Are you SAFE from diabetes medicine

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Side Effects and Interactions of Diabetes
Drugs Written by Sharon Liao ? Medically Reviewed
by Jennifer Robinson, MD on April 17,
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weight and diet. Managing Your Diabetes Are
your 'good' habits doing harm?
Diabetes drugs can be a great way to keep your
blood sugar levels from getting out of whack.
But they can sometimes cause side effects or may
not mix well with other medicines you take. Talk
to your doctor about what you need to watch out
for. Side effects can range from an upset
stomach to a serious condition. And other
medicines you take can make your diabetes drug
stop working -- or even make it work too
well. Know Your Medicines Different types of
diabetes drugs have their own side effects and
ways they interact with other medicines. Biguanid
es Metformin (Glucophage, Glucophage XR,
Glumetza, Fortamet, Riomet). Metformin is
usually the first drug that doctors suggest you
try to treat type 2 diabetes. It cuts blood
sugar by improving the way your body uses
insulin. It also lowers the amount of sugar that
the liver makes. What are the side effects? You
may have nausea , gas, bloating, diarrhea, b12
deficiency, and an upset stomach. These problems
usually go away in a few weeks, as your body gets
used to the medicine. It may also help to take
the drug with food. In rare cases, metformin may
cause a serious condition called lactic acidosis.
That's when too much lactic acid builds up. Call
your doctor right away if you get any of these
symptoms
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Muscle pain that's not normal Sudden stomach
problems, such as vomiting Do they clash with
other drugs? Some drugs may interfere with some
of the enzymes that metformin uses to work. Your
doctor may need to monitor your blood sugar or
adjust your metformin dose if you take any of
these Amiloride (Midamor) Cephalexin (Daxbia,
Keflex) Cimetidine (Tagemet) Digoxin
(Lanoxicaps, Lanoxin) Procainamide
Pyrimethamine (Daraprim) Quinidine
(Quinidex) Quinine Trimethoprim (Primsol)
Vancomycin (Vancocin) Anticholinergic drugs, such
as dicyclomine (Bentyl) and oxybutynin (Ditropan,
Ditropan XL, Oxytrol), may raise the amount of
metformin your body absorbs. This may lead to low
blood sugar. Sulfonylureas Glipizide
(Glucotrol, Glucotrol XL), glimepride (Amaryl),
glyburide (DiaBeta, Glynase PresTab). These
drugs lower your blood sugar by helping your
pancreas make more insulin .
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What are the side effects? The most common one is
low blood sugar . This can make you feel shaky,
sweaty, dizzy, and confused. Severe low blood
sugar can be life-threatening. To prevent it, eat
regularly and don't skip meals. Other side
effects that you might get are weight gain , dark
urine , and an upset stomach. Sulfonylureas can
also cause skin rashes and reactions to the
sun. Do they clash with other drugs? About 100
drugs can change the way sulfonylureas work.
Some can make them work too well, which may lead
to dangerously low blood sugar. Others may cause
the medication to be less effective. Your doctor
may need to keep tabs on your blood sugar or
adjust your sulfonylurea dose. The medicines that
may affect how sulfonylureas work include Azole
antifungals, including fluconazole and
ketoconazole Some antibiotics , such as
chloramphenicol, ciprofloxacin, clarithromycin
(Biaxin), isoniazid (Nydrazid), rifampin, and
sulfasalazine (Azulfidine, Azulfidine Entabs,
Gantrisin Pediatric, Sulfazine, Sulfazine EC,
co-trimoxazole, Zonegran) Cholesterol-lowering
drugs, such as clofibrate and gemfibrozil
Tricyclic antidepressants H2 blockers
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Gout medications, such as probenecid Some high
blood pressure medicines, including ACE
inhibitors and bosentan Beta-blockers Corticoster
oids Calcium channel blockers Oral
contraceptives Thiazide diuretics Thyroid
medicines
Meglitinides nateglinide (Starlix), repaglinide
(Prandin). They help your pancreas make more
insulin. Although these drugs work faster, they
don't last as long in the body. What are the
side effects? These medications can lead to low
blood sugar and weight gain. Do they clash with
other drugs? Some drugs can affect how your body
processes meglitinides. This may cause your
blood sugar to become too low or too high. Your
doctor may need to keep an eye on your blood
sugar levels, adjust your dose, or change your
medicine. The drugs that might not mix well with
meglitinides include Azole antifungals Certain
antibiotics, including rifampin and
isoniazid Some high blood pressure medicines,
such as calcium channel blockers, beta-blockers,
and thiazide diuretics Corticosteroids Estrogen
Nicotinic acid Oral contraceptives
Phenothiazines Phenytoin (Dilantin, Phenytek)
Thyroid supplements Monoamine oxidase inhibitors
NSAIDs Probenecid Salicylic acid
Sulfonamides Thiazolidinediones (TZDs)
Pioglitazone (Actos), rosiglitazone (Avandia).
