Tresiba (insulin degludec) has potential interactions with alcohol, other medications, and some supplements. These interactions could affect how well the drug works or cause harmful effects.
Tresiba manages blood sugar (glucose) levels in adults and certain children with diabetes.
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.
Keep reading to learn about Tresiba’s possible interactions.
Before starting Tresiba, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions.
To learn whether Tresiba interacts with herbs, vitamins, or supplements, see the “Are there other interactions with Tresiba?” section.
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The following table lists drugs that may interact with Tresiba. Keep in mind that this table does not include all drugs that may interact with Tresiba. For more information about some of these interactions, see the “Drug interactions explained” section.
| Drug group or drug name | Drug examples | What can happen |
|---|---|---|
| atypical antipsychotics | • clozapine (Clozaril, Versacloz) • olanzapine (Zyprexa) | can make Tresiba less effective |
| beta-blockers | • carvedilol (Coreg) • metoprolol (Lopressor, Toprol XL) | can increase or decrease the effect of Tresiba |
| corticosteroids | • prednisone • dexamethasone (Hemady) | can make Tresiba less effective |
| diuretics | • furosemide (Lasix, Furoscix) • bumetanide (Bumex) | can make Tresiba less effective |
| monoamine oxidase inhibitors (MAOIs) | • phenelzine (Nardil) • isocarboxazid (Marplan) | can increase the risk for low blood sugar (hypoglycemia) as a side effect of Tresiba |
| other medications that treat diabetes | • glucagon-like peptide-1 (GLP-1) agonists such as semaglutide (Rybelsus, Ozempic) • sodium-glucose transport protein 2 (SGLT-2) inhibitors, such as empagliflozin (Jardiance) | can increase the risk of low blood sugar (hypoglycemia) as a side effect of Tresiba and other medications that treat diabetes |
| protease inhibitors | • atazanavir (Reyataz) • tipranavir (Aptivus) | can make Tresiba less effective |
| thiazolidinediones | • pioglitazone (Actos) • rosiglitazone | can increase the risk of fluid retention as a side effect of thiazolidinediones, which may cause heart failure |
| medications that lower potassium | • sodium polystyrene sulfonate (Kalexate, others) • sodium zirconium cyclosilicate (Lokelma) | can increase the risk of low blood potassium as a side effect of Tresiba |
| certain blood pressure medications | • angiotensin converting enzyme (ACE) inhibitors, such as lisinopril (Zestril, Qbrelis) • angiotensin II receptor blockers (ARBs), such as valsartan (Diovan) | can increase the risk of low blood sugar as a side effect of Tresiba |
Certain health conditions or other factors could raise your risk of harm if you receive Tresiba. These are known as contraindications. In such cases, your doctor may not prescribe this drug for you. The following list includes contraindications of Tresiba.
If you have low blood sugar: You should not inject a dose of Tresiba if you’re actively experiencing low blood sugar. Tresiba lowers blood sugar, so taking this drug during an episode of hypogylcemia can lower it further, which can lead to serious symptoms, including coma. If you have diabetes, talk with your doctor to develop your hypoglycemic action plan. Follow their prescribed plan if your blood sugar level is low, such as eating 15 grams (g) of sugar if it drops below 70 mg/dL.
If you’ve had an allergic reaction: If you’ve had an allergic reaction to Tresiba or any of its ingredients, your doctor likely won’t prescribe Tresiba for you. Talk with them about other treatments that may be better options.
Before starting Tresiba, talk with your doctor if any of the factors mentioned here apply to you. They can determine whether Tresiba may be safe for you.
If you drink alcohol, your doctor will likely advise you to avoid or minimize consuming it during your Tresiba treatment.
Alcohol interacts with diabetes medications, including Tresiba. Consuming alcohol can increase or decrease your blood sugar level and can increase the glucose-lowering effect of Tresiba. This can raise your risk of low blood sugar, including the risk of severe reactions such as coma.
