What are the contraindications, warnings, and precautions for insulin?
- Hypoglycemia (low blood sugar)
- Hypersensitivity to insulin or its excipients (inactive co-ingredients)
Warnings and Precautions
- Hypoglycemia may occur and is the most common side effect of insulin treatment.
- Severe, life-threatening allergic reactions, including anaphylaxis, may occur.
- Hypokalemia (low blood potassium) may occur because insulin stimulates movement of potassium from blood into cells. Combining insulin with potassium-lowering drugs may increase the risk of hypokalemia.
- Hepatic (liver) impairment may reduce the insulin requirement.
- Renal (kidney) dysfunction may reduce the insulin requirement.
- Illness, emotional disturbance, or other stress may alter the insulin requirement.
- Intravenous administration increases the risk of hypoglycemia and hypokalemia.
Which drugs interact with insulin?
Insulin Drug Interactions
|Drug or Drug Class||Effect||Recommendation|
|Beta blockers (for example, propranolol [Inderal, Inderal LA, Innopran XL], atenolol [Tenormin])||Beta blockers may mask symptoms of hypoglycemia or prolong hypoglycemia and alter glucose metabolism||Avoid combination if possible|
|repaglinide (Prandin)||Increased risk of hypoglycemia and heart attack (myocardial infarction)||Avoid combination if possible|
|rosiglitazone (Avandia) or rosiglitazone combination products||Increased incidence of hypoglycemia, fluid retention, ischemia (manifest by angina or heart pain), congestive heart failure||Avoid combination if possible|
|Thiazides and thiazide combination products||Hyperglycemia; may reduce effect of insulin||Monitor glucose levels and adjust accordingly|
|Corticosteroids||Hyperglycemia; may reduce effect of insulin||Monitor glucose levels and adjust accordingly|
|Estrogens||Hyperglycemia; may reduce effect of insulin||Monitor therapy and adjust as needed|
|levofloxacin (Levaquin) and other fluoroquinolones||Increased risk of hypoglycemia or hyperglycemia||Use with caution, monitor therapy|
|Monoamine oxidase inhibitors (MAOIs)||MAIOs may increase insulin secretion. Combination increases risk of prolonged hypoglycemia.||Monitor glucose levels and adjust accordingly|
|Sulfonylureas||Increased risk of hypoglycemia and||Monitor glucose levels and adjust accordingly|
|Thyroid hormones||Thyroid hormones may increase insulin requirement||Monitor glucose levels and adjust accordingly|
|Yohimbe||Yohimbe may increase risk of hypoglycemia||Caution is advised|
Quick GuideType 2 Diabetes Symptoms, Warning Signs, and Management
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