Insulin Rifampicin

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). 

Clinically important, potentially hazardous interactions with amphotericin B, chlorotrianisene, colestyramine, diuretics, estrogens, furosemide, insulin, live vaccines, methotrexate, oral contraceptives, pancuronium, phenobarbital, rifampicin... 

Cronqvist, J. Nilsson-Ehle, I. Determination of acyclovir in human serum hy hi -performance liquid chromatography. J.Liq.Chromatogr., 1988, 11, 2593-2601 [serum non-interfering acetaminophen, allopurinol, baclofen, carbacholine, cefuroxime, chlorpropamide, cilastatin, cloxacillin, diazepam, di-cumarol, digoxin, flucloxacillm, furosemide, fusidic acid, fusidic, glipizide, heparin, hydrochlorothiazide, imipenem, insulin, isoniazid, ketoprofen, metronidazole, naproxen, perphenazine, phenytoin, prednisolone, propranolol, p3razinamide, p3ridoxine, ranitidine, rifampicin, rifampin, spironolactone, streptomycin, sulfamethoxazole, trimethoprim, warfarin]... 

A case report describes a 54-year-old woman with type 1 diabetes whose insulin requirements increased from 36 units to 48 units daily when she took rifampicin. Immediately on discontinuing her antituberculous therapy, she developed frequent hypoglycaemic attacks, which persisted until her insulin dose was reduced back to 36 units daily. ... 

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