Interactions

Drug-Drug

• Ingestion of alcohol may result in disulfiram-like reaction

• Effectiveness may be decreased by concurrent use of diuretics, calcium channel blockers, corticosteroids, phenothiazines, hormonal contraceptives, estrogens, thyroid agents, phenytoin, nicotinic acid, adrenergics, and isoniazid

• Alcohol, androgens (testosterone), chloramphenicol, fluoroquinolones, MAO inhibitors, miconazole, NSAIDs), probenecid, salicylates, sulfonamides, and warfarin may increase the risk of hypoglycemia

• Concurrent use with warfarin may alter the response to both agents (may increase effects of both; close monitoring recommended during any changes in dosage)

• Beta blockers may alter the response to oral hypoglycemic agents (increase or decrease requirements; nonselective agents may cause prolonged hypoglycemia)

Drug-Natural Products
Glucosamine may worsen hypoglycemia. Fenugreek, chromium, and coenzyme Q-10 may produce additive hypoglycemic effects

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