Drug General Information (ID: DDI36DAKSY)
Drug Name			Guanethidine		Drug Info		Insulin glulisine		Drug Info
Drug Type		Small molecule				Hormones
Therapeutic Class		Antihypertensive Agents				Antidiabetic Agents
Structure

Mechanism of Guanethidine-Insulin glulisine Interaction (Severity Level: Moderate)
Increased risk of hypoglycemia Click to Show/Hide Mechanism Graph
Drug Name		Guanethidine				Insulin glulisine
Mechanism		Hypoglycemic effects				Hypoglycemic effects
Key Mechanism Factor 1
		Factor Name		Hypoglycemia
		Factor Description		Hypoglycemia is a condition in which your blood sugar (glucose) level is below the standard range. It causes irregular or rapid heartbeat, pale skin, numbness of the lips, tongue or cheeks, and sweating.
Mechanism Description		Increased risk of hypoglycemia by the combination of Guanethidine and Insulin glulisine

Recommended Action
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 Patients should be observed for loss of glycemic control when antiadrenergic therapy is withdrawn.

References
1	Gupta KK "Guanethidine and glucose tolerance in diabetics." Br Med J 3 (1968): 679
2	Gupta KK "The antidiabetic action of guanethidine." Postgrad Med J 45 (1969): 455-6
3	Gupta KK "Guanethidine and diabetes." Br Med J 2 (1968): 697-8