Basic Information
ID DDInter669 and DDInter50
Interaction Concomitant use of oral products containing aloe vera gel may potentiate the hypoglycemic effect of insulin and other antidiabetic agents.
Management Until more data are available, caution is advised when aloe vera is administered orally to patients receiving insulin or other antidiabetic agents due to the potential for increased risk of hypoglycemia. Patients should be monitored for changes in diabetic medication requirements.
References [1] Yeh GY, Eisenberg DM, Kaptchuk TJ, Phillips RS "Systemic review of herbs and dietary supplements for glycemic control in diabetes." Diabetes Care 26 (2003): 1277-94 [2] Tanaka M, Misawa E, Yousuke I, et al "Identification of five phytosterols from Aloe vera gel as anti-diabetic compounds." Biol Pharm Bull 29 (2006): 1418-22 [3] Vogller BK "Aloe vera: a systematic review of its clinical effectiveness." Br J Gen Pract 49 (1999): 823-8 [4] Skillman TG, Feldman JM "The pharmacology of sulfonylureas." Am J Med 70 (1981): 361-72 [5] "Product Information. Diabinese (chlorpropamide)." Pfizer US Pharmaceuticals, New York, NY. [6] "Product Information. Diabeta (glyburide)." Hoechst Marion-Roussel Inc, Kansas City, MO. [7] 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 [8] 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 [9] Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0 [10] 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 [11] "Product Information. Glucotrol (glipizide)." Pfizer US Pharmaceuticals, New York, NY. [12] "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 [13] Hartling SG, Faber OK, Wegmann ML, Wahlin-Boll E, Melander A "Interaction of ethanol and glipizide in humans." Diabetes Care 10 (1987): 683-6
Alternative for Ertugliflozin A10B
Acetohexamide Troglitazone Simvastatin Rosuvastatin Guar gum
Alternative for Aloe Vera Leaf -
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.