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Comprehensive interaction database and contraindication reference for clinical decision-making
Additive hypoglycemic effect
Increased risk of hypoglycemia, especially during initiation
Reduce insulin dose by 20-50% when starting GLP-1. Monitor BG closely. Titrate based on response.
Additive hypoglycemic effect
Increased hypoglycemia risk
Consider reducing sulfonylurea dose by 50% when initiating GLP-1. May need to discontinue.
Delayed gastric emptying may reduce absorption
Potentially reduced contraceptive efficacy
Use backup contraception during titration. Consider non-oral methods.
GI effects may alter absorption; weight loss affects dosing
INR may fluctuate
Monitor INR more frequently during initiation and dose changes.
Delayed gastric emptying may alter absorption
Variable thyroid hormone levels
Take levothyroxine 1 hour before GLP-1 or at bedtime. Monitor TSH.
GH antagonizes insulin action
May increase insulin requirements
Monitor glucose. May need to increase insulin dose by 10-20%.
Chronic glucocorticoids suppress GH release
Reduced efficacy of GH secretagogues
May need higher doses. Consider alternative approaches if on chronic steroids.
MK-677 may increase insulin resistance
Worsening glycemic control
Monitor HbA1c. May need to increase metformin or add second agent.
Additive dopaminergic effects
Increased stimulation, potential overstimulation
Reduce stimulant dose by 25-50%. Monitor for anxiety, insomnia, tachycardia.
Semax affects catecholamine metabolism
Risk of hypertensive crisis
Avoid combination. Wait 14 days after MAOI discontinuation.
Both affect GABA system
Additive anxiolytic effect, possible enhanced sedation
May allow reduced benzodiazepine dose. Monitor for excessive sedation.
Selank modulates serotonin indirectly
Generally well-tolerated, possible enhanced effect
Monitor for serotonergic effects. Usually safe combination.
Cerebrolysin may lower seizure threshold in susceptible patients
Potential for breakthrough seizures
Ensure anticonvulsant levels therapeutic. Monitor closely.
BPC-157 may protect against NSAID GI damage
Potentially beneficial interaction—reduced GI side effects
Consider adding BPC-157 for patients on chronic NSAIDs.
TB-500 promotes angiogenesis and tissue remodeling
Theoretical increased bleeding at wound sites
Monitor for bleeding. May need INR adjustment during active healing.
PT-141 causes transient BP increase
May counteract antihypertensive effect acutely
Avoid in uncontrolled HTN. Monitor BP. Limit to ≤8 doses/month.
Pharmacokinetic interaction—reduced absorption
Reduced PT-141 efficacy
Contraindicated per FDA label. Avoid combination.
Opposing mechanisms—TA1 enhances immune function
May reduce immunosuppressant efficacy
Generally avoid in transplant patients. Consult transplant team if considering.
Additive immune activation
Enhanced anti-tumor effect but increased autoimmune risk
May be beneficial in oncology. Monitor for immune-related adverse events.
Do not use under these conditions
Use with caution; weigh risk vs benefit