Wechselwirkungen von Saxagliptin

Hypoglycemia Chloroquine has been shown to cause severe hypoglycemia including loss of consciousness that could be life-threatening in patients treated with or without antidiabetic medications (see PRECAUTIONS , Drug Interactions ). (Fachinformation zu Chloroquin, Warnhinweise)

Antidiabetic agents Hypoglycemia including fatal outcomes have been reported. (Fachinformation zu Ciprofloxacin, Arzneimittelwechselwirkungen)

Oral hypoglycemics Clinically significant hypoglycemia may be precipitated by the use of fluconazole with oral hypoglycemic agents; one fatality has been reported from hypoglycemia in association with combined fluconazole and glyburide use. (Fachinformation zu Fluconazol, Arzneimittelwechselwirkungen)

This warning is based on the study conducted by the University Group Diabetes Program (UGDP), 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. (Fachinformation zu Glipizid und Metformin, Gegenanzeigen)

Hypoglycemia PLAQUENIL can cause severe and potentially life-threatening hypoglycemia, in the presence or absence of antidiabetic agents [see Drug Interactions (7) ]. (Fachinformation zu Hydroxychloroquin, Warnhinweise und Vorsichtsmaßnahmen)

Monitor blood glucose in patients with diabetes and assess if antidiabetic agent dose modifications are required. (Fachinformation zu Abirateron, Warnhinweise und Vorsichtsmaßnahmen)

Consideration should be taken in patients being treated with antidiabetic agents. (Fachinformation zu Acetazolamid, Arzneimittelwechselwirkungen)

Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (Fachinformation zu Acetylsalicylsäure und Dipyridamol, Arzneimittelwechselwirkungen)

Glyburide: In a trial of 7 healthy male volunteers, acitretin treatment potentiated the blood glucose-lowering effect of glyburide (a sulfonylurea similar to chlorpropamide) in 3 of the 7 subjects. (Fachinformation zu Acitretin, Arzneimittelwechselwirkungen)

Use caution in a patient with a history of angioedema to another dipeptidyl peptidase-4 (DPP-4) inhibitor because it is unknown whether such patients will be predisposed to angioedema with saxagliptin. (Fachinformation zu Saxagliptin, Warnhinweise und Vorsichtsmaßnahmen)

Use caution in a patient with a history of angioedema to another dipeptidyl peptidase-4 (DPP-4) inhibitor because it is unknown whether such patients will be predisposed to angioedema with saxagliptin. (Fachinformation zu Saxagliptin, Warnhinweise und Vorsichtsmaßnahmen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Antidiabetic Agents: In rare cases, diabetic patients receiving an ACE inhibitor (including benazepril) concomitantly with insulin or oral antidiabetics may develop hypoglycemia. (Fachinformation zu Amlodipin und Benazepril, Arzneimittelwechselwirkungen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Similar significant increases in plasma concentrations of saxagliptin are anticipated with other strong CYP3A4/5 inhibitors (e.g., atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, ritonavir, saquinavir, and telithromycin). (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Antidiabetics: Increased risk of hypoglycemia ( 7.2 ) (Fachinformation zu Benazepril, Arzneimittelwechselwirkungen)

Antidiabetic agents: Dosage adjustment of antidiabetic drug may be required. (Fachinformation zu Benazepril und Hydrochlorothiazid, Arzneimittelwechselwirkungen)

Intervention Consider adding another antihyperglycemic agent in patients who require additional glycemic control. (Fachinformation zu Bexagliflozin, Arzneimittelwechselwirkungen)

However, patients subject to spontaneous hypoglycemia, or diabetic patients receiving insulin or oral hypoglycemic agents, should be cautioned about these possibilities and bisoprolol fumarate should be used with caution. (Fachinformation zu Bisoprolol, Warnhinweise)

Antidiabetic drugs (oral agents and insulin) - dosage adjustment of the antidiabetic drug may be required. (Fachinformation zu Bisoprolol und Hydrochlorothiazid, Vorsichtsmaßnahmen)

