Drug General Information (ID: DDIKB4EYVC)
Drug Name			Diltiazem		Drug Info		Insulin glulisine		Drug Info
Drug Type		Small molecule				Hormones
Therapeutic Class		Antihypertensive Agents				Antidiabetic Agents
Structure

Mechanism of Diltiazem-Insulin glulisine Interaction (Severity Level: Minor)
Antagonize the effect of antidiabetic agents Click to Show/Hide Mechanism Graph
Drug Name		Diltiazem				Insulin glulisine
Mechanism		Decrease the hypoglycemic effect of insulin				Insulin
Key Mechanism Factor 1
		Factor Name		Antidiabetic agents
		Factor Description		The hypoglycemic effect of antidiabetes may be reduced, leading to higher blood glucose, increased blood glucose fluctuations, and the possibility of hyperglycemic complications
Mechanism Description		Antagonize the effect of Insulin glulisine when combined with Diltiazem

Recommended Action
Management		While no special precautions appear to be necessary, patients may consider monitoring blood glucose more closely during the first few days or weeks of diltiazem therapy until glucose control is assured.

References
1	Sigusch H, Henschel L, Kraul H, Merkel U, Hoffmann A "Lack of effect of grapefruit juice on diltiazem bioavailability in normal subjects." Pharmazie 49 (1994): 675-9.[PMID: 7972311]
2	Christensen H, Asberg A, Holmboe AB, Berg KJ "Coadministration of grapefruit juice increases systemic exposure of diltiazem in healthy volunteers." Eur J Clin Pharmacol 58 (2002): 515-520.[PMID: 12451428]
3	Pershadsingh HA, Grant N, McDonald JM "Association of diltiazem therapy with increased insulin resistance in a patient with type I diabetes mellitus." JAMA 257 (1987): 930-1