These drugs boost the way insulin works in the
body.
What are the side effects? It may cause you to
hang on to fluids in your body, which can lead to
swelling. TZDs can also make you gain weight and
raise your levels of LDL "bad" cholesterol .
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They are also linked with serious side effects,
such as bone fractures and heart failure as well
as being associated with an increase risk of
bladder cancer in women. Do they clash with other
drugs? Some drugs block the enzyme that processes
TZDs. Your doctor may want to prescribe another
medicine if you take one of these
medications Fluoxetine (Prozac) Gemfibrozil
(Lopid) Ketoconazole (Nizora l) Rifampin
(Rifadin) Trimethoprim (Primsol) Other
medicines, when combined with a TZD, may raise
your chance of having heart problems
NSAIDs Sulfonylureas Nitrates Alpha-glucosidase
inhibitors Acarbose (Precose,) miglitol
(Glyset). You take alpha- glucosidase inhibitors
with the first bite of each meal. They slow the
breakdown of carbohydrates. What are the side
effects? Because these medicines affect your
digestion, you may have gas , diarrhea, and
stomach pain. They also may cause an increase in
blood markers of a stressed liver.
Do they clash with other drugs? Alpha-glucosidase
inhibitors may not work as well if you also take
digestive enzymes and activated charcoal
supplements. Alpha-glucosidase inhibitors can
also make it harder for the body to absorb
digoxin. They may also change the way warfarin
works. Talk to your doctor if you take either of
these drugs. DPP-4 inhibitors alogliptin
(Nesina), linagliptin (Tradjenta), saxagliptin
(Onglyza), Sitagliptin (Januvia). These
medicines help your pancreas release more insulin
after meals. They also lower the amount of sugar
you make. What are the side effects? You could
get a sore throat, stuffy nose, upset stomach,
and diarrhea. You may also run the risk of acute
pancreatitis, liver failure, possible worsening
heart failure and joint pain Do they clash with
other drugs? Some drugs may affect how much DPP-4
inhibitors are absorbed in the body. Your doctor
will want to track your blood sugar levels
carefully and watch for potential side effects
if you take these medicines Atazanavir (Reyataz)
and ritonavir (Norvir) Clarithromycin (Biaxin)
and rifampin (Rifadin, Rimactane) Diltiazem
(Cardizem) Ketoconazole (Nizoral, Xolegel)
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ACE inhibitors combined with DPP-4 may raise your
chance of swelling. SGLT2 inhibitors
Canagliflozin (Invokana), dapagliflozin
(Farxiga), empagliflozin (Jardiance),
ertugliflozin (Steglatro). They work in the
kidneys and remove extra sugar from your blood
through urine. What are the side effects? These
drugs raise your chances of having urinary tract
and yeast infections. They may also cause low
blood sugar. On the positive side, they may
reduce the risk of kidney disease for those with
diabetes and can reduce the risk of being
hospitalized or dying from heart failure. Do
they clash with other drugs? SGLT2 inhibitors
don't interact with many drugs. Rifampin may
make the drug less effective. SGLT2 inhibitors
may also raise the amount of digoxin in the body.
Insulin therapy insulin aspart (Novolog),
insulin detemir (Levemir), insulin glargine
(Lantus), Insulin glulisine (Apidra), insulin
isophane (Humulin, Novolin N), insulin lispro
(Humalog),. If other medicines aren't doing
enough, you may need insulin therapy. You'll need
to inject insulin using a needle and syringe or
a pen injector. What are the side effects? The
most common side effect is low blood sugar. You
may also have a wide variety of symptoms, such
as headaches, rashes, dizziness, anxiety, cough,
and dry mouth. Talk to your doctor. Some may go
away as your body gets used to the medicine. Do
they clash with other drugs? Some drugs affect
the way that insulin works in the body. This may
cause your blood sugar to become too low or high.
Your doctor may need to monitor your blood sugar
level, adjust your dose, or change your medicine
if you take some of these Diabetes medicines
Salicylic acid Certain antidepressants, such as
fluoxetine and monoamine oxidase inhibitors Some
antibiotics, including isoniazid and
sulfonamide Fibrates Some high blood pressure
medicines, such as ACE inhibitors and angiotensin
II receptor blocking agents Certain cholesterol
-lowering drugs, including fibrates and niacin
Propoxyphene, pentoxifylline and somatostatin
analogs Corticosteroids Oral contraceptives
Estrogens Diuretics Phenothiazines Danazol
(Danocrine) Protease inhibitors Glucagon
(GlucaGen) Thyroid medicine
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