Ginseng, panax ginseng
Horse chestnut (Aesculus
hippocastanum)
Hydrochlorothiazide +
metoprolol
Interferon beta-1b
Levofloxacin
Magnesium salicylate
Metoprolol
Nadolol
Octreotide
Pindolol
Ritodrine
Rituximab
Rosiglitazone
Salicylates
Salsalate
Sodium ferric gluconate
complex
Somatropin
Sotalol
Streptozocin
Sulfadiazine
Tacrolimus
Timolol
Tolazamide
Tolbutamide
DRUGS THAT CAN MASK HYPOGLYCEMIA
Carteolol
Carvedilol
Propranolol
MEDICATIONS THAT INTERACT WITH DIABETES
MEDICATION
Medications that can
interfere with pioglitazone
(Actos)
Alosetron
Alprazolam
Astemizole
Bexarotene
Carbamazepine
Cisapride
Cyclosporine
Diazepam
Diltiazem
Erythromycin
Estradiol + norethindrone
Estradiol + norgestimate
Felodipine
Fexofenadine
Galantamine
Glyburide
Itraconazole
Levonorgestrel
Megestrol
Metformin
Midazolam
Nifedipine
Norethindrone
Norgestrel
Quinidine
Reboxetine
Simvastatin
Terfenadine
Trandolapril + verapamil
Triazolam
Trimetrexate
Verapamil
Medications that can
interfere with rosiglitazone
(Avandia)
Alfentanil Alprazolam Astemizole
Atorvastatin
Bexarotene
Carbamazepine
Citalopram
Conjugated estrogens
Cyclosporine
Docetaxel
Donepezil
Esterified estrogens, estrone,
estropipate
Esterified estrogens +
methyltestosterone
Estradiol, ethinyl estradiol
Estradiol + norethindrone
Estradiol + norgestimate
Fentanyl
Galantamine
Glyburide + metformin
Leflunomide
Levonorgestrel
Medroxyprogesterone
Megestrol
Montelukast
Norethindrone
Norgestrel
Paclitaxel
Reboxetine
Repaglinide
Riluzole
Sildenafil
Tamoxifen
Terfenadine
Warfarin
Ziprasidone
Medications that can
interfere with metformin
(Glucophage)
Amiloride
Cimetidine
Cyanocobalamin (vitamin
B-12)
Digoxin
Dofetilide
Famotidine
Furosemide
Midodrine
Morphine
Nifedipine
Nizatidine
Procainamide
Propantheline
Quinidine
Quinine
Ranitidine
Repaglinide
Sulfamethoxazole +
trimethoprim
Trimethoprim
Vancomycin
Drugs That May Affect Blood Glucose Levels
When we look at drugs that may affect glucose levels, we need to invoke some special rules. There are
medicines that can cause hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar) in diabetic and
in nondiabetic patients. These pharmaceuticals will have an even greater effect on the patient with diabetes
and should either be avoided or used with vigilance and with a consideration of changing the amount of the
diabetes medication used.
Some medications are found to have a possible effect on the patient with diabetes but can be used more freely.
Again, however, vigilance is warranted.
There is also a category of medications that interact with diabetes medications. These medications don’t
actually cause hypoglycemia or hyperglycemia, but rather they interfere with the action of the medicines you
are taking for your diabetes. Whenever you start a new medication, it’s important to understand if it will
affect your blood sugars or interfere with your blood sugar medication. In either case, it is important to
monitor your glucose levels carefully.
Some of the products listed consist of two medications combined in the same pill. These are shown with a plus
sign (+) between the two medications. Only generic names are used in the following lists. Your pharmacist
will be able to tell you the brand names or generic names of medications you use. Due to the aggressive
reporting requirements of the FDA, new contraindication information is constantly becoming available. Check
with your pharmacist on a regular basis. And remember: If you have any questions about how your medicines
can affect your blood sugars, be sure to ask your physician or pharmacist.
