Drugs That Can Affect Blood Glucose Levels Generic Name (Brand Name)

Home , Bicalutamide, Carteolol, Diazoxide, Estramustine, Levonorgestrel, Nilutamide

Diabetes In Control's clinical editors along with a team of pharmacy doctoral students have put together a comprehensive, revised and up-to-date list of "Drugs That Can Affect Blood Glucose Levels." The main sources appear in the Endnotes. We suggest printing out this list, putting a copy in every exam room and you and/or your MA can check patients' medications whenever you prescribe or observe unexpected glucose excursions.

Drugs That Can Cause HYPERGLYCEMIA (High Blood Sugar)

Abacavir (Ziagen®) Captopril + hydrochlorothiazide (Capozide®) Abacavir + lamivudine, zidovudine (Trizivir®) Carteolol (Cartrol® oral, Occupress® Acetazolamide (Diamox®) eyedrops) Acitretin (Soriatane®) Carvedilol (Coreg®) Albuterol (Ventolin®, Proventil®) Chlorothiazide (Diuril®) Albuterol + ipratropium (Combivent®) Chlorthalidone (Chlorthalidone Tablets®, Ammonium chloride Clorpres®, Tenoretic®, Thalitone®) Amphotericin B (Amphocin®, Fungizone®) Choline salicylate (Numerous tradenames of Amphotericin B lipid formulations IV (Abelcet®) aspirin formulations: check label.) Amprenavir (Agenerase®) Choline salicylate + magnesium salicylate Anidulafungin (Eraxis®) (CMT®, Tricosal®, Trilisate®) Aripiprazole (Abilify®) Clobetasol (Clobevate®, Cormax®, Cormax® Arsenic trioxide (Trisenox®) Scalp Application, Embeline® E, Asparaginase (Elspar®) Olux®, Temovate®, Temovate® E, Atazanavir (Reyataz ®) Temovate® Scalp Application) Atenolol + chlorthalidone (Tenoretic®) Clozapine (Clozaril®, FazaClo®) Atorvastatin (Lipitor®) Conjugated estrogens (Estrace®, Estring®, Atovaquone (Mepron®) Femring®, Premarin®, Vagifem®, Baclofen (Lioresal®) Cenestin®, Enjuvia®, Estrace®, Benazepril + hydrochlorothiazide (Lotension®) Femtrace®, Gynodiol®, Menest®, Betamethasone topical (Alphatrex®, Ogen®) Betatrex®, Beta-Val®, Diprolene®, Conjugated estrogens + medroxyprogesterone Diprolene® AF, Diprolene® Lotion, (Premphase®, Prempro®) Luxiq®, Maxivate®) Corticosteroids (Numerous tradenames: check Betamethasone +clotrimazole (Lotrisone® label.) topical) Corticotropin Betaxolol Betoptic® eyedrops, (Kerlone® oral) Cortisone (Numerous tradenames: check Bexarotene (Targretin®) label.) Bicalutamide (Casodex®) Cyclosporine (Sandimmune®, Neoral®, Bisoprolol + hydrochlorothiazide (Ziac®) Gengraf®) Bumetanide (Bumex®) Daclizumab (Zenapax®) Caffeine (Caffeine in moderation may actually Decitabine (Dacogen®) be beneficial in diabetes but in large Desonide (DesOwen®, Tridesilon®) amounts can raise blood sugar.) Desoximetasone (Topicort®) Candesartan + hydrochlorothiazide (Atacand HCT®) Diabetes in Control is a medical e-newsletter dedicated to keeping clinicians current with the rapid changes in diabetes care. Access the continually growing collection of must-know clinical information and education as a subscriber. Complimentary professional subscriptions are available at ( http://www.diabetesincontrol.com/subscribe ).

