Drug General Information (ID: DDIROJ8BPS)
Drug Name			Sulfasalazine		Drug Info		Insulin aspart (aspart protamine)		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiinflammatory Agents				Antidiabetic Agents
Structure

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

Recommended Action
Management		Close monitoring for the development of hypoglycemia is recommended if these drugs are coadministered with insulin, particularly in patients with advanced age and/or 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).

References
1	Asplund K, Wiholm BE, Lithner F "Glibenclamide-associated hypoglycaemia: a report on 57 cases." Diabetologia 24 (1983): 412-7. [PMID: 6411511]
2	Product Information. Apidra (insulin glulisine). Aventis Pharmaceuticals, Bridgewater, NJ.
3	Semel JD, Wortham E, Karl DM "Fasting hypoglycemia associated with disopyramide." Am Heart J 106 (1983): 1160-1. [PMID: 6356848]