Moderate
losartan × metformin
Angiotensin II receptor blockers (sartans)×Biguanides. Oral antihyperglycemic agents
Mechanism
Sartans, like ACE inhibitors, improve tissue insulin sensitivity. In patients on insulin or sulfonylureas with metformin, the risk of hypoglycemia rises modestly when losartan is started.
Management
Monitor glucose 1–2 weeks after losartan initiation. Be prepared to reduce insulin dose if applicable.
Sources
- Lexicomp: Lexicomp Drug Interactions (2024)— Wolters Kluwer Clinical Drug Information, Inc. Lexi-Interact Online, 2024
- Pharmaceutical Press: Stockley's Drug Interactions, 12th edition (2024)— Preston CL (ed.). Stockley's Drug Interactions. 12th ed. London: Pharmaceutical Press; 2024