Tirzépatide : interactions médicamenteuses

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 ). (notice Chloroquine, Mises en garde)

Antidiabetic agents Hypoglycemia including fatal outcomes have been reported. (notice Ciprofloxacine, Interactions médicamenteuses)

Diabetic ketoacidosis should be treated with insulin [see Warnings and Precautions (5.1) and Warnings and Precautions (5.2) ] . (notice Dapagliflozine et metformine, Contre-indications)

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. (notice Fluconazole, Interactions médicamenteuses)

These conditions should be treated with insulin. (notice Glibenclamide, Contre-indications)

Diabetic ketoacidosis should be treated with insulin. (notice Glipizide et metformine, Contre-indications)

Hypoglycemia PLAQUENIL can cause severe and potentially life-threatening hypoglycemia, in the presence or absence of antidiabetic agents [see Drug Interactions (7) ]. (notice Hydroxychloroquine, Mises en garde et précautions)

To avoid medication errors between LEVEMIR and other insulins, instruct patients to always check the insulin label before each injection. (notice Insuline détémir, Mises en garde et précautions)

To avoid medication errors between LYUMJEV and other insulins, instruct patients to always check the insulin label before each injection. (notice Insuline lispro, Mises en garde et précautions)

WARNING: RISK OF THYROID C-CELL TUMORS In rats, tirzepatide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures. (notice Tirzépatide, Mise en garde encadrée)

WARNING: RISK OF THYROID C-CELL TUMORS In rats, tirzepatide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures. (notice Tirzépatide, Mise en garde encadrée)

WARNING: RISK OF THYROID C-CELL TUMORS In rats, tirzepatide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures. (notice Tirzépatide, Mise en garde encadrée)

WARNING: RISK OF THYROID C-CELL TUMORS In rats, tirzepatide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures. (notice Tirzépatide, Mise en garde encadrée)

Risk factors include high dose or overdose, rapid administration (see WARNINGS and DOSAGE AND ADMINISTRATION ), repeated doses, previous administration of protamine, and current or previous use of protamine-containing drugs (NPH insulin, protamine zinc insulin, and certain beta-blockers). (notice Protamine, Mise en garde encadrée)

Diabetic ketoacidosis should be treated with insulin. (notice Saxagliptine et metformine, Contre-indications)

WARNING: RISK OF THYROID C-CELL TUMORS In rats, tirzepatide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures. (notice Tirzépatide, Mise en garde encadrée)

WARNING: RISK OF THYROID C-CELL TUMORS In rats, tirzepatide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures. (notice Tirzépatide, Mise en garde encadrée)

Monitor blood glucose in patients with diabetes and assess if antidiabetic agent dose modifications are required. (notice Abiratérone, Mises en garde et précautions)

When such drugs are withdrawn from patients receiving acarbose tablets in combination with sulfonylureas or insulin, patients should be observed closely for any evidence of hypoglycemia. (notice Acarbose, Interactions médicamenteuses)

Diabetes and Hypoglycemia β-blockers may potentiate insulin-induced hypoglycemia and mask some of its manifestations such as tachycardia; however, dizziness and sweating are usually not significantly affected. (notice Acébutolol, Mises en garde)

Consideration should be taken in patients being treated with antidiabetic agents. (notice Acétazolamide, Interactions médicamenteuses)

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. (notice Acitrétine, Interactions médicamenteuses)

L'alcool peut provoquer une hypoglycémie avec l'insuline ou les sulfamides hypoglycémiants, et une forte consommation d'alcool avec la metformine augmente le risque d'acidose lactique. (NIAAA, Harmful Interactions: Mixing Alcohol with Medicines)

Hypoglycemia: Consider lowering the dosage of insulin secretagogue or insulin to reduce the risk of hypoglycemia when initiating Alogliptin tablets. (notice Alogliptine, Mises en garde et précautions)

Hypoglycemia: Consider lowering the dosage of insulin secretagogue or insulin to reduce the risk of hypoglycemia when initiating Alogliptin and metformin HCl tablets. (notice Alogliptine et metformine, Mises en garde et précautions)

Antidiabetic Agents: In rare cases, diabetic patients receiving an ACE inhibitor (including benazepril) concomitantly with insulin or oral antidiabetics may develop hypoglycemia. (notice Amlodipine et bénazépril, Interactions médicamenteuses)

