More presentations from Naina Mohamed Pakkir Maideen
Ø Diabetes patients may need other drugs to control the coexisting problems-
· ACEIs or ARBs for high blood pressure, heart, or kidney failure
· Diuretics, CCBs or beta-blockers for high blood pressure
· Statins for high cholesterol
· Fibrates for high triglycerides
· Aspirin or Clopidogrel to prevent a heart attack
Ø Combined use of Antidiabetics, Antihypertensives and Lipid regulating drugs may result into either decreased effectiveness or increased adverse effects of drugs.
Ø Thiazide diuretics tend to have diabetogenic effect and hence they reduce the effectiveness of Antidiabetics such as Sulfonylureas, Meglitinides, Thiazolidinediones and DPP4 inhibitors.
Ø The risk of hypoglycemia is increased by the concomitant use of Antidiabetics (sulfonylureas, meglitinides and Metformin) and ACE Inhbitors.
Ø Concurrent therapy with a Beta blocker and an antidiabetic may increase the risk of hypoglycemia or hyperglycemia due to altered glucose metabolism.
Ø Thiazide diuretics, Potassium sparing diuretics (Amiloride or Triamterene) or Nifedipine may increase the risk of lactic acidosis when they are coadministered with Metformin.
Ø The antihypertensive efficacy of Nifedipine and Nimodipine may be decreased by the addition of Pioglitazone.
Ø Concomitant use of repaglinide and gemfibrozil is Contraindicated due to the inhibition of CYP2C8 enzyme mediated metabolism of repaglinide by Gemfibrozil which leads to hypoglycemic risk.
Ø The risk of hypoglycemia is elevated by the coadministration of Antidiabetics (Pioglitazone, Rosiglitazone and Sulfonylureas) and Gemfibrozil.
Ø Calcium channel blockers (Verapamil or Nifedipine) inhibit CYP3A4 mediated metabolism of Statins and increase risk of musculoskeletal toxicity (Myopathy, Rhabdomyolysis).
Ø To avoid serious drug interactions, the diabetics should consult their physician or pharmacist particularly when they begin to take a new medicine.
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