Insulin Human

Pharmacokinetic parameters of pramlintide are altered when mixed with insulin. SYMLIN and insulin must not be mixed and must be administered as separate injections.

Insulin combined with Acarbose may cause further lowering of blood glucose and increase hypoglycemia potential, including rare cases of hypoglycemic shock. Dosage adjustments recommended.

Coadministration may increase risk of hypoglycemia; lower doses of insulin secretagogue may be required.

Coadministration may require lower dosages of insulin secretagogue to reduce risk of hypoglycemia.

Concomitant use increases risk of hypoglycemia. A lower dose of insulin may be required when used in combination with bexagliflozin.

May cause hypoglycemia through additive effects when dosage exceeds maximum recommended daily amount.

Concomitant use increases risk of hypoglycemia. May require lower dosage of insulin to reduce hypoglycemia risk.

Increases risk of hypoglycemia. Concomitant use may require lower insulin dosage.

Risk of hypoglycemia may be increased when dapagliflozin is used concomitantly with insulin. Concomitant use may require lower doses of insulin to reduce hypoglycemia risk.

Concomitant use increases hypoglycemia risk; may require lower insulin doses.

Increased risk of hypoglycemia when used with dapagliflozin and saxagliptin. Concomitant use may require lower insulin doses.

Concomitant use increases risk of hypoglycemia. Consider reducing dose of insulin when initiating TRULICITY.

Risk of hypoglycemia is increased when combined with empagliflozin; lower insulin doses may be needed.

Risk of hypoglycemia is increased when GLYXAMBI is combined with insulin. May require lower insulin dosages.

Concomitant use increases hypoglycemia risk; insulin dosage reduction may be needed.

Concomitant use increases hypoglycemia risk; lower insulin dosages may be required.

Increased risk of hypoglycemia when combined with ertugliflozin; lower insulin dose may be required.

Concomitant use increases risk of hypoglycemia. Lower doses of insulin may be required when used with STEGLUJAN.

Exenatide promotes insulin release, increasing hypoglycemia risk when combined with insulin secretagogues. Dose reduction of secretagogue or insulin recommended.

Coadministration increases risk of hypoglycemia. Lower dosages of insulin may be required when used with linagliptin.

Concomitant use increases hypoglycemia risk. Insulin dosage may require reduction when combined with linagliptin and metformin.

Liraglutide stimulates insulin release and increases risk of hypoglycemia, including severe hypoglycemia, when combined with insulin. Consider reducing insulin dose.

Coadministration with metformin may increase risk of hypoglycemia.

Metoclopramide alters gastric emptying, which may cause insulin to act before food leaves the stomach, leading to hypoglycemia. Insulin dosage or timing may require adjustment.

Metoclopramide may affect insulin absorption and action timing, potentially leading to hypoglycemia; insulin dosage or timing may require adjustment.

Octreotide inhibits insulin secretion, requiring monitoring and adjustment of anti-diabetic treatment and blood glucose levels.

Coadministration increases hypoglycemia risk and may require dose reduction.

Semaglutide lowers blood glucose and increases risk of hypoglycemia when used with insulin. Dose reduction of insulin should be considered when initiating semaglutide.

Increases hypoglycemia risk when combined with ZITUVIMET XR; may require dose reduction.

Risk of hypoglycemia when initiating MOUNJARO; consider reducing insulin dose.

May increase risk of hypoglycemia; dose adjustment and increased glucose monitoring required.

Sympathomimetic agent that may decrease blood glucose lowering effect; dose adjustment and glucose monitoring may be required.

May increase or decrease blood glucose lowering effect; dose adjustment and glucose monitoring may be required.

Coadministration may increase hypoglycemia risk. Lower dosages of insulin may be required when used with alogliptin.

May increase risk of hypoglycemia; dose adjustment and increased glucose monitoring may be required.

Apraclonidine may inhibit catecholamine production in response to insulin-induced hypoglycemia and mask hypoglycemia signs.

Increased risk of hypoglycemia with concomitant administration.

Dosage adjustment may be required due to hydrochlorothiazide effects on glucose metabolism.

Carvedilol may enhance insulin action; monitor for hypoglycemia.

Carvedilol may enhance insulin action; monitor blood glucose.

Chloroquine may enhance hypoglycemic effects of insulin, requiring a decrease in insulin doses.

Dosage adjustment of insulin may be required when used concurrently with chlorothiazide.

Dosage adjustment of insulin may be required when used concurrently with chlorothiazide sodium.

Chlorthalidone may alter insulin requirements in diabetic patients; requirements may be increased, decreased, or unchanged.

May increase or decrease blood glucose effect and blunt hypoglycemia signs; increased glucose monitoring required.

Atypical antipsychotic that may decrease blood glucose lowering effect; dose adjustment and increased glucose monitoring may be required.

May decrease blood glucose lowering effect; dose adjustment and increased glucose monitoring may be required.

May decrease blood glucose lowering effect; dose adjustment and increased glucose monitoring may be required.