Oral Hypoglycemics Moderate doses of aspirin may increase the effectiveness of oral hypoglycemic drugs, leading to hypoglycemia. (notice Aspirine et dipyridamole, Interactions médicamenteuses)

Some patients required either initiation or dose adjustments of insulin or oral hypoglycemic agents for treatment of these events. (notice Atazanavir, Mises en garde et précautions)

At recommended doses atenolol does not potentiate insulin-induced hypoglycemia and, unlike nonselective beta- blockers, does not delay recovery of blood glucose to normal levels. (notice Aténolol et chlortalidone, Mises en garde)

Antidiabetics: Increased risk of hypoglycemia ( 7.2 ) (notice Bénazépril, Interactions médicamenteuses)

Antidiabetic agents: Dosage adjustment of antidiabetic drug may be required. (notice Bénazépril et hydrochlorothiazide, Interactions médicamenteuses)

Unlike nonselective beta-blockers, betaxolol does not prolong insulin-induced hypoglycemia. (notice Bétaxolol, Mises en garde)

Hypoglycemia: Consider a lower dose of insulin or insulin secretagogue to reduce risk of hypoglycemia when used in combination with bexagliflozin tablets. (notice Bexagliflozine, Mises en garde et précautions)

Hypoglycemia Risk in Patients with Diabetes Mellitus In patients using insulin, agents enhancing insulin secretion (e.g., sulfonylureas), or insulin sensitizers (e.g., thiazolidinedione class), based on the mechanism of action, TARGRETIN could enhance the action of these agents, resulting in hypoglycemia. (notice Bexarotène, Mises en garde et précautions)

Nonselective beta-blockers may potentiate insulin-induced hypoglycemia and delay recovery of serum glucose levels. (notice Bisoprolol, Mises en garde)

Also, latent diabetes mellitus may become manifest and diabetic patients given thiazides may require adjustment of their insulin dose. (notice Bisoprolol et hydrochlorothiazide, Mises en garde)

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. (notice Brimonidine et timolol, Mises en garde et précautions)

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. (notice Butalbital, aspirine et caféine, Interactions médicamenteuses)

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. (notice Butalbital, aspirine, caféine et codéine, Interactions médicamenteuses)

• Hypoglycemia with Concomitant Use with Insulin or Insulin Secretagogues : Consider a lower dose of insulin or the insulin secretagogue to reduce the risk of hypoglycemia when used in combination with INVOKANA ( 5.5 ). (notice Canagliflozine, Mises en garde et précautions)

Antidiabetic drugs (oral agents and insulin) − Dosage adjustment of the antidiabetic drug may be required. (notice Candésartan et hydrochlorothiazide, Interactions médicamenteuses)

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). (notice Capécitabine, Interactions médicamenteuses)

During the 8-week trial, serum insulin levels increased by 12 pmol/L in the VRAYLAR 1 mg to 2 mg per day group, 20 pmol/L in the VRAYLAR 2 mg to 4.5 mg per day group, and 8.5 pmol/L in the placebo group. (notice Cariprazine, Mises en garde et précautions)

Insulin and oral hypoglycemics action may be enhanced. (notice Carvédilol, Interactions médicamenteuses)

Antidiabetic Drugs (Oral Agents and Insulin) - dosage adjustment of the antidiabetic drug may be required. (notice Chlorothiazide, Interactions médicamenteuses)

Oral Hypoglycemic Agents/Insulin: The concomitant use of clarithromycin tablets and oral hypoglycemic agents and/or insulin can result in significant hypoglycemia. (notice Clarithromycine, Mises en garde et précautions)

…placebo) and when colesevelam hydrochloride was used in combination with pioglitazone (median increase 11% compared to placebo in combination with pioglitazone), sulfonylureas (median increase 18% compared to placebo in combination with sulfonylureas), and insulin (median increase 22% compared to placebo in combination with insulin) [see Adverse Reactions (6.1) ]. (notice Colésévélam, Mises en garde et précautions)

Caution should be exercised when used with antidiabetic drugs. (notice Danazol, Interactions médicamenteuses)

• Hypoglycemia: Consider a lower dose of insulin or the insulin secretagogue to reduce the risk of hypoglycemia when used in combination with DAPAGLIFLOZIN TABLETS. (notice Dapagliflozine, Mises en garde et précautions)

Initiation or dose adjustments of insulin or oral hypoglycemic agents may be required. (notice Darunavir, Mises en garde et précautions)

