Oral Hypoglycemics

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Oral Hypoglycemics - Interactions and Warnings

Patients taking drugs with a narrow therapeutic index such as hypoglycemic agents should be discouraged from using herbal products. All drugs with a narrow therapeutic index may either have increased adverse effects or be less effective when used in conjunction with herbal products.
- Crit Care Nurse 2002 Apr;22(2):22-8, 30, 32; quiz 34-5 -- Herbal remedies: drug-herb interactions. -- Kuhn MA.

Aspirin should not be given to patients taking oral hypoglycemics.
- J Am Dent Assoc 1999 Mar;130(3):397-407 -- Adverse drug interactions in dental practice: interactions associated with analgesics, Part III in a series. -- Haas DA.

Those using oral hypoglycemics have diminished B12 absorption and low serum total vitamin B12.
- Diabetes Care 2000 Sep;23(9):1227-31 -- Increased intake of calcium reverses vitamin B12 malabsorption induced by metformin. -- Bauman WA, Shaw S, Jayatilleke E, Spungen AM, Herbert V.

Taking vitamin E may have an adverse effect on blood sugar levels.
- Am J Clin Nutr 1993 May;57(5):650-6 -- Pharmacologic doses of vitamin E improve insulin action in healthy subjects and non-insulin-dependent diabetic patients. -- Paolisso G, D'Amore A, Giugliano D, Ceriello A, Varricchio M, D'Onofrio F.

Use of the thiazolidinediones is associated with a triad of fluid retention, edema, and weight gain. Several published cases from postmarketing data demonstrate that thiazolidinedione-induced fluid retention, exhibited by the initial onset of peripheral edema and weight gain, can progress to a more severe form of pulmonary edema that is refractory to diuretic therapy with resolution of symptoms only through discontinuation of the offending thiazolidinedione. In clinical practice, the occurrence of edema secondary to a thiazolidinedione drug may occur more frequently than reported.
- Diabetes Technol Ther 2002;4(4):505-14 -- Management of rosiglitazone-induced edema: two case reports and a review of the literature. -- Wang F, Aleksunes LM, Reagan LA, Vergara CM.

Avandia’s liver safety profile is not fully determined yet. Do not use Avandia for type I diabetes (juvenile diabetes) or diabetic ketoacidosis. When taking Avandia with other oral diabetes medicines, there is a risk of your blood sugar becoming dangerously low. Ask your health care provider abut symptoms of low blood sugar, conditions that make low blood sugar more likely, and what to do if you get it. Make sure to explain to family members. Avandia, like other drugs in this class, may cause insulin resistant women to start ovulating again. If you are a woman who has not reached menopause but have not had menstrual periods; you may become pregnant unless you use an effective method of birth control.

Drug Specific Information Metaglip

last update: November 2008

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