Drugs That Can Cause HYPERGLYCEMIA (High Blood Sugar) Cont'd

Dexamethasone (Adrenocot®, Dalalone®, Glucosamine (possible increase in insulin Decadron®, Decaject®, Dekasol®, resistance; more likely with Dexacort®, Dexasone®, Dexim®, intravenous use) Dexone®, Hexadrol®, Medidex®, Hydrochlorothiazide (Aldactazide®, Aldoril®, Primethasone®, Solurex®, Capozide®, Dyazide®, Dexamethasone Intensol®) HydroDIURIL®, Inderide®, Dextromethorphan + promethazine Lopressor® HCT, Maxzide®, (Phenergan® with Dextromethorphan, Microzide®, Moduretic®, Timolide®, Phen- TussDM®) Vaseretic®) Diazoxide (Proglycem®) Hydrochlorothiazide + irbesartan (Avalide®) Enalapril + hydrochlorothiazide (Vaseretic®) Hydrochlorothiazide + lisinopril (Prinzide®, Encainide (Enkaid®) Zestoretic®) Ephedrine and Guaifenesin (Primatene ® Hydrochlorothiazide + losartan (Hyzaar®) tablets, OTC - this medication includes Hydrochlorothiazide + metoprolol (Lopressor ephedrine and guaifenesin. HCT®) Guaifenesin is not responsible for Hydrochlorothiazide + moexipril (Uniretic®) hyperglycemia.) Hydrochlorothiazide + quinapril (Accuretic®, Epinephrine (EpiPen ®, EpiPen® Jr, Quinaretic®) Primatene® Mist, OTC ) Hydrochlorothiazide + telmisartan (Micardis Esterified estrogens, estrone, estropipate HCT®) Esterified estrogens + methyltestosterone Hydrochlorothiazide + valsartan (Diovan (Estratest®) HCT®) Estradiol, ethinyl estradiol (Alora®, Climara®, Hydrocortisone (Numerous trade names of Congest®, Delestrogen®, Depo- topical hydrocortisone formulations: Estradiol®, Depogen®, Estinyl®, check label.) Estrace®, Estraderm®, Estragyn 5®, Indapamide (Lozol®) Estragyn LA 5®, Estrasorb®, Indinavir (Crixivan®) EstroGel®, Estro-L.A.®, Gynodiol®, Interferon alfa-2a (Roferon-A®) Kestrone-5®, Neo-Estrone®, Interferon alfa-2b (Intron-A®) Menest®, Menostar®, Ogen .625®, Interferon alfa-2b + ribavirin (Rebetron®) Ogen®, Ortho-Est®, Premarin®, Interferon alfa-n1 (Alferon-N®) Valergen®, Vivelle®, Vivelle-Dot®) Irinotecan (Camptosar®) Estradiol + norethindrone (Activella®) Isoniazid (Laniazid®, Nydrazid®) Estradiol + norgestimate (Prefest®) Isotretinoin (Accutane®) Estramustine (Emcyt®) Lamivudine (Epivir®, Epivir-HBV®) Ethacrynic acid (Edecrin®, Sodium Edecrin®) Levalbuterol (Xoponex®, Xopenex HFA®) Everolimus (Afinitor®) Levonorgestrel (Plan B®, Norplant System®) Everolimus (Zortress®) Levothyroxine (Synthroid®, Levoxyl®) Fluoxetine (Prozac®, Sarafem®) Lopinavir + ritonavir (Kaletra®) Flurandrenolide (Cordran®, Cordran® SP, Magnesium salicylate (Bayer Select® Cordran® Tape) Backache Pain Formula, Doans® Pills, Formoterol (Foradil® Aerolizer® Inhaler) Mobidin®, Nuprin® Backache Caplet) Fosamprenavir (Lexiva ®) Medroxyprogesterone (Provera®, Depo- Fosinopril + hydrochlorothiazide (Monopril Provera®) HCT®) Megestrol (Megace®) Furosemide (Lasix®) Gemtuzumab ozogamicin (Mylotarg®) Diabetes in Control is a medical e-newsletter dedicated to keeping clinicians current with the rapid changes in diabetes care. Access the continually growing collection of must-know clinical information and education as a subscriber. Complimentary professional subscriptions are available at ( http://www.diabetesincontrol.com/subscribe ).