Some patients required either initiation or dose adjustments of insulin or oral hypoglycemic agents for treatment of these events. (notice Darunavir et cobicistat, Mises en garde et précautions)

Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation with ZEPBOUND and for 4 weeks after each dose escalation. (notice Tirzépatide, Interactions médicamenteuses)

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. (notice Dexaméthasone, Mises en garde et précautions)

Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation with ZEPBOUND and for 4 weeks after each dose escalation. (notice Tirzépatide, Interactions médicamenteuses)

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. (notice Dorzolamide et timolol, Mises en garde et précautions)

Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation with ZEPBOUND and for 4 weeks after each dose escalation. (notice Tirzépatide, Interactions médicamenteuses)

Hypoglycemia: Concomitant use with an insulin secretagogue or insulin may increase the risk of hypoglycemia, including severe hypoglycemia. (notice Dulaglutide, Mises en garde et précautions)

The effects of increases in the concentration of the progestational component norgestimate are not fully known and can include increased risk of insulin resistance, dyslipidemia, acne, and venous thrombosis. (notice Elvitégravir, cobicistat, emtricitabine et ténofovir, Interactions médicamenteuses)

Hypoglycemia: Adult patients taking an insulin secretagogue or insulin may have an increased risk of hypoglycemia. (notice Empagliflozine, Mises en garde et précautions)

Hypoglycemia: Adult patients taking an insulin secretagogue or insulin may have an increased risk of hypoglycemia. (notice Empagliflozine et metformine, Mises en garde et précautions)

Anti-diabetic drugs (oral agents and insulin) Dosage adjustment of the anti-diabetic drug may be required. (notice Énalapril et hydrochlorothiazide, Interactions médicamenteuses)

Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation with ZEPBOUND and for 4 weeks after each dose escalation. (notice Tirzépatide, Interactions médicamenteuses)

Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation with ZEPBOUND and for 4 weeks after each dose escalation. (notice Tirzépatide, Interactions médicamenteuses)

Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation with ZEPBOUND and for 4 weeks after each dose escalation. (notice Tirzépatide, Interactions médicamenteuses)

Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation with ZEPBOUND and for 4 weeks after each dose escalation. (notice Tirzépatide, Interactions médicamenteuses)

Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation with ZEPBOUND and for 4 weeks after each dose escalation. (notice Tirzépatide, Interactions médicamenteuses)

Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation with ZEPBOUND and for 4 weeks after each dose escalation. (notice Tirzépatide, Interactions médicamenteuses)

Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation with ZEPBOUND and for 4 weeks after each dose escalation. (notice Tirzépatide, Interactions médicamenteuses)

• Hypoglycemia with Concomitant Use of Insulin Secretagogues or Insulin: Patients taking an insulin secretagogue or insulin may have an increased risk of hypoglycemia, including severe hypoglycemia. (notice Exénatide, Mises en garde et précautions)

Monitor for symptoms of hyperglycemia; adjust dosage of antidiabetic drug upward if necessary. (notice Fludrocortisone, Interactions médicamenteuses)

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. (notice Fluoxétine, Mises en garde et précautions)

Some patients required either initiation or dose adjustments of insulin or oral hypoglycemic agents for treatment of these events. (notice Fosamprénavir, Mises en garde et précautions)

Insulin requirements in diabetic patients may be increased, decreased, or unchanged. (notice Fosinopril et hydrochlorothiazide, Interactions médicamenteuses)

Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation with ZEPBOUND and for 4 weeks after each dose escalation. (notice Tirzépatide, Interactions médicamenteuses)

Hypoglycemia: Concomitant use with insulin or an insulin secretagogue may increase the risk of hypoglycemia, including severe hypoglycemia. (notice Tirzépatide, Mises en garde et précautions)

Hypoglycemia: Concomitant use with insulin or an insulin secretagogue may increase the risk of hypoglycemia, including severe hypoglycemia. (notice Tirzépatide, Mises en garde et précautions)

Hypoglycemia: Concomitant use with insulin or an insulin secretagogue may increase the risk of hypoglycemia, including severe hypoglycemia. (notice Tirzépatide, Mises en garde et précautions)

Hypoglycemia in Patients with Insulinoma: In patients with insulinoma, administration may produce an initial increase in blood glucose; however, glucagon may stimulate exaggerated insulin release from an insulinoma and cause hypoglycemia. (notice Glucagon, Mises en garde et précautions)