Masking of Hypoglycemic Symptoms in Patients with Diabetes Mellitus Beta-adrenergic blocking agents should be administered with caution in patients subject to spontaneous hypoglycemia or to diabetic patients (especially those with labile diabetes) who are receiving insulin or oral hypoglycemic agents. (Fachinformation zu Brimonidin und Timolol, Warnhinweise und Vorsichtsmaßnahmen)

Oral antidiabetic agents and insulin, causing hypoglycemia by contributing an additive effect, if dosage of Butalbital, Aspirin, and Caffeine Capsules exceeds maximum recommended daily dosage. (Fachinformation zu Butalbital, Acetylsalicylsäure und Koffein, Arzneimittelwechselwirkungen)

Evaluate the blood pressure and renal function of patients Examples: Metoprolol, propranolol Hypoglycemic Agents Clinical Impact: Aspirin may increase the serum glucose-lowering action of insulin and sulfonylureas leading to hypoglycemia. (Fachinformation zu Butalbital, Acetylsalicylsäure, Koffein und Codein, Arzneimittelwechselwirkungen)

Consider adding another antihyperglycemic agent in patients who require additional glycemic control [see Dosage and Administration (2.3) and Clinical Pharmacology (12.3) ] . (Fachinformation zu Canagliflozin, Arzneimittelwechselwirkungen)

Antidiabetic drugs (oral agents and insulin) − Dosage adjustment of the antidiabetic drug may be required. (Fachinformation zu Candesartan und Hydrochlorothiazid, Arzneimittelwechselwirkungen)

Closely monitor for adverse reactions of CYP2C9 substrates where minimal concentration changes may lead to serious adverse reactions when used concomitantly with XELODA (e.g., anticoagulants, antidiabetic drugs). (Fachinformation zu Capecitabin, Arzneimittelwechselwirkungen)

Insulin and oral hypoglycemics action may be enhanced. (Fachinformation zu Carvedilol, Arzneimittelwechselwirkungen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Antidiabetic Drugs (Oral Agents and Insulin) - dosage adjustment of the antidiabetic drug may be required. (Fachinformation zu Chlorothiazid, Arzneimittelwechselwirkungen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Similar significant increases in plasma concentrations of saxagliptin are anticipated with other strong CYP3A4/5 inhibitors (e.g., atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, ritonavir, saquinavir, and telithromycin). (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Caution should be exercised when used with antidiabetic drugs. (Fachinformation zu Danazol, Arzneimittelwechselwirkungen)

…Coadministered Drug (Dose Regimen) * Dapagliflozin (Dose Regimen) * Effect on Dapagliflozin Exposure [% Change (90% CI)] C max AUC † No dosing adjustments required for the following: Oral Antidiabetic Agents Metformin (1000 mg) 20 mg ↔ ↔ Pioglitazone (45 mg) 50 mg ↔ ↔ Sitagliptin (100 mg) 20 mg ↔ ↔ Glimepiride (4 mg) 20 mg ↔ ↔ Voglibose (0.2 mg three times daily) 10… (Fachinformation zu Dapagliflozin, Arzneimittelwechselwirkungen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Hyperglycemia Corticosteroids can increase blood glucose, worsen pre-existing diabetes, and predispose those on long-term therapy to diabetes mellitus, and may reduce the effect of the antidiabetic drugs. (Fachinformation zu Dexamethason, Warnhinweise und Vorsichtsmaßnahmen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Masking of Hypoglycemic Symptoms in Patients with Diabetes Mellitus Beta-adrenergic blocking agents should be administered with caution in patients subject to spontaneous hypoglycemia or to diabetic patients (especially those with labile diabetes) who are receiving insulin or oral hypoglycemic agents. (Fachinformation zu Dorzolamid und Timolol, Warnhinweise und Vorsichtsmaßnahmen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

