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Insulin Drug Interactions
There are many medications, including sulfa drugs and certain cholesterol medications, which can negatively interact with insulin. Drug interactions with insulin could cause high blood sugar levels (which is usually not immediately dangerous) or dangerously low blood sugar levels (which can cause life-threatening problems very quickly). To help prevent drug interactions, you should notify your healthcare provider any time you start, stop, or change the dose of any medicine.
Any medication that affects blood sugar levels may interact with insulin. Some drug interactions may increase blood sugar levels, which is not healthy, but is usually not dangerous right away (although extremely high blood sugar levels can be dangerous if left untreated). These drug interactions are not discussed in this article. Typically, such interactions are discovered (by regular blood sugar monitoring) and managed before any problems occur.
Other insulin drug interactions can result in dangerously low blood sugar levels (hypoglycemia), which can cause life-threatening complications very quickly (even if you are careful to monitor your blood sugar levels regularly). Some of the medicines that may cause dangerously low blood sugar when combined with insulin include:
- Alcoholic beverages
- Angiotensin-converting enzyme inhibitors (ACE inhibitors), such as:
- Benazepril (Lotensin®, Lotensin® HCT, Lotrel®)
- Captopril (Capoten®, Capozide®)
- Enalapril (Vasotec®, Vaseretic®, Lexxel®)
- Fosinopril (Monopril®, Monopril-HCT®)
- Lisinopril (Prinivil®, Prinzide®, Zestril®, Zestoretic®)
- Quinapril (Accupril®, Accuretic®)
- Ramipril (Altace®)
- Beta blockers, including (but not limited to):
- Atenolol (Tenormin®)
- Bisoprolol (Zebeta®)
- Metoprolol (Lopressor®, Toprol XL®)
- Nadolol (Corgard®)
- Propranolol (Inderal®)
- Sotalol (Betapace®)
- Timolol (Blocadren)
- Carvedilol (Coreg®)
- Labetalol (Trandate®)
- Disopyramide (Norpace®, Norpace® CR)
- Fibrate cholesterol medications, such as:
- Fenofibrate (Antara™, Lofibra™, Tricor®, Triglide™)
- Gemfibrozil (Lopid®)
- Monoamine oxidase inhibitors (MAOIs), such as:
- Isocarboxazid (Marplan®)
- Phenelzine (Nardil®)
- Rasagiline (Azilect®)
- Selegiline (Eldepryl®, Emsam®, Zelapar®)
- Tranylcypromine (Parnate®)
- Octreotide (Sandostatin®)
- Oral diabetes medications
- Propoxyphene (Darvon®, Darvocet®)
- Reserpine
- Salicylates, such as:
- Aspirin (Ecotrin®, Bayer®, Anacin®)
- Choline magnesium trisalicylate (Trilisate®)
- Diflunisal (Dolobid®)
- Salsalate (Salflex®, Disalcid®, Amigesic®)
- Sulfonamide antibiotics ("sulfa drugs"), such as:
Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD