Drugs That Raise Blood Sugar

Several common over-the-counter and prescription medications can affect blood sugar. While there are many different ways in which medication can raise blood sugar, the end result of elevated blood sugar can cause or worsen diabetes. Any medication, whether it requires a prescription or not, should be discussed with your healthcare provider due to the effects it can have on other medications.

This article will discuss some of the common medications that can raise your blood sugar, their uses and potential alternative solutions for people who may experience harmful blood sugar rises.

Corticosteroids

Corticosteroids are medications that reduce inflammation and are commonly used to treat inflammatory conditions, like gout, rheumatoid arthritis, psoriasis, and asthma flares. Corticosteroids are also used along with other immunosuppressants in people who have received an organ transplant.

Corticosteroids have many undesirable side effects, including increased blood sugar, fluid retention, weight gain, poor wound healing, and osteoporosis. For this reason, corticosteroids are often prescribed at the lowest necessary dose and for the shortest time possible, tapering them when necessary.

If you have diabetes and require steroids, such as for severe asthma or inflammatory conditions, your healthcare provider will be sure you take steroids for the shortest duration necessary. Your healthcare provider will also want to work with you on a plan to get your baseline symptoms under control with medications that don't include steroids. This can include things like controller inhalers for asthma or biologic agents in rheumatoid arthritis. These can help reduce the future need for corticosteroids.

Heart Medications

Some medications used to treat heart conditions, high cholesterol, and high blood pressure can increase blood sugar. Your healthcare provider will weigh the risks and benefits for you when prescribing these medications. For many, these medications are essential in reducing the risk of heart attack, stroke, and death. If you're concerned that heart medications could increase your blood sugar, talk with your prescribing provider before stopping them.

Beta-Blockers

Beta-blockers are a class of medication used in treatment of heart failure, heart attack, and arrhythmias (abnormal heart rhythms). Beta-blockers can also be used in treatment of high blood pressure, but they are generally not considered as the first choice, since other medications are more effective and have fewer side effects.

One such side effect is increased blood sugar, which is more notable with some beta-blockers, like Toprol XL (metoprolol) and Tenormin (atenolol), compared to newer beta-blockers with blood vessel–widening properties like Coreg (carvedilol).

Interestingly, beta-blockers can also increase the risk of low blood sugar events (hypoglycemia), and decrease the typical warning signs of low blood sugar, which may mask the warning signs.

Diuretics

Diuretics ("water pills" that rid the body of water and salt) are commonly used for the treatment of high blood pressure. A specific class of diuretics, called thiazide-type diuretics, can raise blood sugar, especially when taken at higher doses. This includes the commonly prescribed blood-pressuring lowering medications HCTZ (hydrochlorothiazide) and chlorthalidone.

People with diabetes should monitor their blood sugar closely when taking these medications, and may wish to discuss alternative medications with a healthcare provider.

Niacin

Prescription-strength niacin (vitamin B3), sold under the brand names Niacor and Niaspan, is used to reduce cholesterol, though it's not as commonly prescribed as it used to be. It is effective at lowering triglycerides, and it is now generally reserved for people with severely elevated triglyceride levels. Niacin has significant side effects, like flushing, that make it difficult to tolerate for many people. Niacin also raises blood sugar, and is associated with increased risk of developing diabetes.

Statins

Statins are commonly prescribed medications for high cholesterol, as well as heart attack and stroke prevention. Some large studies in people taking statins have shown a possible small increase in blood sugar. This is more common in people with abnormal blood sugar levels or risk factors for diabetes. Statins may cause an earlier onset of diabetes in people who are already on their way to developing diabetes.

Because statins are so effective at reducing mortality in people at risk of heart disease, the benefits of taking statins often outweigh the risks of avoiding them due to the possibility of a modest increase in blood sugar. Discuss your concerns about managing blood sugar while on statins with your healthcare provider.

Some Antibiotics

Antibiotics are medications that kill or prevent the growth of bacteria. There are many classes of antibiotics, and some of them have the potential of raising blood sugar.

Fluroquinolones, which include antibiotics like Avelox (moxifloxacin) and levofloxacin, are a class of antibiotics that are commonly used to treat respiratory, urinary tract, and intra-abdominal infections. These antibiotics can cause serious fluctuations in blood sugar (either increases or decreases).

While there are many different types of antibiotics, one will be prescribed depending on the site of infection and the bacteria being targeted. Sometimes healthcare providers will have options to use other antibiotics, and at other times they may be restricted to using fluoroquinolones due to antibiotic resistance.

Birth Control

Depending on the specific formulation, birth control can raise blood sugar. Oral contraceptives can include a combination of estrogen and progestin together (known as combined hormonal contraception), or just progestin alone. Other forms of birth control also use progestin, like the injectable Depo-Provera (medroxyprogesterone acetate) and long-acting reversible contraception, such as implanted devices that include hormonal intrauterine devices (IUDs) and rods.

Conflicting data exist about which types of hormonal contraception increase blood sugar. One large cohort study showed that combined hormonal contraception use was linked to increased risk of prediabetes and diabetes in perimenopausal women. In this study, progestin-only contraception did not show the same risk.

However, other studies have shown that Depo-Provera, which only contains progesterone, increased risk of glucose abnormalities, particularly in those with longterm use who also had obesity and risk factors for diabetes.

Overall the benefits of contraception are considered to outweigh risk of unintended pregnancy, which can be complicated in those with diabetes or in those who develop gestational diabetes. Additionally, newer formulations of hormonal contraception contain a lower concentration of hormones, which may lessen the risks associated with diabetes. As always, any concerns about choosing medication with the lowest side effect profiles should be discussed with a healthcare provider.

Antipsychotics

Antipsychotics are effective medications for those with certain psychiatric conditions, like bipolar disorder and schizophrenia. However, they can have several undesirable side effects, including weight gain and increased blood sugar and cholesterol.

People taking antipsychotics, like Abilify (aripiprazole), Seroquel (quetiapine), and Zyprexa (olanzapine), should closely monitor their blood sugar levels, even if they are normal before starting treatment. Efforts at lifestyle modifications to prevent weight gain and diabetes risk can be helpful but may not be enough to combat blood sugar rises.

Summary

Many medications can increase blood sugar. Your healthcare team will discuss the risks and benefits of increased blood sugar with specific medications. They may be able to choose alternative medications that won't have this effect if you have diabetes or difficulty with blood sugar control. However, in some cases, the medications are needed, and blood sugar should be monitored closely and managed appropriately.