Practice · Interactions · continued

Follow-up: Oral contraceptives and delayed emptying: what the data shows posts 31–36

Practice › Interactions hypoglycaemia delayed gastric emptying needs a source Closed

This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.

cannula_notesTL2Member18 Dec 2024 · edited#31

y.adeyemi, post #20: Coming back to post #18, because the follow-up matters more than the original answer. Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing. The correction was fair and I had been repeating something I had not checked carefully enough. Go to post

Anticoagulants: no direct interaction with the compounds in this class. Weight loss and body composition changes might affect the clearance or effect of warfarin if you are on it; monitoring INR more frequently during weight loss is reasonable.

0 likes in reply to #20 19mo

b.brandtTL2 Moderator23 Dec 2024#32

Worth separating two things that post #28 runs together.

Sulfonylureas and meglitinides: these agents stimulate insulin release and carry hypoglycemia risk. Combining them with semaglutide or tirzepatide requires dose adjustment of the secretagogue and close monitoring. The combination is not contraindicated but requires active management.

0 likes 19mo

MSaarinenTL3Regular28 Dec 2024#33

Insulin interaction: semaglutide and tirzepatide are not contraindicated with insulin but the combination carries hypoglycemia risk if insulin doses are not adjusted. That is a reason for close monitoring, not for avoiding the combination.

7 likes 19mo

t.lindqvistTL2 Moderator3 Jan 2025#34

Metformin: commonly co-administered and relevant to gastrointestinal tolerability. Gastrointestinal side effects can overlap and additive. Taking them separately or adjusting one if tolerability is poor are reasonable approaches.

17 likes 19mo

j.delacroixTL3Regular8 Jan 2025#35

post #34 answers the question as asked. The question underneath it is different.

25 likes 19mo

i.brobergTL2 Moderator13 Jan 2025#36

On post #32 — agreed on the reasoning, with one qualification.

Separation timing versus clinically important interaction: a separation timing inconvenience (taking one medication 2 hours before or after another) is not the same as a clinically important interaction. Both can reduce absorption of one or the other, but only true interactions require active management.

0 likes 18mo

This topic was closed 45 days after the last reply. Closing is automatic for quiet topics so that a settled answer does not collect new questions underneath it. If you have a follow-up, open a new topic and link back to this one — that keeps both readable and gives your question its own title.

Suggested topics

Topic	Participants	Replies	Views	Activity
Follow-up: Reading an interaction checker output critically Practice › Interactions insulin hypoglycaemia delayed gastric emptying needs a source Solved Reading an interaction checker output critically — setting out what I have, and where I think it stops being reliable. I have read the maintained page on this and I still have a gap, so I am asking rather…	+62	66	13k	2d
Metformin co-administration and additive GI effects Practice › Interactions insulin hypoglycaemia metformin delayed gastric emptying Metformin co-administration and additive GI effects Writing it up because I had to work it out twice and would rather nobody else did. Reporting something rather than asking about it, in case the pattern is…	+28	32	2.1k	15mo
A widely repeated interaction claim that turns out to be unsupported — what changed since Practice › Interactions insulin hypoglycaemia metformin needs a source Solved A widely repeated interaction claim that turns out to be unsupported — what changed since Writing it up because I had to work it out twice and would rather nobody else did. I have read the maintained page on…	+89	94	5.9k	2h
Anaesthesia and elective surgery: the aspiration question Practice › Interactions metformin insulin delayed gastric emptying hypoglycaemia Posting this under the heading it deserves: Anaesthesia and elective surgery: the aspiration question Everything below is what sits behind that. A question about technique rather than about dose. I have been…	+103	115	6.6k	3mo
Antibiotics and a course of something with delayed emptying Practice › Interactions insulin hypoglycaemia needs a source metformin Antibiotics and a course of something with delayed emptying — setting out what I have, and where I think it stops being reliable. Reporting something rather than asking about it, in case the pattern is useful…	+99	108	1.4k	12mo

Related topics — sharing the tags hypoglycaemia, delayed gastric emptying, needs a source

Topic	Participants	Replies	Views	Activity
Pregnancy as an absolute contraindication Safety › Contraindications disordered eating delayed gastric emptying pregnancy & planning pancreatitis Solved Pregnancy as an absolute contraindication — setting out what I have, and where I think it stops being reliable. Asking about a population rather than about a person. The published trials in this class mostly…	+102	106	21k	14mo
Revisiting: Absolute versus relative contraindications Safety › Contraindications disordered eating pregnancy & planning pancreatitis delayed gastric emptying Revisiting: Absolute versus relative contraindications Writing it up because I had to work it out twice and would rather nobody else did. Asking about a population rather than about a person. The published…	+11	15	22k	5mo
Constipation management, with a dietitian's contribution Practice › Side effects constipation nausea delayed gastric emptying vomiting Solved Posting this under the heading it deserves: Constipation management, with a dietitian's contribution Everything below is what sits behind that. Practical question with the units stated, because I have seen…	+79	88	27k	21d
Pregnancy as an absolute contraindication — the long version Safety › Contraindications disordered eating pregnancy & planning delayed gastric emptying Under review On the subject in the title: Pregnancy as an absolute contraindication — the long version Working notes rather than a conclusion. General question, not a request for advice about my own care — I know the…		2	5.3k	14mo
Revisiting: Absolute versus relative contraindications Safety › Contraindications disordered eating delayed gastric emptying thyroid C-cell question pancreatitis Revisiting: Absolute versus relative contraindications — setting out what I have, and where I think it stops being reliable. Asking about a population rather than about a person. The published trials in this…	+80	85	7.4k	3mo