insulin NPH

7 DRUG INTERACTIONS Table 1: Clinically Significant Drug Interactions with HUMULIN N Drugs that May Increase the Risk of Hypoglycemia Drugs: Antidiabetic agents, ACE inhibitors, angiotensin II receptor blocking agents, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, pentoxifylline, pramlintide, salicylates, somatostatin analog (e.g., octreotide), and sulfonamide antibiotics Intervention: Dose adjustment and increased frequency of glucose monitoring may be required when HUMULIN N is co-administered with these drugs.

Mechanism: Fluoxetine can cause insulin to have a stronger effect on your blood sugar, making it more likely to drop below normal levels.

What to do: Check your blood sugar more often and ask your doctor if your insulin dose needs to be adjusted.

7 DRUG INTERACTIONS Table 1: Clinically Significant Drug Interactions with HUMULIN N Drugs that May Increase the Risk of Hypoglycemia Drugs: Antidiabetic agents, ACE inhibitors, angiotensin II receptor blocking agents, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, pentoxifylline, pramlintide, salicylates, somatostatin analog (e.g., octreotide), and sulfonamide antibiotics Intervention: Dose adjustment and increased frequency of glucose monitoring may be required when HUMULIN N is co-administered with these drugs.

Mechanism: Both medicines lower blood sugar, so using them at the same time increases the risk of your blood sugar dropping too low.

What to do: Your doctor may need to adjust your insulin dose and you should check your blood sugar levels more often.

7 DRUG INTERACTIONS Table 1: Clinically Significant Drug Interactions with HUMULIN N Drugs that May Increase the Risk of Hypoglycemia Drugs: Antidiabetic agents, ACE inhibitors, angiotensin II receptor blocking agents, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, pentoxifylline, pramlintide, salicylates, somatostatin analog (e.g., octreotide), and sulfonamide antibiotics Intervention: Dose adjustment and increased frequency of glucose monitoring may be required when HUMULIN N is co-administered with these drugs.

Mechanism: Octreotide can lower blood sugar, which adds to the effect of the insulin and makes a dangerous drop in blood sugar more likely.

What to do: You may need a dose adjustment and should monitor your blood sugar more frequently while taking both drugs.

Drugs that May Decrease the Blood Glucose Lowering Effect of HUMULIN N Drugs: Atypical antipsychotics (e.g., olanzapine and clozapine), corticosteroids, danazol, diuretics, estrogens, glucagon, isoniazid, niacin, oral contraceptives, phenothiazines, progestogens (e.g., in oral contraceptives), protease inhibitors, somatropin, sympathomimetic agents (e.g., albuterol, epinephrine, terbutaline), and thyroid hormones.

Mechanism: Albuterol is a stimulant-like drug that can raise blood sugar, making your insulin work less effectively.

What to do: Your doctor may need to adjust your insulin dose or have you check your blood sugar more often.

Drugs that May Increase or Decrease the Blood Glucose Lowering Effect of HUMULIN N Drugs: Alcohol, beta-blockers, clonidine, and lithium salts. Drugs that May Blunt Signs and Symptoms of Hypoglycemia Drugs: Beta-blockers, clonidine, guanethidine, and reserpine Intervention: Increased frequency of glucose monitoring may be required when HUMULIN N is co-administered with these drugs. ( 7 ) Antiadrenergic Drugs (e.g., beta-blockers, clonidine, guanethidine, and reserpine) : Signs and symptoms of hypoglycemia may be reduced or absent.

Mechanism: Clonidine can make your blood sugar levels unpredictable and hide the normal warning signs of low blood sugar, like a fast heartbeat.

What to do: You should check your blood sugar more often and be aware that you might not feel the usual symptoms of a low.