In diabetic patients dosage adjustments of insulin or oral hypoglycemic agents may be required. (Fachinformation zu Enalapril und Hydrochlorothiazid, Vorsichtsmaßnahmen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

If there is worsening glycemic control or failure to achieve target glycemic control, consider alternative antidiabetic therapy. (Fachinformation zu Exenatid, Warnhinweise und Vorsichtsmaßnahmen)

Monitor for symptoms of hyperglycemia; adjust dosage of antidiabetic drug upward if necessary. (Fachinformation zu Fludrocortison, Arzneimittelwechselwirkungen)

As is true with many other types of medication when taken concurrently by patients with diabetes, insulin and/or oral hypoglycemic, dosage may need to be adjusted when therapy with PROZAC is instituted or discontinued. (Fachinformation zu Fluoxetin, Warnhinweise und Vorsichtsmaßnahmen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

• Hypoglycemia with Concomitant Use of Insulin or Insulin Secretagogues: Consider a lower dosage of insulin or insulin secretagogue when used in combination wtih Saxagliptin tablets ( 5.3 ) (Fachinformation zu Saxagliptin, Warnhinweise und Vorsichtsmaßnahmen)

• Hypoglycemia with Concomitant Use of Insulin or Insulin Secretagogues: Consider a lower dosage of insulin or insulin secretagogue when used in combination wtih Saxagliptin tablets ( 5.3 ) (Fachinformation zu Saxagliptin, Warnhinweise und Vorsichtsmaßnahmen)

• Hypoglycemia with Concomitant Use of Insulin or Insulin Secretagogues: Consider a lower dosage of insulin or insulin secretagogue when used in combination wtih Saxagliptin tablets ( 5.3 ) (Fachinformation zu Saxagliptin, Warnhinweise und Vorsichtsmaßnahmen)

• Hypoglycemia with Concomitant Use of Insulin or Insulin Secretagogues: Consider a lower dosage of insulin or insulin secretagogue when used in combination wtih Saxagliptin tablets ( 5.3 ) (Fachinformation zu Saxagliptin, Warnhinweise und Vorsichtsmaßnahmen)

• Hypoglycemia with Concomitant Use of Insulin or Insulin Secretagogues: Consider a lower dosage of insulin or insulin secretagogue when used in combination wtih Saxagliptin tablets ( 5.3 ) (Fachinformation zu Saxagliptin, Warnhinweise und Vorsichtsmaßnahmen)

Antidiabetic drugs: Dosage adjustment of antidiabetic may be required (7.2) (Fachinformation zu Hydrochlorothiazid, Arzneimittelwechselwirkungen)

Antidiabetic Agents Clinical Impact: Corticosteroids in supraphysiologic doses may increase blood glucose concentrations. (Fachinformation zu Hydrocortison, Arzneimittelwechselwirkungen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

• Hypoglycemia with Concomitant Use of Insulin or Insulin Secretagogues: Consider a lower dosage of insulin or insulin secretagogue when used in combination wtih Saxagliptin tablets ( 5.3 ) (Fachinformation zu Saxagliptin, Warnhinweise und Vorsichtsmaßnahmen)

• Hypoglycemia with Concomitant Use of Insulin or Insulin Secretagogues: Consider a lower dosage of insulin or insulin secretagogue when used in combination wtih Saxagliptin tablets ( 5.3 ) (Fachinformation zu Saxagliptin, Warnhinweise und Vorsichtsmaßnahmen)

• Hypoglycemia with Concomitant Use of Insulin or Insulin Secretagogues: Consider a lower dosage of insulin or insulin secretagogue when used in combination wtih Saxagliptin tablets ( 5.3 ) (Fachinformation zu Saxagliptin, Warnhinweise und Vorsichtsmaßnahmen)

• Hypoglycemia with Concomitant Use of Insulin or Insulin Secretagogues: Consider a lower dosage of insulin or insulin secretagogue when used in combination wtih Saxagliptin tablets ( 5.3 ) (Fachinformation zu Saxagliptin, Warnhinweise und Vorsichtsmaßnahmen)

