Nine Drugs

I recently received an e-mail alerting me to a webpage discussing "9 Common Drugs That Every Diabetic Should Avoid Mixing With Their Meds." It was such an intriguing title that I Googled the phrase, and found that several websites had exactly the same list!

I totally disagree with the author's premise that people with diabetes (PWD) should avoid the medications on the list; in fact, all of these medications are reasonable for PWD to take, if their physician and/or pharmacist explains the issues involved.

Here's the original information (including some poor grammar and miscapitalizations), plus my comment for each:

Beta Blockers: Beta-blockers, such as Lopressor (metoprolol), Tenormin (Atenolol), and Inderal (propanolol), have been known to reduce the release of insulin.

The main concern for PWD with the use of beta-blockers, which are very useful drugs for the treatment of hypertension and heart disease, is that they might mask some of the symptoms of hypoglycemia. If you are prone to hypoglycemia, you could expect your usual symptoms relating to pounding heart and shakiness to be blunted while on beta-blockers.

Minoxidil: Minoxidil, a direct vasodilator, has a tendency to raise blood glucose levels.

See my comment after this list...

Thiazide Diuretics: Thiazide diuretics include such drugs as Diuril (Chlorothiazide), Zaroxolyn (Metolazone), and Oretic (Hydrochlorothiazide), and is known to raise glucose levels due to its effect it has on causing the loss of potassium.

See my comment after this list...

Calcium channel blockers: Calcium channel blockers, which are prescribed for Hypertension, management of Angina include such drugs as Calan (Verapamil), Adalat (Nifedipine),and Norvasc (Amlodipine), and is known to reduce the secretion of insulin.

I'm not sure where this information originated, or why someone considered it important enough to include in this list of medications. For instance, the USPI for Calan doesn't even mention the words insulin, diabetes, diabetic, glucose, or sugar. And the USPI for amlodipine states: "No clinically relevant changes were noted in serum glucose" and "Amlodipine besylate tablets have been used safely in patients with ... diabetes mellitus"

Oral contraceptives: Although current oral contraceptives seem to be safe, the older versions were known to have caused hypoglycemia when estrogen doses were taken at higher than normal doses.

See my comment after this list...

Corticosteroids: Even though corticosteroids can be used as a topical solution, it has a tendency to raise blood glucose levels.

I have written about PWD using steroid medications: Your doctor advises using steroids, and I pointed out that use of steroids is associated with rapid and sometimes dramatic increases in BG levels. But if there's no other therapy that's likely to work, and if the patient has been informed of the probable increase of blood sugar level, and if the doctor and the patient have a plan on how to cope with the increased blood sugar levels, they can be safely used in PWD.