Antidiabetic drugs: Dosage adjustment of antidiabetic may be required (7.2) (notice Hydrochlorothiazide, Interactions médicamenteuses)

Antidiabetic Agents Clinical Impact: Corticosteroids in supraphysiologic doses may increase blood glucose concentrations. (notice Hydrocortisone, Interactions médicamenteuses)

Hydroxyurea may falsely elevate sensor glucose results from certain continuous glucose monitoring (CGM) systems and may lead to hypoglycemia if sensor glucose results are relied upon to dose insulin. (notice Hydroxycarbamide, Mises en garde et précautions)

Increase frequency of glucose monitoring with changes to: insulin dosage, concomitantly administered glucose lowering medications, meal pattern, physical activity; and in patients with renal or hepatic impairments and hypoglycemia unawareness ( 5. (notice Insuline asparte, Mises en garde et précautions)

The risk of hypoglycemia after an injection is related to the duration of action of the insulin [see Clinical Pharmacology ( 12.2 )] and, in general, is highest when the glucose lowering effect of the insulin is maximal. (notice Insuline dégludec, Mises en garde et précautions)

For patients with type 2 diabetes, dosage adjustments of concomitant oral and antidiabetic products may be needed. (notice Insuline glargine, Mises en garde et précautions)

For patients with type 2 diabetes mellitus, oral antidiabetic treatment dosage modifications may be needed. (notice Insuline rapide (humaine), Mises en garde et précautions)

Antidiabetic drugs: Dosage adjustment of antidiabetic may be required. (notice Irbésartan et hydrochlorothiazide, Interactions médicamenteuses)

Antidiabetic Drugs Repaglinide Saxagliptin Monitor for adverse reactions. (notice Itraconazole, Interactions médicamenteuses)

Antidiabetics repaglinide, saxagliptin Antihelmintics and Antiprotozoals praziquantel Antimigraine Drugs ergot alkaloids, such as dihydroergotamine, ergometrine (ergonovine), ergotamine, methylergometrine (methylergonovine) eletriptan Ergot alkaloids: The potential increase in plasma concentrations of ergot alkaloids when coadministered with ketoconazole tablets… (notice Kétoconazole, Interactions médicamenteuses)

Hyperglycemia and Hypoglycemia : Glucose monitoring is recommended and antidiabetic treatment adjusted accordingly. (notice Lanréotide, Mises en garde et précautions)

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. (notice Lévofloxacine, Mises en garde et précautions)

Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation with ZEPBOUND and for 4 weeks after each dose escalation. (notice Tirzépatide, Interactions médicamenteuses)

Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation with ZEPBOUND and for 4 weeks after each dose escalation. (notice Tirzépatide, Interactions médicamenteuses)

Hypoglycemia: Consider lowering the dosage of insulin secretagogue or insulin to reduce the risk of hypoglycemia when initiating TRADJENTA ( 5.2 ) (notice Linagliptine, Mises en garde et précautions)

Hypoglycemia: Consider lowering the dosage of insulin secretagogue or insulin to reduce the risk of hypoglycemia when initiating JENTADUETO XR. (notice Linagliptine et metformine, Mises en garde et précautions)

• Hypoglycemia: Postmarketing cases of symptomatic hypoglycemia have been reported in patients with diabetes mellitus receiving insulin or oral hypoglycemic agents. (notice Linézolide, Mises en garde et précautions)

• Hypoglycemia : Adult patients taking an insulin secretagogue or insulin may have an increased risk of hypoglycemia, including severe hypoglycemia. (notice Liraglutide, Mises en garde et précautions)

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

Antidiabetic drugs (oral agents and insulin) - dosage adjustment of the antidiabetic drug may be required. (notice Lisinopril et hydrochlorothiazide, Interactions médicamenteuses)

Some patients required either initiation or dose adjustments of insulin or oral hypoglycemic agents for treatment of these events. (notice Lopinavir et ritonavir, Mises en garde et précautions)

Antidiabetic drugs: dosage adjustment of antidiabetic may be required. (notice Losartan et hydrochlorothiazide, Interactions médicamenteuses)

Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation with ZEPBOUND and for 4 weeks after each dose escalation. (notice Tirzépatide, Interactions médicamenteuses)

Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation with ZEPBOUND and for 4 weeks after each dose escalation. (notice Tirzépatide, Interactions médicamenteuses)

Hypoglycemia with Concomitant Use with Insulin and Insulin Secretagogues : Increased risk of hypoglycemia when used in combination with insulin and/or an insulin secretagogue. (notice Metformine, Mises en garde et précautions)

Antidiabetics : Because corticosteroids may increase blood glucose concentrations, dosage adjustments of antidiabetic agents may be required. (notice Méthylprednisolone, Interactions médicamenteuses)

Insulin: In diabetic patients the metabolic effects of androgens may decrease blood glucose and insulin requirements. (notice Méthyltestostérone, Interactions médicamenteuses)

Insulin Clinical Impact Increased GI motility by metoclopramide may increase delivery of food to the intestines and increase blood glucose. (notice Métoclopramide, Interactions médicamenteuses)

Insulin And Oral Antidiabetic Agents See Glucose Tolerance under PRECAUTIONS , General . (notice Métolazone, Interactions médicamenteuses)

Antidiabetic drugs: Dosage adjustment may be required. (notice Métoprolol et hydrochlorothiazide, Interactions médicamenteuses)

Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation with ZEPBOUND and for 4 weeks after each dose escalation. (notice Tirzépatide, Interactions médicamenteuses)

Antidiabetic agents Carefully monitor blood glucose. (notice Moxifloxacine, Interactions médicamenteuses)

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

Use of Antidiabetic Medications: Weight loss may cause hypoglycemia. (notice Naltrexone et bupropion, Mises en garde et précautions)

Hypoglycemia: Concomitant use with insulin or an insulin secretagogue may increase the risk of hypoglycemia, including severe hypoglycemia. (notice Tirzépatide, Mises en garde et précautions)

Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation with ZEPBOUND and for 4 weeks after each dose escalation. (notice Tirzépatide, Interactions médicamenteuses)

Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation with ZEPBOUND and for 4 weeks after each dose escalation. (notice Tirzépatide, Interactions médicamenteuses)

Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation with ZEPBOUND and for 4 weeks after each dose escalation. (notice Tirzépatide, Interactions médicamenteuses)

Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation with ZEPBOUND and for 4 weeks after each dose escalation. (notice Tirzépatide, Interactions médicamenteuses)

Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation with ZEPBOUND and for 4 weeks after each dose escalation. (notice Tirzépatide, Interactions médicamenteuses)

Hypoglycemia or Hyperglycemia: Monitor glucose and adjust antidiabetic treatment as needed (‎ 5.2 ). (notice Octréotide, Mises en garde et précautions)

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. (notice Ofloxacine, Mises en garde)

• Antidiabetic drugs: Dosage adjustment may be required. (notice Olmésartan et hydrochlorothiazide, Interactions médicamenteuses)

• Increased amlodipine exposure when coadministered with CYP3A inhibitors Hydrochlorothiazide ( 7.3 ): • Antidiabetic drugs: Dosage adjustment of antidiabetic may be required. (notice Olmésartan, amlodipine et hydrochlorothiazide, Interactions médicamenteuses)

A reduction in dose of oral hypoglycemic medication (e.g., sulfonylureas) or insulin may be required in some patients [see Clinical Studies (14) ] . (notice Orlistat, Mises en garde et précautions)

• A reduction in dose of insulin or oral hypoglycemic medication may be required in some patients. (notice Phentermine, Mises en garde et précautions)

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

Combination use with insulin and use in congestive heart failure NYHA Class I and II may increase risk. (notice Pioglitazone, Mises en garde et précautions)

Hypoglycemia: Concomitant use with insulin or an insulin secretagogue may increase the risk of hypoglycemia, including severe hypoglycemia. (notice Tirzépatide, Mises en garde et précautions)

Combination use with insulin and use in congestive heart failure NYHA Class I and II may increase risk. (notice Pioglitazone et metformine, Mises en garde et précautions)

Antidiabetic Agents: Because corticosteroids may increase blood glucose concentrations, dosage adjustments of antidiabetic agents may be required. (notice Prednisolone, Interactions médicamenteuses)

Antidiabetic agents: May increase blood glucose concentrations. (notice Prednisone, Interactions médicamenteuses)

Monitor patients for the development of edema when co-administering LYRICA CR and thiazolidinedione antidiabetic agents. (notice Prégabaline, Mises en garde et précautions)

Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation with ZEPBOUND and for 4 weeks after each dose escalation. (notice Tirzépatide, Interactions médicamenteuses)

Hypoglycemia Quinine stimulates release of insulin from the pancreas, and patients, especially pregnant women, may experience clinically significant hypoglycemia. (notice Quinine, Mises en garde et précautions)

Hypoglycemia: Concomitant use with insulin or an insulin secretagogue may increase the risk of hypoglycemia, including severe hypoglycemia. (notice Tirzépatide, Mises en garde et précautions)

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. (notice Rifampicine, Interactions médicamenteuses)

…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… (notice Rifapentine, Interactions médicamenteuses)

Some patients required either initiation or dose adjustments of insulin or oral hypoglycemic agents for treatment of these events. (notice Ritonavir, Mises en garde et précautions)

Salicylates may enhance the hypoglycemic effect of oral antidiabetic drugs of the sulfonylurea class. (notice Salsalate, Interactions médicamenteuses)

• 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 ) (notice Saxagliptine, Mises en garde et précautions)

• Hypoglycemia with Concomitant Use of Insulin Secretagogues or Insulin : May increase the risk of hypoglycemia, including severe hypoglycemia. (notice Sémaglutide, Mises en garde et précautions)

Hypoglycemia with Concomitant Use with Insulin or Insulin Secretagogues: Increased risk of hypoglycemia when used in combination with insulin and/or an insulin secretagogue. (notice Sitagliptine, Mises en garde et précautions)

Hypoglycemia with Concomitant Use with Insulin or Insulin Secretagogues: Increased risk of hypoglycemia when used in combination with insulin and/or an insulin secretagogue. (notice Sitagliptine et metformine, Mises en garde et précautions)

Glucose Intolerance and Diabetes Mellitus: HUMATROPE may decrease insulin sensitivity, particularly at higher doses. (notice Somatropine, Mises en garde et précautions)

Insulin and Oral Antidiabetics Hyperglycemia may occur, and the dosage of insulin or antidiabetic drugs may require adjustment. (notice Sotalol, Interactions médicamenteuses)

Antidiabetic drugs (e.g., oral agents, insulin): Dosage adjustment of the antidiabetic drug may be required (see Precautions ). (notice Spironolactone et hydrochlorothiazide, Interactions médicamenteuses)

Like other sulfonamide-containing drugs, sulfamethoxazole and trimethoprim potentiates the effect of oral hypoglycemics. (notice Sulfaméthoxazole et triméthoprime, Interactions médicamenteuses)

• Hypoglycemia : Check blood glucose levels regularly and assess if antidiabetic drug dose modifications are required. (notice Sunitinib, Mises en garde et précautions)

Antidiabetic drugs: Dosage adjustment may be required ( 7.6 ) (notice Telmisartan et hydrochlorothiazide, Interactions médicamenteuses)

This may result in the need for an increase in the dose of, or initiation of, insulin and/or oral hypoglycemic agent therapy. (notice Temsirolimus, Mises en garde et précautions)

Insulin: In patients with diabetes, concomitant use with TLANDO may decrease blood glucose and insulin requirements ( 7.1) . (notice Testostérone, Interactions médicamenteuses)

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. (notice Timolol, Mises en garde et précautions)

(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. (notice Trandolapril, Interactions médicamenteuses)

Hypoglycemia in Diabetic Patients Some MAOIs have contributed to hypoglycemic episodes in diabetic patients receiving insulin or other blood-glucose-lowering agents. (notice Tranylcypromine, Mises en garde et précautions)

Antidiabetics: Because corticosteroids may increase blood glucose concentrations, dosage adjustments of antidiabetic agents may be required. (notice Triamcinolone, Interactions médicamenteuses)

Infusion of glucose and insulin has also been used to treat hyperkalemia. (notice Triamtérène, Mises en garde et précautions)

Oral Hypoglycemic Drugs Concurrent use with chlorpropamide may increase the risk of severe hyponatremia. (notice Triamtérène et hydrochlorothiazide, Interactions médicamenteuses)

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. (notice Valsartan et hydrochlorothiazide, Interactions médicamenteuses)

• Effect of Smoking Cessation on Other Drugs: Pharmacokinetics or pharmacodynamics of certain drugs (e.g., theophylline, warfarin, insulin) may be altered, necessitating dose adjustment. (notice Varénicline, Interactions médicamenteuses)

