5 Interactions found for:
Drug Interactions
No drug interactions were found for selected drugs: Jardiance, pantoprazole.
This does not necessarily mean no interactions exist. Always consult your healthcare provider.
Drug and Food Interactions
Moderate
Jardiance
+ Food
The following applies to the ingredients: Empagliflozin (found in Jardiance)
GENERALLY AVOID: Alcohol may cause hypoglycemia or hyperglycemia in patients with diabetes. Hypoglycemia most frequently occurs during acute consumption of alcohol. Even modest amounts can lower blood sugar significantly, especially when the alcohol is ingested on an empty stomach or following exercise. The mechanism involves inhibition of both gluconeogenesis as well as the counter-regulatory response to hypoglycemia. Episodes of hypoglycemia may last for 8 to 12 hours after ethanol ingestion. By contrast, chronic alcohol abuse can cause impaired glucose tolerance and hyperglycemia. Moderate alcohol consumption generally does not affect blood glucose levels in patients with well controlled diabetes. A disulfiram-like reaction (e.g., flushing, headache, and nausea) to alcohol has been reported frequently with the use of chlorpropamide and very rarely with other sulfonylureas.
MANAGEMENT: Patients with diabetes should avoid consuming alcohol if their blood glucose is not well controlled, or if they have hypertriglyceridemia, neuropathy, or pancreatitis. Patients with well controlled diabetes should limit their alcohol intake to one drink daily for women and two drinks daily for men (1 drink = 5 oz wine, 12 oz beer, or 1.5 oz distilled spirits) in conjunction with their normal meal plan. Alcohol should not be consumed on an empty stomach or following exercise.
References
- Jerntorp P, Almer LO "Chlorpropamide-alcohol flushing in relation to macroangiopathy and peripheral neuropathy in non-insulin dependent diabetes." Acta Med Scand 656 (1981): 33-6
- Jerntorp P, Almer LO, Holin H, et al. "Plasma chlorpropamide: a critical factor in chlorpropamide-alcohol flush." Eur J Clin Pharmacol 24 (1983): 237-42
- Barnett AH, Spiliopoulos AJ, Pyke DA, et al. "Metabolic studies in chlorpropamide-alcohol flush positive and negative type 2 (non-insulin dependent) diabetic patients with and without retinopathy." Diabetologia 24 (1983): 213-5
- Hartling SG, Faber OK, Wegmann ML, Wahlin-Boll E, Melander A "Interaction of ethanol and glipizide in humans." Diabetes Care 10 (1987): 683-6
- "Product Information. Diabinese (chlorpropamide)." Pfizer U.S. Pharmaceuticals PROD (2002):
- "Product Information. Glucotrol (glipizide)." Pfizer U.S. Pharmaceuticals PROD (2002):
- "Product Information. Diabeta (glyburide)." Hoechst Marion-Roussel Inc, Kansas City, MO.
- Skillman TG, Feldman JM "The pharmacology of sulfonylureas." Am J Med 70 (1981): 361-72
- "Position Statement: evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes related complications. American Diabetes Association." Diabetes Care 25(Suppl 1) (2002): S50-S60
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
Drug and Pregnancy Interactions
Major
Pantoprazole
+ Pregnancy
The following applies to the ingredients: Pantoprazole
This drug is only recommended for use during pregnancy when there are no alternatives and the benefit outweighs the risk.
-Some experts state that this drug should not be used in pregnancy.
AU TGA pregnancy category: B3
US FDA pregnancy category: Not assigned.
Risk summary: Observational studies indicate that an association of major malformations or adverse events with use of this drug during pregnancy; however, drug-associated risks cannot definitively be established or excluded by observational studies due to methodological limitations.
Animal models have revealed evidence of changes to femur bone length and weight when given during gestation day 6 through lactation day 21. There are no controlled data in human pregnancy.
AU TGA pregnancy category B3: Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed. Studies in animals have shown evidence of an increased occurrence of fetal damage, the significance of which is considered uncertain in humans.
US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out.
References
- "Product Information. Protonix (pantoprazole)." Wyeth-Ayerst Laboratories PROD (2001):
- "Product Information. Protonix IV (pantoprazole)." Wyeth-Ayerst Laboratories PROD
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
Major
Jardiance
+ Pregnancy
The following applies to the ingredients: Empagliflozin (found in Jardiance)
Use should be avoided, especially during the second and third trimesters of pregnancy.
