Debrisoquine hypotensive effect

Two distinct bases for these types of effects may be distinguished pharmacokinetic and pharmacodynamic. Pharmacokinetic-based toxic effects are due to an increase in the concentration of the compound or active metabolite at the target site. This may be due to an increase in the dose, altered metabolism or saturation of elimination processes for example. An example is the increased hypotensive effect of debrisoquine in poor metabolizers where there is a genetic basis for a reduction in metabolic clearance of the drug (see Chapter 5). 

Limited evidence su ests that guanethidine has blood glucoselowering activity, which may possibly add to the effects of conventional antidiabetics. One case report su ests soluble insulin may exaggerate the hypotensive effects of debrisoquine. 

Hume L. Potentiation of hypotensive effect of debrisoquine by insulin. DiabetMed (1985) 2, 390-1. 

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