Drugs That Can Cause Hyperglycemia
Most likely
Acitretin
Amprenavir
Atenolol + chlorthalidone
Benazepril +
hydrochlorothiazide
Bisoprolol +
hydrochlorothiazide
Bumetanide
Candesartan +
hydrochlorothiazide
Captopril +
hydrochlorothiazide
Chlorothiazide
Chlorthalidone
Corticotropin (ACTH)
Cortisone
Dexamethasone
Enalapril +
hydrochlorothiazide
Ethacrynic acid
Fosinopril +
hydrochlorothiazide
Furosemide
Hydrochlorothiazide
Hydrochlorothiazide +
irbesartan
Hydrochlorothiazide +
lisinopril
Hydrochlorothiazide +
losartan
Hydrochlorothiazide +
metoprolol
Hydrochlorothiazide +
moexipril
Hydrochlorothiazide +
quinapril
Hydrochlorothiazide +
telmisartan
Hydrochlorothiazide +
valsartan
Hydrocortisone
Indapamide
Indinavir
Lopinavir + ritonavir
Megestrol
Metolazone
Nelfinavir
Pentamidine
Ritonavir
Saquinavir
Tacrolimus
Torsemide
Less likely
Abacavir
Abacavir + lamivudine,
zidovudine
Acetazolamide
Albuterol, levalbuterol
Albuterol + ipratropium
Ammonium chloride
Amphotericin B
Amphotericin B lipid
formulations
Arsenic trioxide
Atovaquone
Baclofen
Betamethasone
Betamethasone +
clotrimazole
Betaxolol
Bexarotene
Bicalutamide
Caffeine
Carteolol
Carvedilol
Chlorothiazide
Choline salicylate
Choline salicylate +
magnesium salicylate
Clobetasol
Clozapine
Conjugated estrogens
Conjugated estrogens
+ medroxyprogesterone
Cyclosporine
Daclizumab
Desonide
Desoximetasone
Dextromethorphan +
promethazine
Diazoxide
Encainide
Esterified estrogens, estrone,
estropipate
Esterified estrogens +
methyltestosterone
Estradiol, ethinyl estradiol
Estradiol + norethindrone
Estradiol + norgestimate
Estramustine
Fluoxetine
Flurandrenolide
Formoterol
Gatifloxacin
Gemtuzumab ozogamicin
Interferon alfa-2a
Interferon alfa-2b
Interferon alfa-2b +
ribavirin
Interferon alfa-n1
Irinotecan
Isoniazid
Isotretinoin
Lamivudine
L-asparaginase
Levonorgestrel
Magnesium salicylate
Medroxyprogesterone
Methylprednisolone
Metoprolol
Modafinil
Moxifloxacin
Mycophenolate
Nadolol
Niacin, niacinamide
Nilutamide
Nitric oxide
Norethindrone
Norgestrel
Nystatin
Nystatin + triamcinolone
Octreotide
Pantoprazole
Pegaspargase
Peginterferon alfa-2b
Phenytoin
Pipecuronium
Prednisolone
Prednisone
Progesterone
Ritodrine
Rituximab
Salmeterol
Salsalate
Sodium oxybate
Somatropin
Sotalol
Streptozocin
Triamcinolone
Ursodeoxycholic acid,
ursodiol
Valproic acid, divalproex
sodium
Drugs That Can Cause Hypoglycemia
Most likely
Alcohol
Diazoxide
Dicumarol
Dorzolamide + timolol
Fosphenytoin
Glimepiride
Glipizide
Glyburide
Glyburide + metformin
Penicillamine
Pentamidine
Phenytoin
Quinine
Less likely
Acebutolol
Acetohexamide
Amphotericin B
Amphotericin B lipid
formulations
Aspirin
Aspirin + dipyridamole
Atenolol
Atenolol + chlorthalidone
Betaxolol
Bisoprolol
Bisoprolol +
hydrochlorothiazide
Choline salicylate
Choline salicylate +
magnesium salicylate
Chromium
Clarithromycin
Dalfopristin + quinupristin
Disopyramide
Fluoxetine
Gatifloxacin
Ginseng, panax ginseng
Horse chestnut (Aesculus
hippocastanum)
Hydrochlorothiazide +
metoprolol
Interferon beta-1b
Levofloxacin
Magnesium salicylate
Metoprolol
Nadolol
Octreotide
Pindolol
Ritodrine
Rituximab
Rosiglitazone
Salicylates
Salsalate
Sodium ferric gluconate
complex
Somatropin
Sotalol
Streptozocin
Sulfadiazine
Tacrolimus
Timolol
Tolazamide
Tolbutamide
DRUGS THAT CAN MASK HYPOGLYCEMIA
Carteolol
Carvedilol
Propranolol
MEDICATIONS THAT INTERACT WITH DIABETES
MEDICATION
Medications that can
interfere with pioglitazone
(Actos)
Alosetron
Alprazolam
Astemizole
Bexarotene
Carbamazepine
Cisapride
Cyclosporine
Diazepam
Diltiazem
Erythromycin
Estradiol + norethindrone
Estradiol + norgestimate
Felodipine
Fexofenadine
Galantamine
Glyburide
Itraconazole
Levonorgestrel
Megestrol
Metformin
Midazolam
Nifedipine
Norethindrone
Norgestrel
Quinidine
Reboxetine
Simvastatin
Terfenadine
Trandolapril + verapamil
Triazolam
Trimetrexate
Verapamil
Medications that can
interfere with rosiglitazone
(Avandia)
Alfentanil Alprazolam Astemizole
Atorvastatin
Bexarotene
Carbamazepine
Citalopram
Conjugated estrogens
Cyclosporine
Docetaxel
Donepezil
Esterified estrogens, estrone,
estropipate
Esterified estrogens +
methyltestosterone
Estradiol, ethinyl estradiol
Estradiol + norethindrone
Estradiol + norgestimate
Fentanyl
Galantamine
Glyburide + metformin
Leflunomide
Levonorgestrel
Medroxyprogesterone
Megestrol
Montelukast
Norethindrone
Norgestrel
Paclitaxel
Reboxetine
Repaglinide
Riluzole
Sildenafil
Tamoxifen
Terfenadine
Warfarin
Ziprasidone
Medications that can
interfere with metformin
(Glucophage)
Amiloride
Cimetidine
Cyanocobalamin (vitamin
B-12)
Digoxin
Dofetilide
Famotidine
Furosemide
Midodrine
Morphine
Nifedipine
Nizatidine
Procainamide
Propantheline
Quinidine
Quinine
Ranitidine
Repaglinide
Sulfamethoxazole +
trimethoprim
Trimethoprim
Vancomycin