Basic Information
ID DDInter669 and DDInter1081
Interaction Lithium may interfere with the therapeutic effects of insulin and other antidiabetic agents.
Management Blood glucose should be monitored more closely following initiation or discontinuation of lithium in patients receiving insulin or other antidiabetic agents. If hypo- or hyperglycemia occur during lithium therapy, patients should initiate appropriate remedial therapy immediately and contact their physician. Dosage adjustments may be required if an interaction is suspected.
References [1] "Product Information. Lantus (insulin glargine)" Aventis Pharmaceuticals, Swiftwater, PA. [2] "Product Information. NovoLog Mix 70/30 FlexPen (insulin aspart-insulin aspart protamine)." Novo Nordisk Pharmaceuticals Inc, Princeton, NJ. [3] "Product Information. Apidra (insulin glulisine)." Aventis Pharmaceuticals, Bridgewater, NJ. [4] Shopsin B, Stern S, Gershon S "Altered carbohydrate metabolism during treatment with lithium carbonate." Arch Gen Psychiatry 26 (1972): 566-71 [5] Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7 [6] "Product Information. Fycompa (perampanel)." Eisai Inc, Teaneck, NJ. [7] Gilman AG, Rall TW, Nies AS, Taylor P, eds. "Goodman and Gilman's the Pharmacological Basis of Therapeutics. 8th ed." New York, NY: Pergamon Press Inc. (1990): [8] "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc, Rockville, MD. [9] "Product Information. Diabinese (chlorpropamide)." Pfizer US Pharmaceuticals, New York, NY. [10] Skillman TG, Feldman JM "The pharmacology of sulfonylureas." Am J Med 70 (1981): 361-72 [11] Jerntorp P, Almer LO "Chlorpropamide-alcohol flushing in relation to macroangiopathy and peripheral neuropathy in non-insulin dependent diabetes." Acta Med Scand 656 (1981): 33-6 [12] "Product Information. Glucotrol (glipizide)." Pfizer US Pharmaceuticals, New York, NY. [13] "Position Statement: evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes related complications. American Diabetes Association." Diabetes Care 25(Suppl 1) (2002): S50-S60 [14] Hartling SG, Faber OK, Wegmann ML, Wahlin-Boll E, Melander A "Interaction of ethanol and glipizide in humans." Diabetes Care 10 (1987): 683-6 [15] Barnett AH, Spiliopoulos AJ, Pyke DA, et al "Metabolic studies in chlorpropamide-alcohol flush positive and negative type 2 (non-insulin dependent) diabetic patients with and without retinopathy." Diabetologia 24 (1983): 213-5 [16] Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0 [17] "Product Information. Diabeta (glyburide)." Hoechst Marion-Roussel Inc, Kansas City, MO. [18] Jerntorp P, Almer LO, Holin H, et al "Plasma chlorpropamide: a critical factor in chlorpropamide-alcohol flush." Eur J Clin Pharmacol 24 (1983): 237-42
Alternative for Ertugliflozin A10B
Simvastatin Rosuvastatin Guar gum
Alternative for Lithium carbonate -
Potential Metabolism Interactions
Substrate-Substrate Interaction：If more than one drug is metabolized by the same CYP, it is possible that its metabolism is inhibited because of the competition between the drugs. That means, it can be useful to lower the dosage of the drugs in the drug-cocktail because they remain longer in the organism than in monotherapy.
Inhibitor-Inhibitor Interaction：Combining two or more inhibitors of one CYP, should be compensated by lowering the dosage of these drugs because the metabolism is reduced and the drugs remain longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.
Inhibitor-Substrate Interaction：Combining drugs that have inhibitory effect and are substrates of one particular CYP, should be compensated by lowering the dosage. They rest longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.