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What drugs or food have the potential to interact with the fibrate drug gemfibrozil (Lopid)?
- Statin antilipemics greatly increase risk for myopathy.
- Warfarin with fibrates increases risk for bleeding.
- Taken with antidiabetic drugs, fibrates increase risk for hypoglycemia.
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What drugs or food have the potential to interact with the angiotensin-converting enzyme (ACE) inhibitor captopril (Capoten)?
- Potassium-sparing diuretics, potassium supplements, or use of salt substitutes increase risk for hyperkalemia.
- Antihypertensive drugs, diuretics, and nitrates (such as nitroglycerin) increase risk for hypotension.
- NSAIDs may decrease effectiveness.
- Food decreases absorption.
- ACE inhibitors may cause lithium toxicity.
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What drugs or food have the potential to interact with the alpha/beta blocker carvedilol (Coreg)?
- Increases risk for hypoglycemia with insulin or oral hypoglycemic.
- May increase risk for digoxin toxicity.
- MAOI antidepressants cause bradycardia or hypotension.
- Cimetidine increases blood levels.
- Use with other antihypertensive drugs may increase risk for hypotension
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What drugs or food have the potential to interact with the cardiac glycoside digoxin (Lanoxin)?
- Erythromycin and some other antibiotics increase digoxin levels.
- Other antidysrhythmics (verapamil, quinidine, amiodarone, flecainide) increase digoxin levels; decrease digoxin dosage for concurrent administration.
- Diuretics increase risk for digoxin toxicity by decreasing potassium levels.
- Herbal ginseng increases risk of digoxin toxicity.
- St. John's wort decreases digoxin levels.
- This is not a complete list. Check for other interactions
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What drugs or food have the potential to interact with the nitrate drugs nitroglycerin (Nitrostat, Nitro-Dur, Nitro-Bid) and isosorbide dinitrate (Isordil)?
- Increased hypotension may result when used with other antihypertensive drugs or with alcohol.
- PDE5 inhibitors, such as sildenafil (Viagra) may cause severe hypotension.
- Beta blockers and calcium channel blockers decrease tachycardia caused by nitroglycerin.
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What drugs or food have the potential to interact with the calcium channel blocker (dihydropyridine) nifedipine (Adalat, Procardia)?
- Use with beta blockers may increase risk for heart failure; however, they can prevent reflex tachycardia.
- Melatonin increases blood pressure, pulse rate.
- Ginkgo biloba and ginseng increase blood levels.
- St. John's wort decreases blood levels.
- Grapefruit juice may increase blood levels.
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What drugs or food have the potential to interact with the direct acting vasodilator (hydralazine) drug hydralazine (Apresoline)?
- MAOI antidepressants may cause severe hypotension.
- Other antihypertensive drugs may cause hypotension.
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What drugs or food have the potential to interact with the class IA/sodium channel blocker drugs quinidine (Apo-Quinidine, Novo-Quinidine) and procainamide (Pronestyl)?
- Anticholinergic drugs cause increased anticholinergic symptoms (such as tachycardia) ; cholinergic drugs may decrease therapeutic effect.
- Antidysrhythmics may increase adverse or therapeutic effects; amiodarone increases risk for heart block.
- Antihypertensives may increase risk for hypotension.
- Quinidine increases digoxin levels and risk for digoxin toxicity; it also increases risk for warfarin toxicity.
- Large amounts of grapefruit juice may cause toxicity.
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What drugs or food have the potential to interact with the loop diuretic furosemide (Lasix)?
- Digoxin toxicity is a high risk with hypokalemia.
- Other diuretics increase the diuretic effect.
- NSAIDs may decrease diuretic effect.
- Neuromuscular blocking agents may have prolonged effect.
- Lithium toxicity may occur.
- Amphotericin B and corticosteroids increase risk for hypokalemia.
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What drugs or food have the potential to interact with the centrally acting alpha2 agonist clonidine (Catapres)?
- Central nervous system (CNS) depressants increase CNS adverse effects.
- Tricyclic antidepressants (TCAs) may decrease effectiveness.
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What drugs or food have the potential to interact with the class IB/sodium channel blocker lidocaine (Xylocaine)?
- Beta blockers, procainamide and quinidine increase lidocaine effects.
- Phenytoin increases hypotension, bradycardia.
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What drugs or food have the potential to interact with the direct renin inhibitor aliskiren (Tekturna)?
- Other antihypertensive drugs have an additive effect with aliskiren.
- Potassium-sparing diuretics and other drugs that increase potassium levels increase the risk for hyperkalemia.
- The drug decreases the blood level of furosemide (Lasix).
- Atorvastatin (Lipitor) and ketoconazole (Nizoral) increase blood levels.
- Irbesartan (Avapro) decreases blood levels.
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What drugs or food have the potential to interact with the class II/beta adrenergic blocker propranolol (Inderal)?
- Use with other antihypertensive drugs may increase risk for hypotension.
- Antacids may decrease absorption.
- Digoxin has an additive effect and may increase bradycardia.
- Beta blockers with oral hypoglycemic agents may increase risk for hypoglycemia, and propranolol may mask tachycardia caused by hypoglycemia.