Sulfonylurea Oral Hypoglycemics (CYP2C9 Inhibition) Not Studied In Vivo or In Vitro , but Drug Plasma Exposure Likely to be Increased Frequent monitoring of blood glucose and for signs and symptoms of hypoglycemia. (notice Voriconazole, Interactions médicamenteuses)

Monitor patients on oral medications dependent on threshold concentrations for efficacy and those with a narrow therapeutic index (e.g., warfarin) when concomitantly administered with ZEPBOUND. (notice Tirzépatide, Interactions médicamenteuses)

Antidiabetic drug requirements (i.e., insulin) may be altered. (notice Amfépramone, Interactions médicamenteuses)

Such measures include the intravenous administration of sodium bicarbonate solution or oral or parenteral glucose with a rapid-acting insulin preparation. (notice Amiloride, Mises en garde)

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. (notice Bupropion, Mises en garde et précautions)

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. (notice Clozapine, Mises en garde et précautions)

Hyperglycemia Hyperglycemia, resulting from the inhibitory effect of phenytoin (the active metabolite of CEREBYX) on insulin release, has been reported. (notice Fosphénytoïne, Mises en garde et précautions)

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 ). (notice Lovastatine, Interactions médicamenteuses)

In an uncontrolled open-label trial of CAPLYTA for up to 1 year in adult patients with stable schizophrenia, the percentages of patients with shifts in fasting glucose and insulin values from normal to high were 8% and 12%, respectively. (notice Lumatépérone, Mises en garde et précautions)

Administer INCRELEX shortly before or after a meal or snack, because it has insulin-like hypoglycemic effects. (notice Mécasermine, Mises en garde et précautions)

Insulin requirements in diabetes mellitus may be altered in association with the use of methamphetamine and the concomitant dietary regimen. (notice Méthamphétamine, Interactions médicamenteuses)

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. (notice Miconazole, Interactions médicamenteuses)

…been observed in limited experience with patients in whom milrinone was used concurrently with the following drugs: digitalis glycosides; lidocaine, quinidine; hydralazine, prazosin; isosorbide dinitrate, nitroglycerin; chlorthalidone, furosemide, hydrochlorothiazide, spironolactone; captopril; heparin, warfarin, diazepam, insulin; and potassium supplements. (notice Milrinone, Interactions médicamenteuses)

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. (notice Moexipril, Interactions médicamenteuses)

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. (notice Nifédipine, Précautions)

Insulin and Oral Hypoglycemic Medications Requirements may be altered. (notice Phendimétrazine, Interactions médicamenteuses)

Hyperglycemia Hyperglycemia, resulting from the drug’s inhibitory effects on insulin release, has been reported. (notice Phénytoïne, Mises en garde et précautions)

…been administered without any adverse drug interaction in limited clinical experience to date with the following: (1) cardiac glycosides– digitalis and digoxin; (2) hypoglycemics–insulin, chlorpropamide, phenformin, tolazamide, and tolbutamide; (3) tranquilizers and sedatives–chlordiazepoxide, diazepam, and phenobarbital; (4) antigout–allopurinol, colchicine,… (notice Prazosine, Interactions médicamenteuses)

Potentiation of the action of sulfonylurea hypoglycemic agents, thiazide diuretics and uricosuric agents may also be noted. (notice Sulfadiazine, Interactions médicamenteuses)

Administration of intravenous calcium, bicarbonate, and glucose with insulin, with hyperventilation have resulted in successful resuscitation in some of the reported cases. (notice Suxaméthonium, Mises en garde et précautions)

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. (notice Telmisartan et amlodipine, Interactions médicamenteuses)

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. (notice Tolmétine, Interactions médicamenteuses)

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. (notice Ziprasidone, Mises en garde et précautions)

Glyburide Clinical Impact: While oxaprozin does alter the pharmacokinetics of glyburide, coadministration of oxaprozin to type II non-insulin dependent diabetic patients did not affect the area under the glucose concentration curve nor the magnitude or duration of control. (notice Oxaprozine, Interactions médicamenteuses)

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. (notice Sulindac, Interactions médicamenteuses)

Other interactions: Vardenafil hydrochloride tablets had no effect on the pharmacodynamics of glyburide (glucose and insulin concentrations) and warfarin (prothrombin time or other pharmacodynamic parameters). (notice Vardénafil, Interactions médicamenteuses)