AU TGA pregnancy category: D
US FDA pregnancy category: Not Assigned
Risk Summary: There is limited data in pregnant women to determine a drug-associated risk for major birth defects and miscarriage. Based on animal data, this drug may cause adverse renal effects in the developing fetus.
Comments:
-Poorly controlled diabetes in pregnancy increases the risk of adverse maternal and fetal outcomes.
Animal studies have revealed evidence of adverse renal changes and embryofetal toxicity. Administration of this drug to pregnant animals during the period of organogenesis at doses up to 154 times the maximum clinical dose based on AUC resulted in maternal/fetal toxicity, malformations, and reduced offspring body weights. In juvenile rats, direct exposure to this drug at doses approximately 13 times the maximum clinical dose caused increased kidney weights and renal tubular/pelvic dilatations. These findings occurred during a period of renal development in rats corresponding to the late second and third trimester of human renal development. Animal studies do not indicate direct or indirect harmful effects with respect to fertility. There are no controlled data in human pregnancy.
Poorly controlled diabetes in pregnancy increases the maternal risk for diabetic ketoacidosis, pre-eclampsia, spontaneous abortions, preterm delivery, stillbirth, and delivery complications. Fetal risks of poorly controlled diabetes in pregnancy include an increased risk for major birth defects, stillbirth, and macrosomia-related morbidity.
AU TGA pregnancy category D: Drugs which have caused, are suspected to have caused or may be expected to cause, an increased incidence of human fetal malformations or irreversible damage. These drugs may also have adverse pharmacological effects. Accompanying texts should be consulted for further details.
US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out.
References
- "Product Information. Jardiance (empagliflozin)." Boehringer Ingelheim Ltd (2023):
- "Product Information. Jardiance (empagliflozin)." Boehringer Ingelheim SUPPL-42 (2023):
- "Product Information. Jardiance (empagliflozin)." Boehringer Ingelheim Pty Ltd (2024):
Drug and Breastfeeding Interactions
Major
Pantoprazole
+ Breastfeeding
The following applies to the ingredients: Pantoprazole
Use is not recommended and a decision should be made to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother.
Excreted into human milk: Yes (oral); Unknown (parenteral)
Excreted into animal milk: Yes (parenteral)
Comment: The effects in the nursing infant are unknown.
Animal models have evidence of decreased pup weight at doses of at least 10 mg/kg/day. There have been reports of excretion into human breast milk.
References
- "Product Information. Protonix (pantoprazole)." Wyeth-Ayerst Laboratories PROD (2001):
- "Product Information. Protonix IV (pantoprazole)." Wyeth-Ayerst Laboratories PROD
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
- United States National Library of Medicine "Toxnet. Toxicology Data Network. http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT" (2013):
- Briggs GG, Freeman RK. "Drugs in Pregnancy and Lactation." Philadelphia, PA: Wolters Kluwer Health (2015):
Major
Jardiance
+ Breastfeeding
The following applies to the ingredients: Empagliflozin (found in Jardiance)
Use is not recommended
Excreted into human milk: Unknown
Excreted into animal milk: Yes
Comments:
-A risk to the breastfed infant cannot be excluded; there is a potential for serious adverse effects on postnatal renal development.
-An alternate drug may be preferred, especially while nursing a newborn or preterm infant.
Drug accumulation was observed in the milk of lactating animals. Studies in juvenile rats with direct exposure demonstrated pelvic and tubular dilations of the kidney during maturation. Human kidney maturation occurs in utero and during the first 2 years of life; thus, a potential for serious harm to the developing kidney may exist for infants exposed to this drug during breastfeeding. However, some experts anticipate low amounts of this drug in human breastmilk due to high levels of plasma protein binding.
References
- "Product Information. Jardiance (empagliflozin)." Boehringer Ingelheim Ltd (2023):
- "Product Information. Jardiance (empagliflozin)." Boehringer Ingelheim SUPPL-42 (2023):
- Bethesda (MD): National Institute of Child Health and Human Development (US) "Empagliflozin - Drugs and Lactation Database (LactMed) https://www.ncbi.nlm.nih.gov/books/NBK500972/" (2023):
- "Product Information. Jardiance (empagliflozin)." Boehringer Ingelheim Pty Ltd (2024):
Therapeutic Duplication Warnings
No warnings were found for your selected drugs.Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
Switch to: Consumer Interactions
Drug Interaction Classification | |
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These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication. |
|
Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
Unknown | No interaction information available. |
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