• Hypoglycemia with Concomitant Use of Insulin or Insulin Secretagogues: Consider a lower dosage of insulin or insulin secretagogue when used in combination wtih Saxagliptin tablets ( 5.3 ) (Fachinformation zu Saxagliptin, Warnhinweise und Vorsichtsmaßnahmen)

Antidiabetic drugs: Dosage adjustment of antidiabetic may be required. (Fachinformation zu Irbesartan und Hydrochlorothiazid, Arzneimittelwechselwirkungen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Similar significant increases in plasma concentrations of saxagliptin are anticipated with other strong CYP3A4/5 inhibitors (e.g., atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, ritonavir, saquinavir, and telithromycin). (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

• Strong CYP3A4/5 inhibitors (e.g., ketoconazole): Coadministration with saxagliptin significantly increases saxagliptin concentrations. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Hyperglycemia and Hypoglycemia : Glucose monitoring is recommended and antidiabetic treatment adjusted accordingly. (Fachinformation zu Lanreotid, Warnhinweise und Vorsichtsmaßnahmen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Blood Glucose Disturbances Fluoroquinolones, including Levofloxacin in 5% Dextrose Injection, have been associated with disturbances of blood glucose, including symptomatic hyperglycemia and hypoglycemia, usually in diabetic patients receiving concomitant treatment with an oral hypoglycemic agent (e.g., glyburide) or with insulin. (Fachinformation zu Levofloxacin, Warnhinweise und Vorsichtsmaßnahmen)

Worsening of Diabetic Control : May worsen glycemic control and result in increased antidiabetic agent or insulin requirements. (Fachinformation zu Levothyroxin, Warnhinweise und Vorsichtsmaßnahmen)

Insulin or Oral Hypoglycemics — Initiating thyroid replacement therapy may cause increases in insulin or oral hypoglycemic requirements. (Fachinformation zu Levothyroxin und Liothyronin, Arzneimittelwechselwirkungen)

Use caution in a patient with a history of angioedema to another dipeptidyl peptidase-4 (DPP-4) inhibitor because it is unknown whether such patients will be predisposed to angioedema with saxagliptin. (Fachinformation zu Saxagliptin, Warnhinweise und Vorsichtsmaßnahmen)

Use caution in a patient with a history of angioedema to another dipeptidyl peptidase-4 (DPP-4) inhibitor because it is unknown whether such patients will be predisposed to angioedema with saxagliptin. (Fachinformation zu Saxagliptin, Warnhinweise und Vorsichtsmaßnahmen)

• Hypoglycemia: Postmarketing cases of symptomatic hypoglycemia have been reported in patients with diabetes mellitus receiving insulin or oral hypoglycemic agents. (Fachinformation zu Linezolid, Warnhinweise und Vorsichtsmaßnahmen)

• Worsening of diabetic control: Therapy in patients with diabetes mellitus may worsen glycemic control and result in increased antidiabetic agent or insulin requirements. (Fachinformation zu Liothyronin, Warnhinweise und Vorsichtsmaßnahmen)

Antidiabetics Concomitant administration of Zestril and antidiabetic medicines (insulins, oral hypoglycemic agents) may cause an increased blood-glucose-lowering effect with risk of hypoglycemia. (Fachinformation zu Lisinopril, Arzneimittelwechselwirkungen)

Antidiabetic drugs (oral agents and insulin) - dosage adjustment of the antidiabetic drug may be required. (Fachinformation zu Lisinopril und Hydrochlorothiazid, Arzneimittelwechselwirkungen)

Coadministration of lomitapide with P-gp substrates (such as aliskiren, ambrisentan, colchicine, dabigatran etexilate, digoxin, everolimus, fexofenadine, imatinib, lapatinib, maraviroc, nilotinib, posaconazole, ranolazine, saxagliptin, sirolimus, sitagliptin, talinolol, tolvaptan, topotecan) may increase the absorption of P-gp substrates. (Fachinformation zu Lomitapid, Arzneimittelwechselwirkungen)