If you have questions about consuming alcohol during Tresiba treatment, talk with your doctor or pharmacist.
Learn more about certain drug interactions that can occur with Tresiba.
Interaction with other medications that treat diabetes
Tresiba can interact with other medications prescribed to treat diabetes.
Like Tresiba, these other drugs work by lowering your blood sugar. Taking these medications with Tresiba may increase your risk of low blood sugar as a side effect of either drug.
Here are some other medications that treat diabetes that may interact with Tresiba:
- glucagon-like peptide-1 (GLP-1) agonists, such as semaglutide (Rybelsus, Ozempic)
- sodium-glucose transport protein 2 (SGLT-2) inhibitors, such as empagliflozin (Jardiance)
- dipeptidyl peptidase-4 (DPP-4) blockers, such as sitagliptin (Januvia)
- metformin (Fortamet, Glumetza)
- other insulins, such as insulin aspart (NovoLog, others)
What you can do
Although an interaction exists between Tresiba and other medications that treat diabetes, these medications are commonly prescribed together.
If your doctor recommends you receive Tresiba with other diabetes medications, they may prescribe a lower Tresiba dosage or a lower dosage of the other antidiabetic medication. They’ll also likely have you monitor your blood sugar level at home. They can discuss an action plan to follow should your blood sugar level become low, such as eating 15 g of fast-acting carbs (e.g., half a cup of fruit juice).
Interaction with certain blood pressure medications
Receiving Tresiba with certain blood pressure medications can increase the risk of low blood sugar as a side effect of Tresiba.
Here are some blood pressure medications that may interact with Tresiba:
What you can do
Despite this interaction, it’s typically still safe to receive Tresiba with an ACE inhibitor or ARB medication. In fact, Tresiba is commonly prescribed with these drugs.
If your doctor recommends you receive Tresiba with an ACE inhibitor or ARB, they may prescribe a lower dosage of Tresiba or a lower dosage of the ACE inhibitor or ARB medication. They’ll also likely have you monitor your blood sugar level at home and discuss a plan for you to follow should it become low.
If you have questions about using Tresiba with an ACE inhibitor or ARB, talk with your doctor or pharmacist.
Interaction with beta-blockers
Tresiba can interact with beta-blockers, which are prescribed to treat conditions including high blood pressure, heart failure, and arrhythmia.
Tresiba and beta blockers can interact in a few ways:
- beta-blockers can increase or decrease the effect of Tresiba; this can increase your risk of low blood sugar or high blood sugar
- beta-blockers can lessen or even hide the symptoms of low blood sugar, which means you may not notice your blood sugar is low until it becomes severe
Here are some beta-blockers that may interact with Tresiba:
- atenolol (Tenormin)
- bisoprolol
- carvedilol (Coreg)
- metoprolol (Lopressor, Toprol XL)
- propranolol (Inderal LA)
What you can do
Although an interaction exists between Tresiba and beta-blockers, these medications are still commonly prescribed together.
If you receive Tresiba with a beta-blocker, your doctor will adjust your Tresiba dosage based on your blood sugar levels. They’ll also likely have you monitor your blood sugar at home and discuss a plan for you to follow should it become low.
If you have questions about using Tresiba with a beta-blocker, talk with your doctor or pharmacist.
Tresiba may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests.
Here are additional interactions that may occur with Tresiba. Note that this is not a full list of all other possible interactions with Tresiba.
Does Tresiba interact with supplements?
Before starting Tresiba, talk with your doctor and pharmacist about any herbs, vitamins, or supplements you take. Sharing this information with them may help you avoid possible interactions.
Tresiba interactions with herbs
Tresiba can interact with green tea extract supplements. Green tea supplements are used for a wide range of health benefits, such as helping reduce inflammation.
Green tea supplements can lower your blood glucose level. Taking a green tea supplement and using Tresiba may increase your risk of low blood sugar.
For this reason, it’s important to check with your doctor or pharmacist before taking a green tea extract. If you use a green tea extract during treatment, they may adjust your Tresiba dosage.
