Can a patient take Lispro (insulin lispro) and metoprolol succinate (Extended-Release metoprolol succinate)?

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Last updated: March 25, 2025View editorial policy

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From the Guidelines

A patient can take Lispro (insulin lispro) and metoprolol succinate (Extended-Release metoprolol succinate) together, but they should be aware of the potential for metoprolol to mask symptoms of hypoglycemia. This combination is commonly prescribed for patients with both diabetes and cardiovascular conditions, as they work through different mechanisms [ 1 ]. The American Diabetes Association standards of medical care in diabetes suggest that when basal insulin has been titrated to appropriate fasting blood glucose levels but the HbA1c level remains above target, combination injectable therapy should be considered to reduce postprandial glucose excursions [ 1 ].

Key considerations for this combination include:

  • Monitoring blood glucose levels more frequently, especially when first starting metoprolol or after dose adjustments
  • Being familiar with all symptoms of hypoglycemia, not just the cardiovascular ones
  • Supervision by healthcare providers who can monitor for any interactions and adjust dosages as needed
  • Never adjusting or discontinuing either medication without medical guidance

It's also important to note that controlling individual cardiovascular risk factors, such as dyslipidemia, hypertension, and smoking, can prevent or slow atherosclerotic cardiovascular disease (ASCVD) in persons with diabetes [ 1 ]. Therefore, the combination of Lispro and metoprolol succinate should be part of a comprehensive management plan that includes regular assessment of cardiovascular risk factors.

From the Research

Interaction between Lispro and Metoprolol Succinate

  • There is no direct evidence in the provided studies that addresses the interaction between Lispro (insulin lispro) and metoprolol succinate (Extended-Release metoprolol succinate) 2, 3, 4, 5, 6.
  • However, studies have shown that Lispro can be used to improve glycemic control in patients with diabetes mellitus, including type 1 and type 2 diabetes 2, 3, 4, 6.
  • Metoprolol succinate, on the other hand, has been shown to lower blood pressure without altering insulin sensitivity in diabetic patients 5.
  • It is essential to note that the use of Lispro and metoprolol succinate together may require careful monitoring of blood glucose levels and blood pressure, as well as adjustment of dosages as needed.

Efficacy and Safety of Lispro

  • Lispro has been shown to be effective in reducing postprandial glucose levels and improving glycemic control in patients with diabetes mellitus 2, 3, 4, 6.
  • The use of Lispro has also been associated with a lower risk of hypoglycemia compared to regular human insulin 2, 4.

Efficacy and Safety of Metoprolol Succinate

  • Metoprolol succinate has been shown to be effective in lowering blood pressure in diabetic patients without altering insulin sensitivity 5.
  • The use of metoprolol succinate has not been associated with significant changes in measures of insulin sensitivity, plasma lipids, or hemoglobin A1c 5.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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