Similar significant increases in plasma concentrations of saxagliptin are anticipated with other strong CYP3A4/5 inhibitors (e.g., atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, ritonavir, saquinavir, and telithromycin). (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Antidiabetic drugs: dosage adjustment of antidiabetic may be required. (Fachinformation zu Losartan und Hydrochlorothiazid, Arzneimittelwechselwirkungen)

Antidiabetics : Because corticosteroids may increase blood glucose concentrations, dosage adjustments of antidiabetic agents may be required. (Fachinformation zu Methylprednisolon, Arzneimittelwechselwirkungen)

Insulin And Oral Antidiabetic Agents See Glucose Tolerance under PRECAUTIONS , General . (Fachinformation zu Metolazon, Arzneimittelwechselwirkungen)

Antidiabetic drugs: Dosage adjustment may be required. (Fachinformation zu Metoprolol und Hydrochlorothiazid, Arzneimittelwechselwirkungen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Antidiabetic agents Carefully monitor blood glucose. (Fachinformation zu Moxifloxacin, Arzneimittelwechselwirkungen)

Beta-blockade also reduces the release of insulin in response to hyperglycemia; therefore, it may be necessary to adjust the dose of antidiabetic drugs. (Fachinformation zu Nadolol, Warnhinweise)

Use of Antidiabetic Medications: Weight loss may cause hypoglycemia. (Fachinformation zu Naltrexon und Bupropion, Warnhinweise und Vorsichtsmaßnahmen)

• Hypoglycemia with Concomitant Use of Insulin or Insulin Secretagogues: Consider a lower dosage of insulin or insulin secretagogue when used in combination wtih Saxagliptin tablets ( 5.3 ) (Fachinformation zu Saxagliptin, Warnhinweise und Vorsichtsmaßnahmen)

Similar significant increases in plasma concentrations of saxagliptin are anticipated with other strong CYP3A4/5 inhibitors (e.g., atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, ritonavir, saquinavir, and telithromycin). (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Similar significant increases in plasma concentrations of saxagliptin are anticipated with other strong CYP3A4/5 inhibitors (e.g., atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, ritonavir, saquinavir, and telithromycin). (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Hypoglycemia or Hyperglycemia: Monitor glucose and adjust antidiabetic treatment as needed (‎ 5.2 ). (Fachinformation zu Octreotid, Warnhinweise und Vorsichtsmaßnahmen)

Fluoroquinolones have been associated with disturbances of blood glucose, including symptomatic hyperglycemia and hypoglycemia, usually in diabetic patients receiving concomitant treatment with an oral hypoglycemic agent (e.g., glyburide) or with insulin. (Fachinformation zu Ofloxacin, Warnhinweise)

• Antidiabetic drugs: Dosage adjustment may be required. (Fachinformation zu Olmesartan und Hydrochlorothiazid, Arzneimittelwechselwirkungen)

• Increased amlodipine exposure when coadministered with CYP3A inhibitors Hydrochlorothiazide ( 7.3 ): • Antidiabetic drugs: Dosage adjustment of antidiabetic may be required. (Fachinformation zu Olmesartan, Amlodipin und Hydrochlorothiazid, Arzneimittelwechselwirkungen)

A reduction in dose of oral hypoglycemic medication (e.g., sulfonylureas) or insulin may be required in some patients [see Clinical Studies (14) ] . (Fachinformation zu Orlistat, Warnhinweise und Vorsichtsmaßnahmen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

• A reduction in dose of insulin or oral hypoglycemic medication may be required in some patients. (Fachinformation zu Phentermin, Warnhinweise und Vorsichtsmaßnahmen)

Beta-blockade also reduces the release of insulin in response to hyperglycemia; therefore, it may be necessary to adjust the dose of antidiabetic drugs. (Fachinformation zu Pindolol, Warnhinweise)