Drugs That Can Cause HYPERGLYCEMIA (High Blood Sugar) Cont'd

Methylprednisolone (A-methaPred®, ADD- G® Liquifilm®, Delta Cortef®, Vantage®, Depo-Medrol®, Medrol®, Pediapred®, Prelone®) Medrol® Dosepak, Meprolone® Prednisone (Prednisone Intensol®, Unipak, Solu-Medrol®) Sterapred®, Sterapred® DS) Metolazone (Zaroxolyn®, Mykrox®) Progesterone (Prometrium®) Metoprolol (Lopressor®, Lopressor® HCT, Pseudoephedrine* (Claritin D®, Sudafed®, Toprol XL®) and others) Modafinil (Provigil®) Quetiapine (Seroquel®) Moxifloxacin (Avelox®, Avelox® I.V.) Risperidone (Risperdal®, Risperdal® M- Mycophenolate (CellCept®) TAB®) Nadolol (Corgard®) Ritodrine (Yutopar®) Nelfinavir (Viracept®) Ritonavir (Norvir®) Niacin, niacinamide (Niacor®, Niaspan®, Rituximab (Rituxan®) Nicolar®, Nicotinex®, Slo-Niacin®) Salmeterol (Serevent®, Serevent® Diskus®) Nilotinib (Tasigna®) Salsalate (Argesic®-SA, Disalcid®, Mono- Nilutamide (Nilandron®) Gesic®, Salflex®, Salsitab®) Nitric oxide (INOmax®) Saquinavir (Invirase®) Norethindrone (Aygestin®, Nor-QD®, Sodium oxybate (Xyrem®) Micronor®) Somatropin (Genotropin®, Genotropin Norgestrel (Orvette®) Miniquick®, Humatrope®, Norditropin Nystatin (Mycostatin®, Nystat-Rx®, Nystop®, artridges®, Norditropin NordiFlex®, Pedi-Dri®) Nutropin®, Nutropin AQ®, Saizen®, Nystatin + triamcinolone (Dermacomb®, Myco Serostim®, Zorbtive®) II®, Mycobiotic II®, Mycogen II®, Sotalol (Betapace®, Betapace AF®, Sorine®) Mycolog II®, Myco-Triacet II®, Streptozocin (Zanosar®) Mykacet®, Mykacet II®, Mytrex®, Tacrolimus (Prograf®, Protopic®) Tristatin II®) Temsirolimus (Torisel®) Octreotide (Sandostatin®, Sandostatin LAR®) Tipranavir (Aptivus®) Olanzapine (Zyprexa®) Tolvaptan (Samsca®) Pantoprazole (Protonix®, Protonix® I.V.) Torsemide (Demadex®, Demadex Oral®) Pegaspargase (Oncaspar®) Triamcinolone (Aristocort®, Aristospan®, Peginterferon alfa-2b (PEG-Intron®) Asthmacort®, Flutex®, Kenalog®, Pentamidine (Pentam 300®) Tac®, Triacet®) Phenylephrine* (Sudafed PE®, and others) Ursodeoxycholic acid, ursodiol (Actigall®, Phenytoin (Dilantin®, Dilantin-125®, Dilantin Urso®) Infatabs®, Dilantin Kapseals®, Valproic acid, divalproex sodium (Depacon®, Phenytek®) Depakene®, Depakene® Syrup, Prednisolone (AK-Pred®, Blephamide®, Depakote®, Depakote® ER, Blephamide®, Liquifilm®, Econopred® Depakote® Sprinkle) Plus, Inflamase® Forte, Inflamase® Vitamin C (Ascorbic acid, Ascorbate) Mild, Poly-Pred® Liquifilm®, Pred Vitamin E (Tocopherol, Tocotrienol) Forte®, Pred Mild®, Pred-G®, Pred- Ziprasidone (Geodone®)

Diabetes in Control is a medical e-newsletter dedicated to keeping clinicians current with the rapid changes in diabetes care. Access the continually growing collection of must-know clinical information and education as a subscriber. Complimentary professional subscriptions are available at ( http://www.diabetesincontrol.com/subscribe ).

Drugs That Can Cause HYPOGLYCEMIA (Low Blood Sugar)

