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Oral Diabetes Medications (cont.)

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What are the warnings and precautions for non-insulin diabetes medications?

Diabetes medications can have interactions with other medications or supplements being used. Use of more than one diabetes medication can increase the risk for hypoglycemia. Beta-blocker medications can mask the symptoms of hypoglycemia.

Sulfonylureasmay increase the risk of death from cardiovascular disease. Prolonged exercise and alcohol intake increase the risk for hypoglycemia. Patients undergoing surgery or who have had recent trauma, stress, or infection may need to switch from a sulfonylurea to insulin to manage blood sugar levels. People with kidney or liver disease need to take precaution.

Because meglitinides may cause hypoglycemia, they should be taken right before meals to minimize the possibility of hypoglycemia. If a meal is to be skipped, the dose of the medication should also be skipped.

Thiazolidinediones may cause or exacerbate heart failure. Trouble breathing, rapid weight gain and fluid retention may indicate the onset of heart failure.

Avandia may potentially increase the risk of heart attack.

Alpha-glucosidase inhibitors should not be used in people with intestinal diseases such as inflammatory bowel disease or intestinal obstruction. People with kidney dysfunction may not be able to these medications.

Alpha-glucosidase inhibitors should be taken with the first bite of each meal.

Patients with kidney disease may require dosage adjustment if they are using a DPP-4 inhibitor.

People with a history of liver disease, heavy drinking, or kidney disease may not be able to take biguanides. Inform medical personnel of biguanide use prior to any radiological tests which require injection of dye.

Severe hypersensitivity reactions have occurred during use of sitagliptin.

Pramlintide is only appropriate for certain people with diabetes who use insulin and are having problems maintaining their blood sugar levels. Because of the potential for severe hypoglycemia with the use of pramlintide is with insulin, adjustments to insulin dosage and more frequent glucose monitoring may be necessary. Insulin and pramlintide should not be mixed in the same syringe.

Exenatide may increase the risk of severe even fatal pancreatitis. Byetta should not be used in people with type 1 diabetes or to treat diabetic ketoacidosis.

Patients with severe kidney disease or gastrointestinal disease should not use exenatide.

Hypersensitivity reactions may occur following treatment with exenatide due to formation of antibodies.



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