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This article originally posted and appeared in  Special Edition - Top Tools for Your PracticeIssue 697

Drugs That Can Affect Blood Glucose Levels

altKnowing the drugs that can affect blood glucose levels is essential in properly caring for your diabetes patients. Some medicines raise blood sugar in patients and other might lower their levels. However, not all drugs affect patients the same way.

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Keep this comprehensive, up-to-date list of drugs that can affect blood glucose levels in every exam room in your healthcare facility. Check patients’ meds against this list on each visit and carefully monitor their symptoms to ensure their health and safety.

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Drugs That Can Affect Blood Glucose Levels

Contents

Drugs That Can Cause Hyperglycemia (High Blood Sugar)

GENERIC NAME (BRAND NAME)
Abacavir (Ziagen®)
Abacavir + lamivudine,zidovudine (Trizivir®)
Acetazolamide (Diamox®)
Acitretin (Soriatane®)
Albuterol (Ventolin®, Proventil®)
Albuterol + ipratropium (Combivent®)
Ammonium chloride
Amphotericin B (Amphocin®, Fungizone®)
Amphotericin B lipid formulations (IV) (Abelcet®)
Amprenavir (Agenerase)
Anidulafungin (Eraxis®)
Aripiprazole (Abilify®)
Arsenic trioxide (Trisenox®)
Asparaginase (Elspar®)
Atazanavir (Reyataz®)
Atenolol + chlorthalidone (Tenoretic®)
Atorvastatin (Lipitor®)
Atovaquone (Mepron®)
Baclofen (Lioresal®)
Benazepril + hydrochlorothiazide (Lotension®)
Betamethasone (topical) (Alphatrex®, Betatrex®, Beta-Val®, Diprolene®, Diprolene® AF, Diprolene® Lotion, Luxiq®, Maxivate®)
Betamethasone +clotrimazole (Lotrisone® {topical})
Betaxolol Betoptic® (eyedrops) (Kerlone® {oral})
Bexarotene (Targretin®)
Bicalutamide (Casodex®)
Bisoprolol + hydrochlorothiazide (Ziac®)
Bumetanide (Bumex®)
Caffeine (Caffeine in moderation may actually be beneficial in diabetes but in large amounts can raise blood sugar)
Candesartan + hydrochlorothiazide (Atacand HCT®)
Captopril + hydrochlorothiazide (Capozide®)
Carteolol (Cartrol® {oral}, Occupress® {eyedrops})
Carvedilol (Coreg®)
Chlorothiazide (Diuril®)
Chlorthalidone (Chlorthalidone Tablets®, Clorpres®, Tenoretic®, Thalitone®)
Choline salicylate (Numerous tradenames of aspirin formulations; check label)
Choline salicylate + magnesium salicylate (CMT®, Tricosal®,Trilisate®)
Clobetasol (Clobevate®, Cormax®, Cormax® Scalp Application, Embeline® E, Olux®, Temovate®, Temovate® E, Temovate® Scalp Application)
Clozapine (Clozaril®, FazaClo®)
Conjugated estrogens (Estrace®, Estring®, Femring®, Premarin®, Vagifem®, Cenestin®, Enjuvia®, Estrace®, Femtrace®, Gynodiol®, Menest®, Ogen®)
Conjugated estrogens + medroxyprogesterone (Premphase®, Prempro®)