Acebutolol (Sectral®) Glipizide (Glucotrol®, Glucotrol XL®) Acetohexamide (Dymelor®) Glipizide and Metformin (Metaglip®) Alcohol Glyburide (Diabeta®, Glynase®, Micronase®, Aloe - oral herbal supplement, especially if Glycron®) taken with other agents such as Glyburide + metformin (Glucovance®) glyburide, glipizide, nateglinide, Horse chestnut (Aesculus hippocastanum) repaglinide, glimepiride, or insulin. Hydrochlorothiazide + metoprolol (Lopressor Amphotericin B (Ambisome®, Amphocin®, HCT®) Fungizone Intravenous® Amphotec®, Insulin (Lantus®, Levemir®, NPH®, Humulin®, Abelcet®) Novolin®, Apidra®, Novolog®, Amphotericin B lipid formulations (Abelcet®, Humalog®) AmBisome®) Interferon beta-1b (Betaseron®) Asian Ginseng (Ginseng; Panax ginseng) Levofloxacin (Levaquin®, Levaquin® in Aspirin (Numerous tradenames: check label.) Dextrose Injection Premix, Quixin®) Aspirin + dipyridamole (Aggrenox®) Liraglutide (Victoza®) Atenolol (Tenormin®, Tenoretic® containing Magnesium salicylate (Bayer Select® atenolol & chlorthalidone) Backache Pain Formula, Doans® Pills, Betaxolol (Betoptic®, Betoptic S® eyedrops, Mobidin®, Nuprin® Backache Caplet) Kerlone® oral) Metformin (Fortamet®, Glucophage®, Bisoprolol (Zebeta®) Glucophage XR®, Glumetza®, Bisoprolol + hydrochlorothiazide (Ziac®) Riomet®) Bromocriptine (Cycloset®) Metoprolol (Lopressor®, Lopressor® HCT, Chloramphenicol (Chloromycetin®) Toprol XL®) Chlorpropamide (Diabinese®) Morphine (Kadian®, MS Contin®, MSIR®, Choline salicylate (Acuprin 81®, Amigesic®, Roxanol®) Anacin Caplets®, Anacin Maximum Nadolol (Corgard®) Strength®, Anacin Tablets®, Anaflex Nateglinide (Starlix®) 750® Arthritis Pain, Ascriptin® Arthritis Nifedipine (Adalat CC®, Procardia®, Afeditab Pain) ® CR) Choline salicylate + magnesium salicylate C Octreotide (Sandostatin®, Sandostatin LAR® (MT®, Tricosal®, Trilisate®) Depot) Chromium (Various tradenames: check label.) Paloperidone (Invega®) Clarithromycin B (Biaxin® Filmtab®, Biaxin® Penicillamine (Cuprimine®, Depen®) Granules, Biaxin® XL, Filmtab, Pentamidine (Nebupent®, Pentam 300®) Biaxin® XL Pac, Prevpac®) Phenelzine (Nardil®) Diazoxide (Proglycem®) Phenytoin (Dilantin®, Dilantin-125®, Dilantin Dicumarol (Coumadin®, Miradon®) Infatabs®, Dilantin Kapseals®, Diltiazem (Cardizem®, Tiazac®) Phenytek®) Disopyramide (Norpace®, Norpace® CR) Pindolol (Visken®) Dorzolamide + timolol (Cosopt®) Pioglitazone (Actos®) – hypoglycemia usually Exenatide (Byetta®) only when in combination with other Fluoxetine (Prozac®, Sarafem®) diabetic drugs such as sulfonylureas Fosphenytoin (Cerebyx®, Dilantin®, Dilantin- or insulin) 125®, Dilantin Infatabs®, Dilantin Kapseals®, Mesantoin®, Peganone®, Phenytek®) Glimepiride (Amaryl®) Glimepiride and Rosiglitazone (Avandaryl®) Diabetes in Control is a medical e-newsletter dedicated to keeping clinicians current with the rapid changes in diabetes care. Access the continually growing collection of must-know clinical information and education as a subscriber. Complimentary professional subscriptions are available at ( http://www.diabetesincontrol.com/subscribe ).

Drugs That Can Cause HYPOGLYCEMIA (Low Blood Sugar) Cont'd

Pioglitazone and Glimepiride (Duetact®) - the Saxagliptin (Onglyza®) glimepiride component of this drug Selegiline (Eldepryl®) gives it the possibility of causing Sitagliptin (Januvia®) hypoglycemia alone or in combination Sitagliptin and Metformin HCL (Janumet®) with other diabetes medicines. This is Sodium ferric gluconate complex (Ferrlecit®) more likely to occur when one skips a Somatropin (Genotropin®, Genotropin regular meal or when unusual physical Miniquick®, Humatrope®, Norditropin activities occur. cartridges®, Norditropin NordiFlex®, Pioglitazone and Metformin (Actoplus Met®, Nutropin, Nutropin AQ®, Saizen®, ActoPlus Met XR®) Serostim®, Zorbtive®) Pramlintide (Symlin®) Sotalol (Betapace®, Betapace AF®, Sorine®) Probenecid (Benemid®, Probalan®) Streptozocin (Zanosar®) Quinine (Quinamm®, Quindan®, Quiphile®, Q- Sulfadiazine (Microsulfon®) vel®, Strema®) Tacrolimus P (Prograf®, Protopic®) Quinupristin + dalfopristin (Synercid®) Tetracaine (Altacaine®, Tetcaine®, Repaglinide (Prandin®) Pontocaine®) Repaglinide and Metformin (PrandiMet®) Theophylline (Theo-24®, Theo-Dur®, Ritodrine (Yutopar®) TheoCap®) Rituximab (Rituxan®) Timolol (Timoptic®, Timoptic-XE®) Rosiglitazone (Avandia®) Tolazamide (Tolinase®) Rosiglitazone and Metformin (Avandamet®) Tolbutamide (Orinase®) Rotigotine (Neupro®) Tranylcypromine (Parnate®) Salicylates (Numerous tradenames of aspirin Varenicline (Chantix®) formulations: check label.) Verapamil (Calan®, Calan SR®, Isoptin SR®, Salsalate (Argesic®-SA, Disalcid®, Mono- Verelan®) Gesic®, Salflex®, Salsitab®)

