Insulin for Diabetes Treatment (Types, Side Effects, and Preparations) (cont.)

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Medical and Pharmacy Editor:

What are the contraindications, warnings, and precautions for insulin?

Contraindications

  • 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

Examples of Regular 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
Levefloxacin 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
Medically Reviewed by a Doctor on 1/9/2013


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