Congestive Heart Failure ACTOS, like other thiazolidinediones, can cause dose-related fluid retention when used alone or in combination with other antidiabetic medications and is most common when ACTOS is used in combination with insulin. (Fachinformation zu Pioglitazon, Warnhinweise und Vorsichtsmaßnahmen)

• Hypoglycemia with Concomitant Use of Insulin or Insulin Secretagogues: Consider a lower dosage of insulin or insulin secretagogue when used in combination wtih Saxagliptin tablets ( 5.3 ) (Fachinformation zu Saxagliptin, Warnhinweise und Vorsichtsmaßnahmen)

Congestive Heart Failure Pioglitazone, like other thiazolidinediones, can cause dose-related fluid retention when used alone or in combination with other antidiabetic medications and is most common when pioglitazone is used in combination with insulin. (Fachinformation zu Pioglitazon und Metformin, Warnhinweise und Vorsichtsmaßnahmen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Antidiabetic Agents: Because corticosteroids may increase blood glucose concentrations, dosage adjustments of antidiabetic agents may be required. (Fachinformation zu Prednisolon, Arzneimittelwechselwirkungen)

Antidiabetic agents: May increase blood glucose concentrations. (Fachinformation zu Prednison, Arzneimittelwechselwirkungen)

Monitor patients for the development of edema when co-administering LYRICA CR and thiazolidinedione antidiabetic agents. (Fachinformation zu Pregabalin, Warnhinweise und Vorsichtsmaßnahmen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

• Hypoglycemia with Concomitant Use of Insulin or Insulin Secretagogues: Consider a lower dosage of insulin or insulin secretagogue when used in combination wtih Saxagliptin tablets ( 5.3 ) (Fachinformation zu Saxagliptin, Warnhinweise und Vorsichtsmaßnahmen)

Decrease exposure Digitoxin Decrease exposure Fluoroquinolones Pefloxacin Administered with rifampin 900 mg daily Decrease exposure Moxifloxacin , Decrease exposure Oral Hypoglycemic Agents (e.g., sulfonylureas) Glyburide Decrease exposure Rifampin may worsen glucose control of glyburide. (Fachinformation zu Rifampicin, Arzneimittelwechselwirkungen)

…Diazepam Beta-Blockers Propranolol Calcium Channel Blockers Diltiazem, nifedipine, verapamil Cardiac Glycoside Preparations Digoxin Corticosteroids Prednisone Fibrates Clofibrate Oral Hypoglycemics Sulfonylureas (e.g., glyburide, glipizide) Hormonal Contraceptives/Progestins Ethinyl estradiol, levonorgestrel Immunosuppressants Cyclosporine, tacrolimus Methylxanthines… (Fachinformation zu Rifapentin, Arzneimittelwechselwirkungen)

Similar significant increases in plasma concentrations of saxagliptin are anticipated with other strong CYP3A4/5 inhibitors (e.g., atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, ritonavir, saquinavir, and telithromycin). (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Salicylates may enhance the hypoglycemic effect of oral antidiabetic drugs of the sulfonylurea class. (Fachinformation zu Salsalat, Arzneimittelwechselwirkungen)

Use caution in a patient with a history of angioedema to another dipeptidyl peptidase-4 (DPP-4) inhibitor because it is unknown whether such patients will be predisposed to angioedema with saxagliptin. (Fachinformation zu Saxagliptin, Warnhinweise und Vorsichtsmaßnahmen)

Use caution in a patient with a history of angioedema to another dipeptidyl peptidase-4 (DPP-4) inhibitor because it is unknown whether such patients will be predisposed to angioedema with saxagliptin. (Fachinformation zu Saxagliptin, Warnhinweise und Vorsichtsmaßnahmen)

