Insulin Lispro, Recombinant with Metoprolol Interaction Details

Brand Names Associated with Insulin Lispro, Recombinant

Brand Names Associated with Metoprolol

Medical Content Editor Dr. Brian Staiger, PharmD
Last updated Nov 13, 2023

Interaction Effect

Hypoglycemia or hyperglycemia; decreased symptoms of hypoglycemia

Interaction Summary

Concomitant antidiabetic drugs and beta-blockers may lead to hypo- or hyperglycemia, or may obscure symptoms of hypoglycemia. Tachycardia, but not other symptoms of hypoglycemia, such as dizziness and sweating, may be affected . Nonselective beta blockers can potentiate insulin-induced hypoglycemia and interfere with recovery of serum glucose levels. Worsening hyperglycemia may occur in patients with heart failure and diabetes . Increased frequency of glucose monitoring or dose adjustment of the antidiabetic agent may be required . Closely monitor for signs and symptoms of hypoglycemia with concurrent use, and if the beta-blocker is withdrawn, observe for loss of glycemic control .

Severity

Moderate

Onset

Delayed

Evidence

Probable

How To Manage Interaction

Concurrent use of antidiabetic agents with beta-blockers may increase or decrease the blood glucose lowering effect of the antidiabetic agent, and may decrease or obscure signs and symptoms of hypoglycemia. Increased frequency of glucose monitoring or dose adjustment of the antidiabetic agent may be required. Closely monitor for hypoglycemia with concurrent use, and if the beta-blocker is withdrawn, observe for signs of loss of glycemic control .

Mechanism Of Interaction

Altered glucose metabolism and beta blockade

Literature Reports

A) The choice of antihypertensive drug in elderly patients with diabetes who were taking either insulin or sulfonylureas had little effect on the risk of hypoglycemia, but after adjustment for other risk factors, the lowest risk was with cardioselective beta blockers and the highest with non-cardioselective beta blockers, with other antihypertensive drugs having intermediate results (N=13,559) .

B) Beta blockers, but not alpha blockade and ACE inhibitors, caused a deterioration in long-term glycemic control in patients with hypertension and non-insulin dependent diabetes. Some adverse effects on the lipid profile also occurred with beta blockade. These effects were especially apparent with propranolol. Concurrent use of an alpha blocker with the beta blocker prevented the deterioration due to beta blockade .

Insulin Lispro, Recombinant Overview

• Insulin lispro injection products are used to treat type 1 diabetes (condition in which the body does not produce insulin and therefore cannot control the amount of sugar in the blood). Insulin lispro injection products are also used to treat people with type 2 diabetes (condition in which the body does not use insulin normally and therefore cannot control the amount of sugar in the blood) who need insulin to control their diabetes. In patients with type 1 diabetes, insulin lispro injection products are always used with another type of insulin, unless it is used in an external insulin pump. In patients with type 2 diabetes, insulin lispro injection products may be used with another type of insulin or with oral medication(s) for diabetes. Insulin lispro injection products are a short-acting, manmade version of human insulin. Insulin lispro injection products work by replacing the insulin that is normally produced by the body and by helping move sugar from the blood into other body tissues where it is used for energy. They also stops the liver from producing more sugar.

• Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems. Using medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye problems, including changes or loss of vision, or gum disease.Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes.

Metoprolol Overview

• Metoprolol is used alone or in combination with other medications to treat high blood pressure. It also is used to treat chronic (long-term) angina (chest pain). Metoprolol is also used to improve survival after a heart attack. Metoprolol also is used in combination with other medications to treat heart failure. Metoprolol is in a class of medications called beta blockers. It works by relaxing blood vessels and slowing heart rate to improve blood flow and decrease blood pressure.

• High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation.

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Definitions

Severity Categories

Contraindicated

These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.

Major

This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.

Moderate

This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.

Minor

While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.

Onset

Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.

Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.

Evidence

Level of documentation of the interaction.

Established: The interaction is documented and substantiated in peer-reviewed medical literature.

Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.

How To Manage The Interaction

Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.

It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.

Mechanism Of Interaction

The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.

Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.

Where Does Our Information Come From?

Information for our drug interactions is compiled from several drug compendia, including:

• Gold Standard Drug Database
• Micromedex
• Lexicomp
• DrugBank

The prescribing information for each drug, as published on DailyMED, is also used. 

Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.

The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.