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Pentamidine and Tolazamide

Determining the interaction of Pentamidine and Tolazamide and the possibility of their joint administration.

Check result:

Pentamidine <> Tolazamide

Relevance: 21.02.2023 Reviewer: Shkutko P.M., M.D., in

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.

Consumer:

Pentamidine can sometimes affect blood glucose levels. Both hyperglycemia (high blood glucose) and hypoglycemia (low blood glucose) have been reported. The risk is greater when the medication is given by injection than when given by oral inhalation. Patients with reduced kidney function, such as the elderly, may also be at greater risk for developing these problems. Your blood glucose should be closely monitored during treatment with pentamidine so that your diabetic regimen may be adjusted, if needed. Let your doctor know if you experience hyperglycemia or hypoglycemia, or if you notice a loss of blood glucose control. Symptoms of hyperglycemia may include increased thirst, increased hunger, and increased urination. Symptoms of hypoglycemia include headache, dizziness, drowsiness, nervousness, confusion, tremor, nausea, hunger, weakness, perspiration, palpitation, and rapid heartbeat. 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.

Professional:

MONITOR: Pentamidine may interfere with the therapeutic effects of insulin and other antidiabetic agents. The use of pentamidine has been associated with disturbances in blood glucose homeostasis due to direct toxic effects on beta cells of the pancreas. Hypoglycemia, which may be severe and/or prolonged, as well as hyperglycemia and insulin-dependent diabetes mellitus, the latter of which may be irreversible, have been reported. The onset of pentamidine-induced hypoglycemia generally varied from 5 to 7 days after start of therapy to several days after therapy stops. In some cases, hyperglycemia and progression to diabetes followed, although these effects have occurred independently also. Pancreatic toxicity has been reported with both parenteral use and, less frequently, oral inhalation of pentamidine. The risk appears to be related to total cumulative dosage and prior therapy with the drug, particularly within the last 3 months. Renal impairment also appears to be a risk factor.

MANAGEMENT: Blood glucose should be monitored closely during and after pentamidine therapy in patients receiving insulin or other antidiabetic agents, especially if they are elderly or have renal impairment. Patients should learn to recognize the symptoms of hypoglycemia such as headache, dizziness, drowsiness, nervousness, confusion, tremor, hunger, weakness, perspiration, palpitation, and tachycardia. If hypo- or hyperglycemia occur during pentamidine therapy, patients should initiate appropriate remedial therapy immediately and contact their physician. Dosage adjustments may be required if an interaction is suspected.

References

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Hardy H, Esch LD, Morse GD "Glucose disorders associated with HIV and its drug therapy." Ann Pharmacother 35 (2001): 343-51
Shen M, Orwoll ES, Conte JE, Prince MJ "Pentamidine-induced pancreatic beta-cell dysfunction." Am J Med 86 (1989): 726-8
Liegl U, Bogner JR, Goebel FD "Insulin-dependent diabetes mellitus following pentamidine therapy in a patient with AIDS." Clin Investig 72 (1994): 1027-9
"Product Information. Lantus (insulin glargine)" Aventis Pharmaceuticals, Swiftwater, PA.
Wood G, Wetzig N, Hogan P, Whitby M "Survival from pentamidine induced pancreatitis and diabetes mellitus." Aust N Z J Med 21 (1991): 341-2
Stahl-Bayliss CM, Kalman CM, Laskin OL "Pentamidine-induced hypoglycemia in patients with the acquired immune deficiency syndrome." Clin Pharmacol Ther 39 (1986): 271-5
Bouchard PH, Sai P, Reach G, et al "Diabetes mellitus following pentamidine-induced hypoglycemia in humans." Diabetes 31 (1982): 40-5
"Product Information. NebuPent (pentamidine)." Fujisawa, Deerfield, IL.
Kallas EG, Galvao LL, Roland RK, Medeiros EA, Levi GC, Mendonca JS "Pentamidine induced ketoacidosis in acquired immunodeficiency syndrome patients." Int Conf AIDS 9 (1993): 474
Assan R, Mayaud C, Perronne C, Matheron S, Assan D, Zucman D, Chotard L "Pentamidine-induced derangements of glucose homeostasis: determinant roles of renal failure and drug accumulation - a study of 128 patients." Diabetes Care 18 (1995): 47-55
Millard PS, van der Horst C "Reversible diabetes mellitus after intravenous pentamidine." Am J Med 91 (1991): 442
Coyle P, Carr AD, Depczynski BB, Chisholm DJ "Diabetes mellitus associated with pentamidine use in HIV-infected patients." Med J Aust 165 (1996): 587-8
"Product Information. Pentam 300 (pentamidine)." Fujisawa, Deerfield, IL.
Ostrowski M, Walmsley S, Pluemecke G, Salit I, Rachlis A, Krajden S "Pentamidine-induced diabetes mellitus (PIDM)." Int Conf AIDS 9 (1993): 465
"Product Information. Novolog (insulin aspart)" Novo Nordisk Pharmaceuticals Inc, Princeton, NJ.

Pentamidine

Generic Name: pentamidine

Brand name: Nebupent, Pentam 300, Pentam

Synonyms: Pentamidine (Oral Inhalation)

What is Pentamidine?

Tolazamide

Generic Name: tolazamide

Brand name: Tolinase

Synonyms: TOLAZamide

What is Tolazamide?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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