Nifedipine Insulin

No adverse interactions appear to occur with clopidogrel and alu-minium/magnesium hydroxide, atenolol, cimetidine, digoxin, food, insulin, nifedipine, oestrogens, phenobarbital, phenytoin or tolbutamide. 

Metformin 1 000 mg orally twice daily Hydrochlorothiazide 25 mg orally once daily Nifedipine XL 60 mg orally once daily Regular insulin 4 units SC 3 times daily with meals Insulin glargine 20 units SC at bedtime... 

T Pancreatic insulin release Metformin Peripheral insulin sensitivity hepatic glucose output/production i intestinal glucose absorption Dose Ist-line (naive pts), 1.25/250 mg PO daily-bid 2nd-line, 2.5/500 mg or 5/500 mg bid (max 20/2000 mg) take w/ meals, slowly T dose hold before 48 h after ionic contrast media Caution [C, -] Contra SCr >1.4 mg/dL in females or >1.5 mg/dL in males hypoxemic conditions (sepsis, recent MI) alcoholism metabolic acidosis liver Dz Disp Tabs SE HA, hypoglycemia, lactic acidosis, anorexia, N/V, rash Additional Interactions T Effects W/ amiloride, ciprofloxacin cimetidine, digoxin, miconazole, morphine, nifedipine, procainamide, quinidine, quinine, ranitidine, triamterene,... 

Julie Singer is a 55-year-old white woman who was admitted to the emergency department in acute distress. A previous physical examination showed hypertension and diabetes mellitus type 2. The patient s present medications include enalapril 40 mg, nifedipine 60 mg, and 100 U insulin. A physical examination revealed prominent ankle edema, a palpable spleen, and hepatomegaly. Chest radiography revealed diffuse cardiac enlargement and left ventricular hypertrophy. Based upon the history and clinical hndings, what is your diagnosis and what treatment do you recommend ... 

Donnelly T, Harrower AD. Effect of nifedipine on glucose tolerance and insulin secretion in diabetic and non-diabetic patients. Curr Med Res Opin 1980 6(10) 690-3. 

CALCIUM CHANNEL BLOCKERS INSULIN Single case reports of impaired glucose intolerance requiring t insulin requirements with diltiazem and nifedipine Uncertain at present Evidence suggests that calcium channel blockers are safe in diabetics monitor blood glucose levels when starting calcium channel blockers... 

Teng, C.L.D. Groves, M.J. The effect of compactional pressure on urease activity. Pharm. Res. 1988, 5, 776-780. Alur, H.H. Paher, S.I. Mitra, A.K. Johnston, T.P. Transmucosal sustained delivery of chlorpheniramine maleate in rabbits using a novel, natural mucoadhesive gum as an excipient in buccal tablets. Int. J. Pharm. 1999,188, 1-10. Kondo, S. Sugimoto, I. Moment analysis of intravenous, intraduodenal, buccal, rectal, and percutaneous nifedipine in rats. J. Pharmacobio. Dyn. 1987, 10, 462 69. Yamamoto, A. Hayakawa, E. Lee, V.H. Insulin and proinsulin proteolysis in mucosal homogenates of the albino rabbit implications in peptide delivery from nonoral routes. Life Sci. 1990, 26, 2465-2474. 

Tobacco smoke reduces serum levels of a wide range of drugs and dose adjustment may be necessary when smokers have given up, particularly with theophylline, beta-blockers, adrenergic agonists, nifedipine, tricyclic antidepressants, phenothiazines, benzodiazepines and insulin. 

In another case, an elderly man treated with quinapril 20 mg daily for essential hypertension was found to have hyperkalaemia (serum potassium 7 to 7.4 mmol/L) and azotaemia after 20 days of treatment with co-tri-moxazole for mild acute pyelonephritis. Co-trimoxazole and quinapril were stopped, and nifedipine was given to control blood pressure. After treatment with dextrose, insulin, sodium polystyrene sulfonate and calcium gluconate, the azotaemia and hyperkalaemia resolved over 36 hours. ... 

Insulin. One study found that nifedipine 10 mg increased the rate of absorption of subcutaneous insulin by about 50%. ... 

Gt liano D, Torella R, Cacciapuoti F, Gentile S, Verza M, Varricchio M. Impairment of insulin secretion in man by nifedipine. EurJ Clin Pharmacol (1980) 18,395-8. 

Ko> ma Y, Kodama K, Suzuki 1 Harano Y. Improvement of insulin sensitivity by a loi -acting nifedipine preparation (nifedipine-CR) in patients with essential l pertension. Am J Hypertens(2fm) 15,927-31. 

Kanatsuna T, Nakano K, Mori H, Kano Y, Ni dca H, Kajiyama S, Kitagawa Y, Yoshida T, Kcmdo Nakamura N, Aochi O. Effects of nifedipine on insulin secretion and glucose metabolism in rats and hypertensive type 2 (non-insulin dependent) diabetics. Arzneimittelforsc-hung 9Z5) 35, 514-17. 

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