Corticosteroids (Numerous tradenames; check label)
Corticotropin
Cortisone (Numerous tradenames; check label)
Cyclosporine (Sandimmune®, Neoral®, Gengraf®)
Daclizumab (Zenapax®)
Decitabine (Dacogen®)
Desonide (DesOwen®, Tridesilon®)
Desoximetasone (Topicort®)
Dexamethasone (Adrenocot®, Dalalone®, Decadron®, Decaject®, Dekasol®, Dexacort®, Dexasone®, Dexim®, Dexone®, Hexadrol®, Medidex®, Primethasone®, Solurex®, Dexamethasone Intensol®)
Dextromethorphan + promethazine (Phenergan® with Dextromethorphan, Phen-TussDM®)
Diazoxide (Proglycem®)
Enalapril + hydrochlorothiazide (Vaseretic®)
Encainide (Enkaid®)
Ephedrine and Guaifenesin (Primatene® tablets otc – this medication includes ephedrine and guaifenesin. Guaifenesin is not responsible for hyperglycemia)
Epinephrine (EpiPen®, EpiPen® Jr, Primatene® Mist otc)
Esterified estrogens, estrone, estropipate
Esterified estrogens + methyltestosterone (Estratest®)
Estradiol, ethinyl estradiol (Alora®, Climara®, Congest®, Delestrogen®, Depo-Estradiol®, Depogen®, Estinyl®, Estrace®, Estraderm®, Estragyn 5®, Estragyn LA 5®, Estrasorb®, EstroGel®, Estro-L.A.®, Gynodiol®, Kestrone-5®, Neo-Estrone®, Menest®, Menostar®, Ogen .625®, Ogen®, Ortho-Est®, Premarin®, Valergen®, Vivelle®, Vivelle-Dot®)
Estradiol + norethindrone (Activella®)
Estradiol + norgestimate (Prefest®)
Estramustine (Emcyt®)
Ethacrynic acid (Edecrin®, Sodium Edecrin®)
Everolimus (Afinitor®)
Everolimus (Zortress®)
Fluoxetine (Prozac®, Sarafem®)
Flurandrenolide (Cordran®, Cordran® SP, Cordran® Tape)
Formoterol (Foradil® Aerolizer® Inhaler)
Fosamprenavir (Lexiva®)
Fosinopril + hydrochlorothiazide (Monopril HCT®)
Furosemide (Lasix®)
Gemtuzumab ozogamicin (Mylotarg®)
Glucosamine (Possible increase in insulin resistance; more likely with intravenous use)
Hydrochlorothiazide (Aldactazide®, Aldoril®, Capozide®, Dyazide®, HydroDIURIL®, Inderide®, Lopressor® HCT, Maxzide®, Microzide®, Moduretic®, Timolide®, Vaseretic®)
Hydrochlorothiazide + irbesartan (Avalide®)
Hydrochlorothiazide + lisinopril (Prinzide®, Zestoretic®)
Hydrochlorothiazide + losartan (Hyzaar®)
Hydrochlorothiazide + metoprolol (Lopressor HCT®)
Hydrochlorothiazide + moexipril (Uniretic®)
Hydrochlorothiazide + quinapril (Accuretic®, Quinaretic®)
Hydrochlorothiazide + telmisartan (Micardis HCT®)
Hydrochlorothiazide + valsartan (Diovan HCT®)
Hydrocortisone (Numerous tradenames of topical hydrocortisone formulations; check label)
Indapamide (Lozol®)
Indinavir (Crixivan®)
Interferon alfa-2a (Roferon-A®)
Interferon alfa-2b (Intron-A®)
Interferon alfa-2b + ribavirin (Rebetron®)
Interferon alfa-n1 (Alferon-N®)
Irinotecan (Camptosar®)
Isoniazid (Laniazid®, Nydrazid®)
Isotretinoin (Accutane®)
Lamivudine (Epivir®, Epivir-HBV®)
Levalbuterol (Xoponex®, Xopenex HFA®)
Levonorgestrel (Plan B®, Norplant System®)
