Moderate
Losartan × Metformin
Angiotensin II receptor blockers (sartans)×Biguanides. Oral antihyperglycemic agents
Mechanism
ARBs, like ACE inhibitors, improve tissue insulin sensitivity. In patients on insulin or sulfonylureas with metformin, the glucose-lowering effect may be amplified.
Symptoms
Signs of hypoglycaemia: sweating, tremor, hunger, tachycardia, confusion. Symptoms appear at glucose below 3.9 mmol/L.
Management
On metformin alone, no dose adjustment needed. On insulin or sulfonylureas, intensify glucose self-monitoring for the first 2 weeks after starting losartan. The effect is helpful in type 2 diabetes with arterial hypertension.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
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