Antidiabetic drug requirements may be altered when used concurrently with diethylpropion.

May increase risk of hypoglycemia; dose adjustment and increased glucose monitoring may be required.

May decrease blood glucose lowering effect; dose adjustment and increased glucose monitoring may be required.

Concomitant use increases hypoglycemia risk; insulin dosage may require reduction.

Sympathomimetic agent that may decrease blood glucose lowering effect; dose adjustment and glucose monitoring may be required.

Risk of hypoglycemia is increased when STEGLATRO is used in combination with insulin. A lower dose of insulin may be required to minimize hypoglycemia risk.

In diabetic patients, androgens' metabolic effects may decrease blood glucose and insulin requirements; monitoring recommended.

May decrease blood glucose lowering effect; dose adjustment and increased glucose monitoring may be required.

May increase risk of hypoglycemia; dose adjustment and increased glucose monitoring may be required.

Diminished antidiabetic effect. Monitor for hyperglycemia and adjust insulin dosage upward if necessary.

May increase risk of hypoglycemia; dose adjustment and increased glucose monitoring may be required.

May increase glucose-lowering effect of glimepiride, increasing susceptibility to and/or intensity of hypoglycemia.

Insulin acts antagonistically to glucagon. Monitor blood glucose when glucagon is used as a diagnostic aid in patients receiving insulin.

Insulin acts antagonistically to glucagon. Monitor blood glucose when glucagon is used as a diagnostic aid in patients receiving insulin.

May blunt signs and symptoms of hypoglycemia; increased glucose monitoring required.

Dosage adjustment of the antidiabetic drug may be required.

Hydroxychloroquine may enhance insulin effects and increase hypoglycemic risk; dosage adjustment may be necessary.

Hydroxychloroquine sulfate may enhance hypoglycemic effects, requiring a decrease in insulin doses.

Patients with insulin-dependent diabetes may require modification of insulin dosage following initiation of EXTRANEAL treatment. Blood glucose must be monitored and insulin adjusted if needed.

Dosage adjustment of insulin may be required when coadministered with hydrochlorothiazide.

May decrease blood glucose lowering effect; dose adjustment and increased glucose monitoring may be required.

Lanreotide inhibits insulin secretion; blood glucose monitoring and antidiabetic treatment adjustment are recommended.

Initiating thyroid replacement therapy may increase insulin requirements. Close monitoring recommended during initiation of thyroid therapy.

Levothyroxine therapy may result in increased insulin requirements. Monitor glycemic control, especially when thyroid therapy is started, changed, or discontinued.

Addition of levothyroxine to insulin therapy may result in increased insulin requirements. Careful monitoring of diabetic control is recommended.

Initiating thyroid replacement therapy may cause increases in insulin requirements. Patients should be closely monitored during initiation of thyroid replacement therapy.

Concomitant administration may cause increased blood-glucose-lowering effect with risk of hypoglycemia.

May increase or decrease blood glucose lowering effect; dose adjustment and glucose monitoring may be required.

SKYTROFA may decrease insulin sensitivity, particularly at higher doses. Patients with diabetes mellitus may require adjustment of insulin doses.

May impact accuracy of MACRILEN diagnostic test by directly affecting pituitary growth hormone secretion and transiently elevating GH. Avoid concomitant use.

May increase risk of hypoglycemia; dose adjustment and increased glucose monitoring may be required.

May increase risk of hypoglycemia; dose adjustment and increased glucose monitoring may be required.

Coadministration with metformin may increase the risk of hypoglycemia.

Coadministration with metformin may increase risk of hypoglycemia. Patient may require lower insulin doses.

Coadministration with metformin may increase hypoglycemia risk; insulin dose may require reduction.

Coadministration with metformin may increase risk of hypoglycemia requiring dose reduction.

Insulin requirements in diabetes mellitus may be altered in association with methamphetamine use and concomitant dietary regimen.

In diabetic patients, metabolic effects of androgens may decrease blood glucose and insulin requirements.

May affect glucose tolerance; dosage adjustments of insulin may be necessary.

Hydrochlorothiazide may increase, decrease, or have no effect on insulin requirements in diabetic patients; monitoring recommended.

May increase risk of hypoglycemia; dose adjustment and increased glucose monitoring may be required.

Nadolol may cause hypoglycemia or hyperglycemia; adjust dosage of insulin accordingly.

May decrease blood glucose lowering effect; dose adjustment and increased glucose monitoring may be required.

Smoking cessation with nicotine replacement may require dose decrease due to increased subcutaneous insulin absorption.

May increase or decrease blood glucose effect and blunt signs/symptoms of hypoglycemia; increased glucose monitoring required.

Norepinephrine can decrease insulin sensitivity and raise blood glucose. Monitor glucose and consider dosage adjustment.

Somatostatin analog that may increase risk of hypoglycemia; dose adjustment and increased glucose monitoring may be required.

Atypical antipsychotic that may decrease blood glucose lowering effect; dose adjustment and increased glucose monitoring may be required.