Tresiba interactions with vitamins and minerals
Tresiba can interact with chromium supplements. Chromium is a mineral that can improve how well insulin works.
Chromium supplements can lower your blood glucose level. Taking a chromium supplement and using Tresiba may increase your risk of low blood sugar.
For this reason, it’s important to check with your doctor or pharmacist before taking a chromium supplement while using Tresiba. If you continue using a chromium supplement during Tresiba treatment, your doctor may adjust your Tresiba dosage.
Does Tresiba interact with food?
Tresiba may interact with green tea. Green tea drinks can lower your blood glucose level. Since Tresiba also lowers blood glucose, consuming green tea drinks while using Tresiba may increase your risk of low blood sugar.
For this reason, it’s important to let your doctor know if you consume green tea drinks during Tresiba treatment. They’ll likely advise you to keep your green tea consumption consistent from day to day. They can adjust your Tresiba dosage to minimize your risk of hypoglycemia based on your blood sugar levels and the amount of green tea you drink.
If you have questions about consuming green tea during your treatment with Tresiba, talk with your doctor.
Does Tresiba interact with vaccines?
There are currently no reports of Tresiba interacting with vaccines. If you have questions about getting certain vaccines during Tresiba treatment, talk with your doctor.
Does Tresiba interact with lab tests?
There are currently no reports of Tresiba interacting with lab tests. If you have questions about having certain lab tests during your treatment with Tresiba, talk with the healthcare professional ordering the test.
Does Tresiba interact with cannabis or CBD?There are currently no reports of Tresiba interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Tresiba.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may increase the risk of interactions with Tresiba. Before starting this medication, talk with your doctor about your health history. They’ll determine whether Tresiba is right for you.
Health conditions or other factors that might interact with Tresiba include:
Kidney problems: If you have chronic kidney disease (CKD) or another kidney problem, you may have a higher risk of low blood sugar as a side effect of Tresiba. Due to this, your doctor may want you to monitor your blood sugar more frequently during Tresiba treatment.
Liver problems: Having cirrhosis or another liver problem can raise your risk of developing low blood sugar as a side effect of Tresiba. Because of this risk, your doctor may want you to monitor your blood sugar more frequently during Tresiba treatment.
Tobacco use: Let your doctor know if you smoke cigarettes or other tobacco products before you begin Tresiba treatment. Smoking tobacco can affect how well Tresiba works. If you stop smoking during Tresiba treatment, the effect of Tresiba could increase. If you’re interested in smoking cessation, be sure to tell your doctor during Tresiba treatment. They may want to adjust your Tresiba dosage to lower your risk of low blood sugar.
Pregnancy: Studies to date have not identified a risk of harm — such as pregnancy loss or problems with fetal development (commonly known as birth defects) — when Tresiba is used during pregnancy. There are known risks to not managing diabetes (the condition Tresiba is prescribed to treat) during pregnancy. If you’re pregnant or may become pregnant, talk with your doctor about the best way to treat your diabetes during this time.
Breastfeeding: It is unknown whether it’s safe to receive Tresiba while breastfeeding. It is unknown whether the drug passes into breast milk or the effects it might have on a child who’s breastfed. If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options.
Allergic reaction: If you’ve had an allergic reaction to Tresiba or any of its ingredients, your doctor will likely not prescribe Tresiba for you. They can recommend other treatments that may be better options.
Taking certain steps can help you avoid interactions with Tresiba. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- whether you drink alcohol or use cannabis
- the
list of medications you take, as well as any vitamins, supplements, and herbs - what to do if you start taking a new drug during your Tresiba treatment
It’s also important to understand Tresiba’s
If you did not get paperwork with Tresiba, ask your pharmacist to print a copy for you. If you have difficulty reading or understanding this information, your doctor or pharmacist can help.
Using Tresiba exactly as prescribed can also help prevent interactions.
If you have questions about Tresiba interactions that may affect you, talk with your doctor or pharmacist.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.