- Beta blockers may increase effect of neuromuscular blockers.
- Antimuscarinic and anticholinergic drugs may decrease beta blocker effects.
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What drugs or food have the potential to interact with the class III/potassium channel blocker amiodarone (Cordarone)?
- CYP3A4 inhibitors, including grapefruit juice, azole antifungal drugs, and erythromycin increase risk for toxicity.
- CYP34A inducers, such as St. John's wort, and phenytoin decrease blood levels.
- Diuretics and drugs that increase QT interval increase risk for dysrhythmias.
- Beta blockers and calcium channel blockers increase risk for bradycardia.
- Amiodarone increases blood levels of quinidine, procainamide, phenytoin, digoxin, diltiazem, warfarin, and some statin drugs.
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What drugs or food have the potential to interact with the class IV/calcium channel blocker verapamil (Calan)?
- Digoxin levels are increased and risk for atrioventricular (AV) block increases with use of digoxin.
- Beta blockers increase risk for bradycardia and heart failure.
- With other antihypertensives, risk for hypotension is increased.
- IV calcium decreases effects.
- Levels of lithium and cyclosporine may be increased.
- Large amounts of grapefruit juice may increase blood levels
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What drugs or food have the potential to interact with the class IC/sodium channel blockers flecainide (Tambocor) and propafenone (Rythmol)?
- Increases digoxin levels.
- Beta blockers and calcium channel blockers potentiate cardiac effects.
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What drugs or food have the potential to interact with the alpha1 adrenergic blocker doxazosin (Cardura)?
Sildenafil (Viagra) and other phosphodiesterase inhibitors may increase risk for hypotension.
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What drugs or food have the potential to interact with the HMG-CoA reductase inhibitor (statin) drug simvastatin (Zocor)?
- Concurrent use of a fibrate or other drug to lower cholesterol can increase risk for myopathy or liver toxicity.
- Drugs that inhibit CYP3A4, such as erythromycin, azole antifungal drugs, and HIV protease inhibitors, increase blood levels of some statins (especially lovastatin and simvastatin).
- Drinking large amounts of grapefruit juice also inhibits CYP3A4 and can increase risk for adverse effects.
- Warfarin with a statin increases risk for bleeding and increased prothrombin (PT) levels.
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What drugs or food have the potential to interact with the angiotensin receptor blocker (ARB) losartan (Cozaar)?
- Antihypertensive drugs increase risk for hypotension.
- Phenobarbital decreases serum levels of losartan.
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What drugs or food have the potential to interact with the potassium-sparing diuretic spironolactone (Aldactone)?
- Counteracts adverse effect (hypokalemia) of loop and thiazide diuretics (may be the desired effect).
- Angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), direct renin blockers, potassium supplements, salt substitutes increase risk of hyperkalemia.
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What drugs or food have the potential to interact with the phosphodiesterase inhibitor milrinone (Primacor)?
- The antidysrhythmic drug disopyramide (Norpace) may cause severe hypotension.
- Incompatible in solution with furosemide and procainamide.
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What drugs or food have the potential to interact with the sympathomimetic drug dobutamine (Dobutrex)?
- MAOI and tricyclic antidepressants cause toxicity with greatly increased risk for tachydysrhythmias (decrease dobutamine dosage).
- General anesthetics also may cause dysrhythmias.
- Beta blockers decrease effects of dobutamine.
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What drugs or food have the potential to interact with the beta adrenergic blockers atenolol (Tenormin) and metoprolol (Lopressor)?
- Use with other antihypertensive drugs may increase effects.
- Antacids may decrease absorption.
- Digoxin has an additive effect and may increase bradycardia.
- Beta blockers with oral hypoglycemic agents may increase risk for hypoglycemia.
- Beta blockers may increase effect of neuromuscular blockers.
- Antimuscarinic and anticholinergic drugs may decrease beta blocker effects.
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What drugs or food have the potential to interact with the thiazide diuretic hydrochlorothiazide (HydroDIURIL)?
- Lithium toxicity may occur.
- Increased risk of digoxin toxicity with potassium or magnesium deficiency.
- Corticosteroids and amphotericin B increase risk for hypokalemia.
- Decreased absorption with cholestyramine (Questran) or colestipol (Colestid).
- Increased blood glucose with insulin and oral sulfonylurea antidiabetic drugs
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What drugs or food have the potential to interact with the adrenergic neuron blocker reserpine (Serpalan and Sk-Reserpine)?
- Use with MAOI antidepressants within 14 days may cause hypertensive crisis.
- Antihypertensive drugs may increase risk for hypotension.
- Digoxin increases risk for bradycardia.
- St. John's wort may increase risk for hypotension.
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What drugs or food have the potential to interact with the aldosterone antagonist spironolactone (Aldactone)?
- Drugs that inhibit CYP3A4, such as ketoconazole, erythromycin, and verapamil may greatly increase risk for toxicity and hyperkalemia.
- Drugs that raise potassium levels, such as angiotensin-converting enzyme (ACE) inhibitors and potassium-sparing diuretics increase risk for hyperkalemia.
- May cause lithium toxicity.
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