Levothyroxine (Synthroid®, Levoxyl®)
Lopinavir + ritonavir (Kaletra®)
Magnesium salicylate (Bayer Select® Backache Pain Formula, Doans® Pills, Mobidin®, Nuprin® Backache Caplet)
Medroxyprogesterone (Provera®, Depo-Provera®)
Megestrol (Megace®)
Methylprednisolone (A-methaPred®, ADD-Vantage®, Depo-Medrol®, Medrol®, Medrol®, Dosepak, Meprolone® Unipak, Solu-Medrol®)
Metolazone (Zaroxolyn®, Mykrox®)
Metoprolol (Lopressor®, Lopressor® HCT, Toprol XL®)
Modafinil (Provigil®)
Moxifloxacin (Avelox®, Avelox® I.V.)
Mycophenolate (CellCept®)
Nadolol (Corgard®)
Nelfinavir (Viracept®)
Niacin, niacinamide (Niacor®, Niaspan®, Nicolar®, Nicotinex®, Slo-Niacin®)
Nilotinib (Tasigna®)
Nilutamide (Nilandron®)
Nitric oxide (INOmax®)
Norethindrone (Aygestin®, Nor-QD®, Micronor®)
Norgestrel (Orvette®)
Nystatin (Mycostatin®, Nystat-Rx®, Nystop®, Pedi-Dri®)
Nystatin + triamcinolone (Dermacomb®, Myco II®, Mycobiotic II®, Mycogen II®, Mycolog II®, Myco-Triacet II®, Mykacet®, Mykacet II®, Mytrex®, Tristatin II®)
Octreotide (Sandostatin®, Sandostatin LAR®)
Olanzapine (Zyprexa®)
Pantoprazole (Protonix®, Protonix® I.V.)
Pegaspargase (Oncaspar®)
Peginterferon alfa-2b (PEG-Intron®)
Pentamidine (Pentam 300®)
Phenylephrine* (Sudafed PE®, and others)
Phenytoin (Dilantin®, Dilantin-125®, Dilantin Infatabs®, Dilantin Kapseals®, Phenytek®)
Prednisolone* (AK-Pred®, Blephamide®, Blephamide® Liquifilm®, Econopred® Plus, Inflamase® Forte, Inflamase® Mild, Poly-Pred® Liquifilm®, Pred Forte®, Pred Mild®, Pred-G®, Pred-G® Liquifilm®, Delta Cortef®, Pediapred®, Prelone®)
Prednisone (Prednisone Intensol®, Sterapred®, Sterapred® DS)
Progesterone (Prometrium®)
Pseudoephedrine* (Claritin D®, Sudafed®, and others)
* There are many other OTC and prescription medications that contain pseudoephedrine and phenylephrine.
Quetiapine (Seroquel®)
Risperidone (Risperdal®, Risperdal® M-TAB®)
Ritodrine (Yutopar®)
Ritonavir (Norvir®)
Rituximab (Rituxan®)
Salmeterol (Serevent®, Serevent® Diskus®)
Salsalate (Argesic®-SA, Disalcid®, Mono-Gesic®, Salflex®, Salsitab®)
Saquinavir (Invirase®)
Sodium oxybate (Xyrem®)
Somatropin (Genotropin®, Genotropin Miniquick®, Humatrope®, Norditropin cartridges®, Norditropin NordiFlex®, Nutropin®, Nutropin AQ®, Saizen®, Serostim®, Zorbtive®)
Sotalol (Betapace®, Betapace AF®, Sorine®)
Streptozocin (Zanosar®)
Tacrolimus (Prograf®, Protopic®)
Temsirolimus (Torisel®)
Tipranavir (Aptivus®)
Tolvaptan (Samsca®)
Torsemide (Demadex®, Demadex Oral®)
Triamcinolone (Aristocort®, Aristospan®, Asthmacort®, Flutex®, Kenalog®, Tac®, Triacet®)
Ursodeoxycholic acid, ursodiol (Actigall®, Urso®)
Valproic acid, divalproex sodium (Depacon®, Depakene®, Depakene® Syrup, Depakote®, Depakote® ER, Depakote® Sprinkle)
Vitamin C (Ascorbic acid, Ascorbate)
Vitamin E (Tocopherol, Tocotrienol)
Ziprasidone (Geodone®)