Use caution in a patient with a history of angioedema to another dipeptidyl peptidase-4 (DPP-4) inhibitor because it is unknown whether such patients will be predisposed to angioedema with saxagliptin. (Fachinformation zu Saxagliptin, Warnhinweise und Vorsichtsmaßnahmen)

The doses of antidiabetic agents may require adjustment when HUMATROPE is initiated. (Fachinformation zu Somatropin, Warnhinweise und Vorsichtsmaßnahmen)

Insulin and Oral Antidiabetics Hyperglycemia may occur, and the dosage of insulin or antidiabetic drugs may require adjustment. (Fachinformation zu Sotalol, Arzneimittelwechselwirkungen)

Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (Fachinformation zu Spironolacton und Hydrochlorothiazid, Arzneimittelwechselwirkungen)

Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (Fachinformation zu Sulfamethoxazol und Trimethoprim (Cotrimoxazol), Arzneimittelwechselwirkungen)

• Hypoglycemia : Check blood glucose levels regularly and assess if antidiabetic drug dose modifications are required. (Fachinformation zu Sunitinib, Warnhinweise und Vorsichtsmaßnahmen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Antidiabetic drugs: Dosage adjustment may be required ( 7.6 ) (Fachinformation zu Telmisartan und Hydrochlorothiazid, Arzneimittelwechselwirkungen)

This may result in the need for an increase in the dose of, or initiation of, insulin and/or oral hypoglycemic agent therapy. (Fachinformation zu Temsirolimus, Warnhinweise und Vorsichtsmaßnahmen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Masking of Hypoglycemic Symptoms in Patients with Diabetes Mellitus Beta-adrenergic blocking agents should be administered with caution in patients subject to spontaneous hypoglycemia or to diabetic patients (especially those with labile diabetes) who are receiving insulin or oral hypoglycemic agents. (Fachinformation zu Timolol, Warnhinweise und Vorsichtsmaßnahmen)

• Hypoglycemia with Concomitant Use of Insulin or Insulin Secretagogues: Consider a lower dosage of insulin or insulin secretagogue when used in combination wtih Saxagliptin tablets ( 5.3 ) (Fachinformation zu Saxagliptin, Warnhinweise und Vorsichtsmaßnahmen)

(See PRECAUTIONS . ) Antidiabetic Agents Concomitant use of ACE inhibitors and antidiabetic medicines (insulin or oral hypoglycemic agents) may cause an increased blood glucose lowering effect with greater risk of hypoglycemia. (Fachinformation zu Trandolapril, Arzneimittelwechselwirkungen)

Hypoglycemia in Diabetic Patients Some MAOIs have contributed to hypoglycemic episodes in diabetic patients receiving insulin or other blood-glucose-lowering agents. (Fachinformation zu Tranylcypromin, Warnhinweise und Vorsichtsmaßnahmen)

Antidiabetics: Because corticosteroids may increase blood glucose concentrations, dosage adjustments of antidiabetic agents may be required. (Fachinformation zu Triamcinolon, Arzneimittelwechselwirkungen)

Dyrenium (triamterene) may raise blood glucose levels; for adult-onset diabetes, dosage adjustments of hypoglycemic agents may be necessary during and/or after therapy; concurrent use with chlorpropamide may increase the risk of severe hyponatremia. (Fachinformation zu Triamteren, Arzneimittelwechselwirkungen)

Oral Hypoglycemic Drugs Concurrent use with chlorpropamide may increase the risk of severe hyponatremia. (Fachinformation zu Triamteren und Hydrochlorothiazid, Arzneimittelwechselwirkungen)

Hydrochlorothiazide: When administered concurrently, the following drugs may interact with thiazide diuretics: Antidiabetic Drugs (oral agents and insulin) - Dosage adjustment of the antidiabetic drug may be required. (Fachinformation zu Valsartan und Hydrochlorothiazid, Arzneimittelwechselwirkungen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Strong Inhibitors of CYP3A4/5 Enzymes Ketoconazole significantly increased saxagliptin exposure. (Fachinformation zu Saxagliptin, Arzneimittelwechselwirkungen)

