Ismelin and Tolazamide

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Using guanethidine together with insulin or certain other diabetes medications may increase the risk of hypoglycemia, or low blood sugar. In addition, guanethidine may mask some of the symptoms of hypoglycemia such as tremor, palpitation and rapid heartbeat, making it more difficult to recognize an oncoming episode. Other symptoms of hypoglycemia such as headache, dizziness, drowsiness, nervousness, confusion, nausea, hunger, weakness, and perspiration are not affected. Talk to your doctor if you have any questions or concerns. You may need to monitor your blood glucose levels more frequently, especially if you are prone to developing hypoglycemia. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

MONITOR: Postganglionic adrenergic blocking agents may potentiate the hypoglycemic effects of insulin and insulin secretagogues (e.g., sulfonylureas, meglitinides). Limited data have demonstrated possible hypoglycemic activity with agents such as guanethidine and reserpine. The mechanism may involve depletion of catecholamine stores from adrenergic nerve endings, which can interfere with glycogenolysis and other mechanisms related to regulation of blood glucose levels. In one case report, a diabetic patient required an insulin dose increase following discontinuation of guanethidine therapy. Another study found improved glucose tolerance in three patients with type II diabetes given guanethidine 50 to 90 mg/day. Postganglionic adrenergic blocking agents can also diminish the physiological response to hypoglycemia induced by insulin and insulin secretagogues, as catecholamines are responsible for certain symptoms of hypoglycemia such as tremor, tachycardia, and blood pressure changes.

MANAGEMENT: Close monitoring for the development of hypoglycemia is recommended when postganglionic adrenergic blocking agents are coadministered with insulin or insulin secretagogues, particularly in patients with advanced age and/or renal impairment. Insulin and oral antidiabetic dosages may require adjustment if an interaction is suspected. Patients should be instructed about the need for regular monitoring of blood glucose levels and be aware that certain symptoms of hypoglycemia such as tremor and tachycardia may be masked during antiadrenergic therapy. However, other symptoms such as headache, dizziness, drowsiness, nausea, hunger, and sweating may be unaffected. Patients should be observed for loss of glycemic control when antiadrenergic therapy is withdrawn.

Ismelin

Generic Name: guanethidine

Brand name:

Synonyms: Ismelin (Oral)

What is Ismelin?

Tolazamide

Generic Name: tolazamide

Brand name: Tolinase

Synonyms: TOLAZamide

What is Tolazamide?