Drugs That Can Cause Hypoglycemia (Low Blood Sugar)

GENERIC NAME (BRAND NAME)
Acebutolol (Sectral®)
Acetohexamide (Dymelor®)
Alcohol
Aloe – Oral Herbal Supplement, especially if taken with other agents such as glyburide, glipizide, nateglinide, repaglinide, glimepiride, or insulin.
Amphotericin B (Ambisome®, Amphocin®, Fungizone Intravenous® Amphotec®, Abelcet®)
Amphotericin B lipid formulations (Abelcet®, AmBisome®)
Asian Ginseng (Ginseng; Panax ginseng)
Aspirin (Numerous tradenames; check label.)
Aspirin + dipyridamole (Aggrenox®)
Atenolol (Tenormin®, Tenoretic® containing atenolol & chlorthalidone)
Betaxolol (Betoptic®, Betoptic S® {eyedrops}, Kerlone® {oral})
Bisoprolol (Zebeta®)
Bisoprolol + hydrochlorothiazide (Ziac®)
Bromocriptine (Cycloset®)
Chloramphenicol (Chloromycetin®)
Chlorpropamide (Diabinese®)
Choline salicylate (Acuprin 81®, Amigesic®, Anacin Caplets®, Anacin Maximum Strength®, Anacin Tablets®, Anaflex 750® Arthritis Pain, Ascriptin® Arthritis Pain)
Choline salicylate + magnesium salicylate C (MT®, Tricosal®, Trilisate®)
Chromium (Various tradenames; check label)
Clarithromycin B (Biaxin® Filmtab®, Biaxin® Granules, Biaxin® XL Filmtab, Biaxin® XL Pac, Prevpac®)
Diazoxide (Proglycem®)
Dicumarol (Coumadin®, Miradon®)
Diltiazem (Cardizem®, Tiazac®)
Disopyramide (Norpace®, Norpace® CR)
Dorzolamide + timolol (Cosopt®)
Exenatide (Byetta®)
Fluoxetine (Prozac®, Sarafem®)
Fosphenytoin (Cerebyx®, Dilantin®, Dilantin-125®, Dilantin Infatabs®, Dilantin Kapseals®, Mesantoin®, Peganone®, Phenytek®)
Glimepiride (Amaryl®)
Glimepiride and Rosiglitazone (Avandaryl®)
Glipizide (Glucotrol®, Glucotrol XL®)
Glipizide and Metformin (Metaglip®)
Glyburide (Diabeta®, Glynase®, Micronase®, Glycron®)
Glyburide + metformin (Glucovance®)
Horse chestnut (Aesculus hippocastanum)
Hydrochlorothiazide + metoprolol (Lopressor HCT®)
Insulin (Lantus®, Levemir®, NPH®, Humulin®, Novolin®, Apidra®, Novolog®, Humalog®)
Interferon beta-1b (Betaseron®)
Levofloxacin (Levaquin®, Levaquin® in Dextrose Injection Premix, Quixin®)
Liraglutide (Victoza®)
Magnesium salicylate (Bayer Select® Backache Pain Formula, Doans® Pills, Mobidin®, Nuprin® Backache Caplet)
Metformin (Fortamet®, Glucophage®, Glucophage XR®, Glumetza®, Riomet®)
Metoprolol (Lopressor®, Lopressor® HCT, Toprol XL®)
Morphine (Kadian®, MS Contin®, MSIR®, Roxanol®)
Nadolol (Corgard®)
Nateglinide (Starlix®)
Nifedipine (Adalat CC®, Procardia®, Afeditab® CR)
Octreotide (Sandostatin®, Sandostatin LAR® Depot)
Paloperidone (Invega®)
Penicillamine (Cuprimine®, Depen®)
Pentamidine (Nebupent®, Pentam 300®)
Phenelzine (Nardil®)
Phenytoin (Dilantin®, Dilantin-125®, Dilantin Infatabs®, Dilantin Kapseals®, Phenytek®)
Pindolol (Visken®)
Pioglitazone (Actos®) –(hypoglycemia usually only when in combination with other diabetic drugs such as sulfonylureas or insulin)
Pioglitazone and Glimepiride (Duetact®)
- the glimepiride component of this drug gives it the possibility of causing hypoglycemia alone or in combination with other diabetes medicines. This is more likely to occur when one skips a regular meal or when unusual physical activities occur.
Pioglitazone and Metformin (Actoplus Met®, ActoPlus Met XR®)
Pramlintide (Symlin®) (with insulin-induced hypoglycemia)
Probenecid (Benemid®, Probalan®)
Quinine (Quinamm®, Quindan®, Quiphile®, Q-vel®, Strema®)
Quinupristin + dalfopristin (Synercid®)
Repaglinide (Prandin®)
Repaglinide and Metformin (PrandiMet®)
Ritodrine (Yutopar®)
Rituximab (Rituxan®)
Rosiglitazone (Avandia®)
Rosiglitazone and Metformin (Avandamet®)
Rotigotine (Neupro®)
Salicylates (Numerous tradenames of aspirin formulations; check label)
Salsalate (Argesic®-SA, Disalcid®, Mono-Gesic®, Salflex®, Salsitab®)
Saxagliptin (Onglyza®)
Selegiline (Eldepryl®)
Sitagliptin (Januvia®)
Sitagliptin and Metformin HCL (Janumet®)
Sodium ferric gluconate complex (Ferrlecit®)
Somatropin (Genotropin®, Genotropin Miniquick®, Humatrope®, Norditropin cartridges®, Norditropin NordiFlex®, Nutropin, Nutropin AQ®, Saizen®, Serostim®, Zorbtive®)
Sotalol (Betapace®, Betapace AF®, Sorine®)
Streptozocin (Zanosar®)
Sulfadiazine (Microsulfon®)
Tacrolimus P (Prograf®, Protopic®)
Tetracaine (Altacaine®, Tetcaine®, Pontocaine®)
Theophylline (Theo-24®, Theo-Dur®, TheoCap®)
Timolol (Timoptic®, Timoptic-XE®)
Tolazamide (Tolinase®)
Tolbutamide (Orinase®)
Tranylcypromine (Parnate®)
Varenicline (Chantix®)
Verapamil (Calan®, Calan SR®, Isoptin SR®, Verelan®)