Antidiabetic drug requirements (i.e., insulin) may be altered. (Fachinformation zu Amfepramon, Arzneimittelwechselwirkungen)

Additional predisposing conditions include diabetes mellitus treated with oral hypoglycemic drugs or insulin, use of anorectic drugs, excessive use of alcohol, use of benzodiazepines, sedatives/hypnotics, or opiates. (Fachinformation zu Bupropion, Warnhinweise und Vorsichtsmaßnahmen)

In some cases, hyperglycemia has resolved when the atypical antipsychotic was discontinued; however, some patients required continuation of antidiabetic treatment despite discontinuation of the suspect drug. (Fachinformation zu Clozapin, Warnhinweise und Vorsichtsmaßnahmen)

Oral Hypoglycemic Agents In pharmacokinetic studies of lovastatin in hypercholesterolemic non-insulin dependent diabetic patients, there was no drug interaction with glipizide or with chlorpropamide (see CLINICAL PHARMACOLOGY , Clinical Studies in Adults ). (Fachinformation zu Lovastatin, Arzneimittelwechselwirkungen)

Although the systemic absorption of miconazole following ORAVIG administration is minimal and plasma concentrations of miconazole are substantially lower than when given intravenously, the potential for interaction with drugs metabolized through CYP2C9 and CYP3A4 such as oral hypoglycemics, phenytoin, or ergot alkaloids cannot be ruled out. (Fachinformation zu Miconazol, Arzneimittelwechselwirkungen)

Moexipril hydrochloride has been used in clinical trials concomitantly with calcium-channel-blocking agents, diuretics, H 2 blockers, digoxin, oral hypoglycemic agents, and cholesterol-lowering agents. (Fachinformation zu Moexipril, Arzneimittelwechselwirkungen)

Glucose Lowering Drugs Pioglitazone: Co-administration of pioglitazone for 7 days with 30 mg nifedipine ER administered orally q.d. for 4 days to male and female volunteers resulted in least square mean (90% CI) values for unchanged nifedipine of 0.83 (0.73-0.95) for C max and 0.88 (0.80-0.96) for AUC relative to nifedipine monotherapy. (Fachinformation zu Nifedipin, Vorsichtsmaßnahmen)

Insulin and Oral Hypoglycemic Medications Requirements may be altered. (Fachinformation zu Phendimetrazin, Arzneimittelwechselwirkungen)

Potentiation of the action of sulfonylurea hypoglycemic agents, thiazide diuretics and uricosuric agents may also be noted. (Fachinformation zu Sulfadiazin, Arzneimittelwechselwirkungen)

Drug Interactions with Amlodipine In clinical trials, amlodipine has been safely administered with thiazide diuretics, beta-blockers, angiotensin-converting enzyme inhibitors, long-acting nitrates, sublingual nitroglycerin, digoxin, warfarin, non-steroidal anti-inflammatory drugs, antibiotics, and oral hypoglycemic drugs. (Fachinformation zu Telmisartan und Amlodipin, Arzneimittelwechselwirkungen)

Hypoglycemic Agents: In adult diabetic patients under treatment with either sulfonylureas or insulin there is no change in the clinical effects of either TOLECTIN or the hypoglycemic agents. (Fachinformation zu Tolmetin, Arzneimittelwechselwirkungen)

In some cases, hyperglycemia has resolved when the atypical antipsychotic was discontinued; however, some patients required continuation of antidiabetic treatment despite discontinuation of the suspect drug. (Fachinformation zu Ziprasidon, Warnhinweise und Vorsichtsmaßnahmen)

Oral hypoglycemic agents Although sulindac and its sulfide metabolite are highly bound to protein, studies in which sulindac was given at a dose of 400 mg daily, have shown no clinically significant interaction with oral hypoglycemic agents. (Fachinformation zu Sulindac, Arzneimittelwechselwirkungen)