Hypoglycemic agents, oral, interaction

Itraconazole has significant interactions with a number of commonly prescribed drugs, such as rifampin, phenytoin, and carbamazepine. Itraconazole raises serum digoxin and cyclosporine levels and may affect the metabolism of oral hypoglycemic agents and coumadin. Absorption of itraconazole is impaired by antacids, Hj blockers, proton pump inhibitors, and drugs that contain buffers, such as the antiretroviral agent didanosine. 

Beta-blockers interact with a large number of other medications. The combination of beta-blockers with calcium antagonists should be avoided, given the risk for hypotension and cardiac arrhythmias. Cimetidine, hydralazine, and alcohol all increase blood levels of beta-blockers, whereas rifampicin decreases their concentrations. Beta-blockers may increase blood levels of phenothiazines and other neuroleptics, clonidine, phen-ytoin, anesthetics, lidocaine, epinephrine, monoamine oxidase inhibitors and other antidepressants, benzodiazepines, and thyroxine. Beta-blockers decrease the effects of insulin and oral hypoglycemic agents. Smoking, oral contraceptives, carbamazepine, and nonsteroidal anti-inflammatory analgesics decrease the effects of beta-blockers (Coffey, 1990). 

Drug interactions Sandostatin has been associated with changes in nutrient absorption, so it may effect the absorption of orally administered drugs. Concomitant administration of Sandostatin with cyclosporine may decrease blood levels of cyclosporine and result in transplant rejection. Patients receiving insulin, oral hypoglycemic agents, beta blockers. 

Pharmacodynamic interactions are also of great clinical significance. The additive CNS depression that occurs when alcohol is combined with other CNS depressants, particularly sedative-hypnotics, is most important. Alcohol also potentiates the pharmacologic effects of many nonsedative drugs, including vasodilators and oral hypoglycemic agents. 

Menzies DJ, Dorsainvil PA, Cunha BA, Johnson DH. Severe and persistent hypoglycemia due to gatifloxacin interaction with oral hypoglycemic agents. Am J Med 2002 113(3) 232-4. 

Drug Interactions Contraceptive effects are decreased when "the pill" is taken with ANTIDIOTICS (ampicillin, isoniazid, neomycin, pen V, rifampin, sulfonamides, tetracycline) or CNS AGENTS (barbiturates, benzodiazepines, phenytoin). Contraceptives increase the effects of corticosteroids and worsen side effects of tricyclic antidepressants. Oral contraceptives decrease the effectiveness of oral anticoagulants, anticonvulsants, and oral hypoglycemic agents. 

Drug interactions occur with many commonly prescribed medications such as oral hypoglycemic agents, valproic acid, methotrexate, lithium, and ACE inhibitors. 

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