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When two drugs affect each other, it is a drug–drug interaction (DDI). The risk of a DDI increases with the number of drugs used. [1] A large share of elderly people regularly use five or more medications or supplements, with a significant risk of side-effects from drug–drug interactions. [2] Drug interactions can be of three kinds:
It has possible interactions with dozens of prescription drugs and other supplements. [34] Diabetic people who take insulin should not use chromium picolinate, as it may adversely affect insulin levels and control of blood glucose. [33] Chromium picolinate should not be used while pregnant or during breastfeeding. [33]
Many drugs to combat diabetes are aimed at modifying the function of the beta cell. Sulfonylureas are insulin secretagogues that act by closing the ATP-sensitive potassium channels, thereby causing insulin release. [31] [32] These drugs are known to cause hypoglycemia and can lead to beta-cell failure due to overstimulation. [2]
Insulin is also used along with glucose to treat hyperkalemia (high blood potassium levels). [7] Typically it is given by injection under the skin, but some forms may also be used by injection into a vein or muscle. [6] There are various types of insulin, suitable for various time spans.
[1] [3] Other medications used to rapidly reduce blood potassium levels include insulin with dextrose, salbutamol, and sodium bicarbonate. [1] [5] Medications that might worsen the condition should be stopped and a low potassium diet should be started. [1]
An example demonstrating how drug combination with additive effect can cause adverse effects is the co-administration of ACEI and potassium-sparing diuretics. [3] Despite having different mechanisms of action, the drugs are able to reduce potassium excretion from the body.