Drug General Information (ID: DDIZRTKY84)
Drug Name			Pentamidine		Drug Info		Dulaglutide		Drug Info
Drug Type		Small molecule				Protein/peptide
Therapeutic Class		Antifungal Agents				Antidiabetic Agents

Mechanism of Pentamidine-Dulaglutide Interaction (Severity Level: Moderate)
Increased risk of hypoglycemia Click to Show/Hide Mechanism Graph
Drug Name		Pentamidine				Dulaglutide
Mechanism 1		Hypoglycemic effects				Antidiabetic agent
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 Pentamidine and Dulaglutide
Antagonize the effect of antihypertensive agents Click to Show/Hide Mechanism Graph
Drug Name		Pentamidine				Dulaglutide
Mechanism 2		Hyperglycemia				Antidiabetic agent
Key Mechanism Factor 2
		Factor Name		Antihypertensive agents
		Factor Description		The hypotensive effect of antihypertensive agents may be reduced, leading to higher blood pressure, increased blood pressure fluctuations, and possible cardiovascular damage.
Mechanism Description		Antagonize the effect of Dulaglutide when combined with Pentamidine
Mechanism 3		Hyperglycemic effects				Antidiabetic agent
Key Mechanism Factor 3
		Factor Name		Antihypertensive agents
		Factor Description		The hypotensive effect of antihypertensive agents may be reduced, leading to higher blood pressure, increased blood pressure fluctuations, and possible cardiovascular damage.
Mechanism Description		Antagonize the effect of Dulaglutide when combined with Pentamidine

Recommended Action
Management		Blood glucose should be monitored closely during and after pentamidine therapy in patients receiving insulin or other antidiabetic agents, especially if they are elderly or have renal impairment. Patients should learn to recognize the symptoms of hypoglycemia such as headache, dizziness, drowsiness, nervousness, confusion, tremor, hunger, weakness, perspiration, palpitation, and tachycardia. If hypo- or hyperglycemia occur during pentamidine therapy, patients should initiate appropriate remedial therapy immediately and contact their physician. Dosage adjustments may be required if an interaction is suspected.

References
1	Product Information. Pentam 300 (pentamidine). Fujisawa, Deerfield, IL.
2	Coyle P, Carr AD, Depczynski BB, Chisholm DJ "Diabetes mellitus associated with pentamidine use in HIV-infected patients." Med J Aust 165 (1996): 587-8. [PMID: 8941253]
3	Shen M, Orwoll ES, Conte JE, Prince MJ "Pentamidine-induced pancreatic beta-cell dysfunction." Am J Med 86 (1989): 726-8. [PMID: 2658578]