Insunova Drug Interactions

A number of drugs with Insunova are known to interact with the glucose metabolism. Possible interactions must therefore be taken into account by the physician.
Some of the drugs leading to reduced insulin requirement: Oral hypoglycemic agents (OHA), octreotide, monoamine oxidase inhibitors (MAOIs), non-selective β-blocking agents, angiotensin-converting enzyme (ACE) inhibitors, salicylates, alcohol and anabolic steroids.
Some of the drugs leading to increased insulin requirement: Oral contraceptives, thiazides, glucocorticoids, thyroid hormones and sympathomimetics, danazol, etc. Beta-blocking agents may mask the symptoms of hypoglycaemia and delay recovery from hypoglycaemia.
Alpha-lipoic acid, chromium, ephedra (Ma Huang), Ginkgo biloba, ginseng, etc, when co-prescribed may need a change in the insulin dosage and close monitoring of blood glucose levels.
Food Interactions: Insulin requirements are increased when larger amounts of calories are ingested, especially simple sugars and carbohydrates.
Disease Interactions: Insulin requirements are increased by infections, psychological stress or an uncontrolled overactive thyroid, and often at a time of surgery. Requirements may diminish with kidney disease or a less active adrenal or pituitary gland.
Incompatibilities: In general terms, insulin should only be added to compounds with which it is known to be compatible. Insulin suspensions should not be added in infusion fluids.
Insunova-R Cartridge: Drugs added to the insulin solution may cause degradation of the insulin eg, if the drugs contains thiols or sulphites.
Insunova-G: A number of substances affect glucose metabolism and may require dose adjustment of insulin glargine.
Substances that may enhance the blood glucose-lowering effect and increase susceptibility to hypoglycaemia include oral antidiabetic medicinal products, angiotensin converting enzyme (ACE) inhibitors, disopyramide, fibrates, fluoxetine, monoamine oxidase (MAO) inhibitors, pentoxifylline, propoxyphene, salicylates and sulphonamide antibiotics.
Substances that may reduce the blood glucose-lowering effect include corticosteroids, danazol, diazoxide, diuretics, glucagon, isoniazid, oestrogens and progestogens, phenothiazine derivatives, somatropin, sympathomimetic medicinal products [eg, epinephrine (adrenaline), salbutamol, terbutaline], thyroid hormones, atypical antipsychotic medicinal products (eg, clozapine and olanzapine) and protease inhibitors.
Beta-blockers, clonidine, lithium salts or alcohol may either potentiate or weaken the blood glucose-lowering effect of insulin. Pentamidine may cause hypoglycaemia, which may sometimes be followed by hyperglycaemia.
In addition, under the influence of sympatholytic medicinal products eg, β-blockers, clonidine, guanethidine and reserpine, the signs of adrenergic counter-regulation may be reduced or absent.
Incompatibilities: lnsunova-G must not be mixed with other medicinal products. It is important to ensure that syringes do not contain traces of any other material.