Drugs That Can Cause Hyper- or Hypo- glycemia

GENERIC NAME (BRAND NAME)
Amphotericin B (Ambisome®, Amphocin®, Fungizone Intravenous®, Amphotec®, Abelcet®)
Amphotericin B lipid formulations (Abelcet®, AmBisome®, Betaxolol Betoptic® {eyedrops}, KERLONE® {oral})
Bisoprolol + hydrochlorothiazide (Ziac®)
Choline salicylate (Numerous tradenames of aspirin formulations; check label)
Choline salicylate + magnesium salicylate (CMT®, Tricosal®, Trilisate®)
Darunavir (Prezista®)
Diazoxide (Proglycem®)
Fluoxetine (Prozac®, Sarafem®)
Hydrochlorothiazide + metoprolol (Lopressor HCT®)
Lanreotide acetate (Somatuline®)
Lithium (Eskalith®, Eskalith CR®, Lithobid®)
Magnesium salicylate (Bayer Select® Backache Pain Formula, Doans® Pills, Mobidin®, Nuprin® Backache Caplet)
Mecasermin (Increlex®)
Mecasermin Rinfabate (Iplex®)
Metoprolol (Lopressor®, Lopressor® HCT, Toprol XL®)
Nadolol (Corgard®)
Octreotide (Sandostatin®, Sandostatin LAR® Depot)
Pazopanib (Votrient®)
Pentamidine (Nebupent®, Pentam 300®)
Phenytoin (Dilantin®, Dilantin-125®, Dilantin Infatabs®, Dilantin Kapseals®, Phenytek®)
Rifampin (Rifadin®, Rimactane®)
Ritodrine (Yutopar®)
Rituximab (Rituxan®)
Salsalate (Argesic®-SA, Disalcid®, Mono-Gesic®, Salflex®, Salsitab®)
Sunitinib (Sutent®)
Somatropin (Genotropin®, Genotropin Miniquick®, Humatrope®, Norditropin cartridges®, Norditropin NordiFlex®, Nutropin®, Nutropin AQ®, Saizen®, Serostim®, Zorbtive®)
Sotalol (Betapace®, Betapace AF®, Sorine®)
Streptozocin (Zanosar®)
Tacrolimus P (Prograf®, Protopic®)

Drugs That Can MASK Hypoglycemia

GENERIC NAME (BRAND NAME)
Atenolol (Tenormin®, Tenoretic® containing Atenolol & Chlorthalidone)
Carteolol (Cartrol® {oral}, Occupress® {eyedrops})
Carvedilol (Coreg®, Coreg® Tiltabs®)
Clonidine (Duraclon®, Catapres®, Catapres-TTS-1®, Catapres-TTS-2®, Catapres-TTS-3®)
Metoprolol (Lopressor®, Lopressor® HCT, Toprol XL®)
Nadolol (Corgard®)
Nebivolol (Bystolic®)
Pindolol (Visken®)
Propranolol (Inderal®, Inderal LA®, Inderide®, Innopran® XL, Propranolol Hydrochloride Intensol®)
Timolol (Timoptic®, Timoptic-XE®)

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.

This list was comprised from these 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
© 2010 Diabetes In Control, Inc.
www.diabetesincontrol.com
For permission to reprint, email Heather Moran at hmoran@diabetesincontrol.com
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This article originally posted 27 July, 2010 and appeared in  Special Edition - Top Tools for Your PracticeIssue 697

Past five issues: Issue 752 | SGLT-2 Inhibitors Special Edition October 2014 | Diabetes Clinical Mastery Series Issue 211 | Issue 751 | Humulin Insulin Special Edition October 2014 |

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