Some medicines that are used for treating other medical conditions can cause elevated blood sugar in people with diabetes. You may need to monitor your blood glucose more closely if you take one of the medicines listed below.
It’s important to note that just because a medicine has the possibility of raising blood sugar, it does not mean the medicine is unsafe for a person with diabetes. For instance, many people with type 2 diabetes need to take a diuretic and a statin to lower blood pressure and cholesterol. In these and many other cases, the pros will almost always outweigh the cons. Don’t ever take matters of medication into your own hands. Discuss any concerns you have with your healthcare provider.
Of all the different antibiotics, the ones known as quinolones are the only ones that may affect blood glucose. They are prescribed for certain types of infection.
- Levofloxacin (Levaquin)
- Ofloxacin (Floxin)
- Moxifloxacin (Avelox)
- Ciprofloxacin (Cipro, Cipro XR, Proquin XR)
- Gemifloxacin (Factive)
Second Generation Antipsychotics
These medicines are used for a variety of mental health conditions. There is a strong association between these medicines and elevated blood sugar, and frequent monitoring is recommended.
- Clozapine (Clozaril)
- Olanzapine (Zyprexa)
- Paliperidone (Invega)
- Quietiapine (Seroquel, Seroquel XR)
- Risperidone (Risperdal)
- Aripiprazole (Abilify)
- Ziprasidone (Geodon)
- Iloperidone (Fanapt)
- Lurasidone (Latuda)
- Pemavanserin (Nuplazid)
- Asenapine (Saphris)
Beta blockers are used to treat high blood pressure and certain heart conditions. Not all available beta blockers have been shown to cause high blood sugar.
Corticosteroids are used to treat conditions where there is inflammation, such as arthritis and bone and joint injuries. They are also used for asthma, severe allergy, COPD, and during cancer therapy. Corticosteroids, also known as steroids, are strongly associated with elevated blood sugar, and frequent monitoring is recommended. Inhaled steroids, and those applied to the skin, are not likely to affect blood sugar.
- Prednisone (Steripred)
- Prednisolone (Prelone and others)
- Methylprednisolone (Medrol, Depo-Medrol)
- Hydrocortisone (Cortef)
- Dexamethasone (Decadron)
- Fludrocortisone (Florinef)
- Betamethasone (Celestone)
Diuretics are used to reduce excess fluid in the body, and to treat high blood pressure. Many people with type 2 diabetes take one of these drugs. In lower doses, they are less likely to affect blood sugar.
Calcineurin Inhibitors (CNIs)
These medicines are used in organ transplant patients to prevent rejection.
- Cyclosporine (Genfgraf, Neoral, Sandimmune)
- Tacrolimus (Astagraf XL, Invarsus XR, Prograf)
- Sirolimus (Rapamune)
These medicines are used to treat HIV and AIDS.
- Atazanavir (Reyataz)
- Darunavir (Prezista)
- Fosamprinavir (Lexiva)
- Indinavir (Crixivan)
- Nelfinavir Viracept)
- Ritonivir (Norvir)
- Saquinavir (Invirase)
- Tipranivir (Aptivus)
Statins lower cholesterol levels, and are recommended for most people with type 2 diabetes to reduce the risk of heart attack and stroke. The benefits of heart attack and stroke prevention far outweigh the risk of elevating blood sugar.
- Rosuvastatin (Crestor)
- Lovastatin (Mevacor)
- Simvastatin (Zocor)
- Atorvastatin (Lipitor)
- Pravastatin (Pravachol)
- Fluvastatin (Lescol)
- Pitavastatin (Livalo)
Niacin (nicotinic acid)
Niacin is used to lower triglycerides and cholesterol. In higher doses, it can raise blood sugar.
- Niacin (Niaspan, Niacor, Slo-Niacin and various non-prescription products)
Over-the-Counter (Non-Prescription) Medicines That May Affect Blood Sugar
The most common offenders are in the class of medicines known as decongestants. Decongestants don’t contain sugar, but cause the release of stored sugar into the bloodstream. They are used to reduce nasal congestion, often during cold season and allergy season. There are two decongestants available in the U.S. and one, pseudoephedrine, is usually kept behind the counter, to be sold only by a pharmacist. These decongestants are included in many multi-symptom products.
- Nyquil Severe Cold and Flu liquid (phenylephrine)
- Tylenol Multi-Symptom Severe liquid (phenylephrine)
- Robitussin Severe Multi-Symptom liquid (phenylephrine)
- Alka-Seltzer Day/Night Multi-Symptom (phenylephrine)
- Advil Cold and Sinus tablets (pseudoephedrine)
- Mucinex D tablets (pseudoephedrine)
- Allegra D tablets (pseudoephedrine)
The second category is products that actually contain sugar: most often cough syrups, cough drops, and lozenges. The extent of the effect on blood sugar relates to the amount taken per dose, and the number of doses taken daily. As an example, a non-sugar-free cough drop may contain 2 to 4 grams of sugar, and a typical non-sugar-free cough syrup may contain 3 to 5 grams of sugar per two teaspoons. Multi-symptom cough and cold syrups may contain sugar as well as a decongestant. These are almost always available in a sugar-free variety, but they may be more expensive and taste slightly different than those containing sugar.
- Robitussin Cough Syrup
- Robitussin DM Cough Syrup
- Luden’s cough drops
- Hall’s cough drops
One other medicine that can affect blood glucose is ephedrine. It’s an ingredient in the asthma medicines Primatene and Bronkaid. Ephedrine is known to cause elevated blood pressure, blood sugar, and heart rate, and is best avoided.
Remember, too, herbal and other “natural” products may contain chemicals that can affect your diabetes, and you should always consult your healthcare provider before taking these products. Your pharmacist is also a great resource for information on the products they stock in the pharmacy, so do not hesitate to ask advice.
Reviewed by James A. Bennett, RPh, FACA, CDE, 10/16.