Drugs That Can Cause HYPER- or HYPOGLYCEMIA

Amphotericin B (Ambisome®, Amphocin®, Lanreotide acetate (Somatuline®) anFungizone Intravenous® Lithium (Eskalith®, Eskalith CR®, Lithobid®) Amphotec®, Abelcet®) Magnesium salicylate (Bayer Select® Amphotericin B lipid formulations (Abelcet®, Backache Pain Formula, Doans® Pills, AmBisome®) Mobidin®, Nuprin® Backache Caplet) Betaxolol Betoptic® eyedrops, (KERLONE® Mecasermin (Increlex®) oral) Mecasermin Rinfabate (Iplex®) Bisoprolol + hydrochlorothiazide (Ziac®) Metoprolol (Lopressor®, Lopressor® HCT, Choline salicylate (Numerous tradenames of Toprol XL®) aspirin formulations: check label.) Nadolol (Corgard®) Choline salicylate + magnesium salicylate Octreotide (Sandostatin®, Sandostatin LAR® (CMT®, Tricosal®, Trilisate®) Depot) Darunavir (Prezista®) Pazopanib (Votrient ®) Diazoxide (Proglycem®) Pentamidine (Nebupent®, Pentam 300®) Fluoxetine (Prozac®, Sarafem®) Phenytoin (Dilantin®, Dilantin-125®, Dilantin Hydrochlorothiazide + metoprolol (Lopressor Infatabs®, Dilantin Kapseals®, HCT®) Phenytek®) Diabetes in Control is a medical e-newsletter dedicated to keeping clinicians current with the rapid changes in diabetes care. Access the continually growing collection of must-know clinical information and education as a subscriber. Complimentary professional subscriptions are available at ( http://www.diabetesincontrol.com/subscribe ).

Drugs That Can Cause HYPER- or HYPOGLYCEMIA Cont'd

Rifampin (Rifadin®, Rimactane®) cartridges®, Norditropin NordiFlex®, Ritodrine (Yutopar®) Nutropin®, Nutropin AQ®, Saizen®, Rituximab (Rituxan®) Serostim®, Zorbtive®) Salsalate (Argesic®-SA, Disalcid®, Mono- Sotalol (Betapace®, Betapace AF®, Sorine®) Gesic®, Salflex®, Salsitab®) Streptozocin (Zanosar®) Sunitinib (Sutent®) Tacrolimus P (Prograf®, Protopic®) Somatropin (Genotropin®, Genotropin Miniquick®, Humatrope®, Norditropin

Drugs That Can MASK* HYPOGLYCEMIA

Atenolol (Tenormin®, Tenoretic® containing Nadolol (Corgard®) Atenolol & Chlorthalidone) Nebivolol (Bystolic®) Carteolol (Cartrol® oral, Occupress® Pindolol (Visken®) eyedrops) Propranolol, Propranolol Hydrochloride, Carvedilol (Coreg®, Coreg® Tiltabs®) (Inderal®, Inderal LA®, Inderide®, Clonidine (Duraclon®, Catapres®, Catapres- Innopran® XL, Intensol®) TTS-1®, Catapres-TTS-2®, Catapres- Timolol (Timoptic®, Timoptic-XE®) TTS-3®) Metoprolol (Lopressor®, Lopressor® HCT, *Recent research suggests that this may not occur. Toprol XL®)

Note: There are many other OTC and prescription medications that contain pseudoephedrine and phenylephrine.

Sources: 1. Facts & Comparisons®, a part of Wolters Kluwer Health 2. Clinician’s Handbook of Prescription Drugs® 3. ADA/PDR Medications for the Treatment of Diabetes 4. Pharmacist’s Letter® 5. Prescriber’s Letter® 6. EPOCRATES Rx

Because of the constantly changing nature of the U.S. prescription and OTC drug marketplace, this list may not reflect the full range of drugs that may impact blood glucose levels. The information contained in this document is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over-the-counter drugs (including any herbal medicines or supplements) or following any treatment or regimen.

Please contact Heather Moran at [email protected] for permission to reprint and distribute.