May decrease blood glucose lowering effect; dose adjustment and increased glucose monitoring may be required.

When initiating FOUNDAYO, consider reducing the dose of concomitantly administered insulin due to potential additive effects on glucose lowering.

Patients with acromegaly and diabetes mellitus may require dose reductions of insulin after PEGVISOMANT initiation.

May cause hypoglycemia followed sometimes by hyperglycemia; dose adjustment and glucose monitoring may be required.

May increase risk of hypoglycemia; dose adjustment and increased glucose monitoring may be required.

Phendimetrazine tartrate may alter insulin requirements.

May decrease blood glucose lowering effect; dose adjustment and increased glucose monitoring may be required.

Requirements may be altered when used with phentermine.

May increase glucose-lowering effect of glimepiride, increasing susceptibility to hypoglycemia. Close monitoring required.

May increase risk of hypoglycemia; dose adjustment and increased glucose monitoring may be required.

May decrease blood glucose lowering effect; dose adjustment and increased glucose monitoring may be required.

May blunt signs and symptoms of hypoglycemia; increased glucose monitoring required.

May increase risk of hypoglycemia; dose adjustment and increased glucose monitoring may be required.

Concomitant use may increase hypoglycemia risk. Lower dosages of insulin may be required when used with saxagliptin.

Concomitant use may cause hypoglycemia. May require lower dosages of insulin to reduce hypoglycemia risk.

Coadministration may require lower doses of insulin to reduce the risk of hypoglycemia.

Coadministration may require lower dosages of insulin to reduce the risk of hypoglycemia.

Coadministration with sitagliptin may require lower doses of insulin to reduce the risk of hypoglycemia.

Diabetic patients may require dosage adjustments of insulin due to dialysis effects on blood glucose control.

SOGROYA may decrease insulin sensitivity, particularly at higher doses, requiring adjustment of insulin doses in diabetic patients.

NGENLA may decrease insulin sensitivity, particularly at higher doses. Patients with diabetes may require adjustment of insulin doses.

Insulin dose may require adjustment when used concomitantly with somatropin.

Dosage may require adjustment due to potential hyperglycemia when used concomitantly with sotalol.

Dosage adjustment of the antidiabetic drug may be required.

Sympathomimetic agent that may decrease blood glucose lowering effect; dose adjustment and glucose monitoring may be required.

Androgens may decrease blood glucose and insulin requirement in diabetic patients. Changes in insulin sensitivity or glycemic control may occur.

In diabetic patients, androgens may decrease blood glucose and insulin requirements, necessitating insulin dosage adjustment.

Androgens may decrease blood glucose and insulin sensitivity, necessitating decreased insulin doses in diabetic patients.

Androgens may decrease blood glucose and insulin requirements in diabetic patients. Monitor glycemic control and adjust insulin dosing as needed.

Androgens may decrease blood glucose and insulin requirements in diabetic patients, necessitating insulin dose adjustment.

Initiating thyroid replacement therapy may cause increases in insulin requirements. Patients receiving insulin should be closely monitored during thyroid replacement initiation.

May decrease blood glucose lowering effect; dose adjustment and increased glucose monitoring may be required.

Initiating thyroid replacement therapy may increase insulin requirements. Patients should be closely monitored during initiation of thyroid replacement therapy.

Concomitant use may cause increased blood glucose lowering effect with greater risk of hypoglycemia.

Concomitant use may increase blood glucose lowering effect with greater risk of hypoglycemia.

Dosage adjustment may be required when hydrochlorothiazide is administered concurrently.

Smoking cessation with varenicline may alter insulin pharmacokinetics or pharmacodynamics, necessitating dose adjustment.

Smoking cessation may alter pharmacokinetics or pharmacodynamics, necessitating dose adjustment.

No clinically significant interactions noted with concomitant use, though caution advised pending wider clinical experience.

Prazosin has been administered without adverse drug interaction with insulin in limited clinical experience.

Administered without adverse drug interaction in limited clinical experience.

7 DRUG INTERACTIONS Table 1: Clinically Significant Drug Interactions with HUMULIN N Drugs that May Increase the Risk of Hypoglycemia Drugs: Antidiabetic agents, ACE inhibitors, angiotensin II receptor blocking agents, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, pentoxifylline, pramlintide, salicylates, somatostatin analog (e.g., octreotide), and sulfonamide antibiotics Intervention: Dose adjustment and increased frequency of glucose monitoring may be required when HUMULIN N is co-administered with these drugs.

7 DRUG INTERACTIONS Table 1: Clinically Significant Drug Interactions with HUMULIN N Drugs that May Increase the Risk of Hypoglycemia Drugs: Antidiabetic agents, ACE inhibitors, angiotensin II receptor blocking agents, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, pentoxifylline, pramlintide, salicylates, somatostatin analog (e.g., octreotide), and sulfonamide antibiotics Intervention: Dose adjustment and increased frequency of glucose monitoring may be required when HUMULIN N is co-administered with these drugs.