Drug General Information (ID: DDIJTSDX3O)
Drug Name			Doxycycline		Drug Info		Insulin detemir		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiinflammatory Agents				Antidiabetic Agents
Structure

Mechanism of Doxycycline-Insulin detemir Interaction (Severity Level: Moderate)
Increased risk of hypoglycemia Click to Show/Hide Mechanism Graph
Drug Name		Doxycycline				Insulin detemir
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 Doxycycline and Insulin detemir

Recommended Action
Management		Blood glucose should be monitored closely whenever tetracyclines are prescribed to patients on insulin, especially if they are elderly or have renal impairment. The insulin dosage may require adjustment if an interaction is suspected. Patients should be apprised of the signs and symptoms of hypoglycemia (e.g., headache, dizziness, drowsiness, nausea, hunger, tremor, weakness, sweating, palpitations), how to treat it, and to contact their physician if it occurs.

References
1	Miller JB "Hypoglycaemic effect of oxytetracycline." BMJ 2 (1966): 1007
2	Begin-Heick N, Heick HM, Norman MG "Regranulation of Islets of Langerhans and normalization of in vivo insulin secretion in ob/ob mice treated with oxytetracycline." Diabetes 28 (1979): 65-70
3	Dalpe-Scott M, Heick HM, Begin-Heick N "Insulin secretion in the obese (ob/ob) mouse: the effect of oxytetracycline on insulin release." Diabetes 32 (1983): 932-7