Drug Interactions Clause Samples

Drug Interactions. For full detail of drug interactions please refer to the current Summary Product Characteristic (SPC) available at ▇▇▇.▇▇▇▇▇▇▇▇▇.▇▇▇.▇▇.

Drug Interactions. Some medication combinations are dangerous and can lead to adverse reactions, such as difficulty breathing and lowered alertness, resulting in blackouts, unintentional overdose, or death. Potential interactions are more significant in people over age sixty-five or with underlying lung disease. ⬩ Alcohol ⬩ Benzodiazepines (Xanax, Valium, Ativan, etc.) ⬩ Muscle relaxers (Flexeril, methocarbamol, soma, etc). ⬩ Opioids (morphine, oxycodone, hydrocodone, Percocet, Codeine, Lortab, Vicodin, Tramadol, etc.) ⬩ Antihistamines available in many over-the-counter medications. ⬩ Tylenol (acetaminophen) may be an ingredient in prescription pain medications and are available in many over the counter medications and may exceed the recommended daily limit. Acetaminophen poisoning is one of the leading causes of acute liver failure. People who drink alcohol regularly or occasional binge drink are at higher risk. People with compromised liver function are at extremely high risk. ⬩ Methadone.

Drug Interactions. In vitro studies show that bicalutamide inhibits enzymes of the cytochrome P450 system, and may displace warfarin from plasma protein binding sites. Concomitant use of other enzyme inhibitors, e.g. cimetidine, could theoretically increase plasma concentrations of bicalutamide with the potential for increased adverse effects. In clinical practice, drug interactions are not generally seen (expert opinion). Caution is advised when drugs with a narrow therapeutic index are given with bicalutamide e.g. ciclosporin, where dose reductions and monitoring of plasma levels may be necessary. Caution should also be exercised with calcium channel blockers.

Drug Interactions. The use of aliskiren in combination with ARBs or ACEIs is contraindicated in patients with diabetes mellitus or renal impairment (GFR < 60 ml/min/1.73 m2) It is recommended that the effects of furosemide be monitored when initiating and adjusting furosemide or aliskiren therapy to avoid changes in extracellular fluid volume and possible situations of volume overload. Digoxin bioavailability may be slightly decreased by ▇▇▇▇▇▇▇▇▇. Preliminary data suggest that irbesartan may decrease Aliskiren AUC and Cmax. The concomitant use of aliskiren with highly potent P-glycoprotein (P-gp) inhibitors (ciclosporin, quinidine, and verapamil), is contraindicated. Because of the risk of therapeutic failure, fruit juices and herbal teas should not be taken whilst a patient is being treated with aliskiren. Caution should be exercised when aliskiren is administered with ketoconazole or other moderate P-gp inhibitors (itraconazole, clarithromycin, telithromycin, erythromycin, amiodarone). No relevant interactions with have been observed when aliskiren is used with P-gp substrates or weak inhibitors (atenolol, digoxin, amlodipine or cimetidine). Inducers of P-gp (St. John's wort, rifampicin) may decrease the bioavailability of Aliskiren. Based on experience with the use of other substances that affect the renin-angiotensin system, concomitant use of potassium-sparing diuretics, potassium supplements, salt substitutes containing potassium or other substances that may increase serum potassium levels (e.g. heparin) may lead to increases in serum potassium. If co-medication is considered necessary, caution is advisable. Non-steroidal anti-inflammatory drugs (NSAIDs) may reduce the antihypertensive effect of aliskiren. In some patients with compromised renal function (eg, dehydrated or elderly patients) aliskiren given concomitantly with NSAIDs may result in further deterioration of renal function, including possible acute renal failure, which is usually reversible when treatment is stopped. Meals with a high fat content have been shown to reduce the absorption of aliskiren substantially.

Drug Interactions. Hydroxychloroquine may increase plasma digoxin levels and reduce effectiveness of amiodarone. It may enhance the effects of a hypoglycaemic treatment. Antacids may reduce absorption of hydroxychloroquine so it is advised that a 4-hour interval be observed between hydroxychloroquine and antacid use.

Drug Interactions. No well-controlled studies have been performed on patients taking antiovulatory agents. The physician must use judgment and evaluate any patient taking antiovulatory drugs prior to initiating treatment with Sotradecol®. (See ADVERSE REACTIONS section). Heparin should not be included in the same syringe as Sotradecol®, since the two are incompatible. When tested in the L5178YTK +/- mouse lymphoma assay, sodium tetradecyl sulfate did not induce a dose-related increase in the frequency of thymidine kinase-deficient mutants and, therefore, was judged to be nonmutagenic in this system. However, no long-term animal carcinogenicity studies with sodium tetradecyl sulfate have been performed.

Drug Interactions. There is low potential for drug-drug interactions (see SPC). In postmenopausal women with osteoporosis the pharmacokinetics and pharmacodynamics of denosumab were not altered by previous alendronate therapy, based on data from a transition study (alendronate to denosumab).

Drug Interactions. Tamoxifen – increased risk of retinal toxicity Digoxin - levels may be increased Neostigmine and pyridostigmine - antagonistic effect Insulin or antidiabetic drugs - consider reducing doses Anti-arrhythmic drugs – caution as may contribute to QT prolongation Anti-convulsants – may reduce effectiveness due to lower seizure threshold ALT Alanine Transaminase ACE Angiotensin Converting Enzyme BNF British National Formulary BP Blood Pressure CRP C Reactive Protein DMARD Disease-modifying Anti-rheumatic Drugs EBV ▇▇▇▇▇▇▇ - ▇▇▇▇ virus eGFR Estimated Glomerular Filtration Rate ESR Erythrocyte Sedimentation Rate FBC Full Blood Count GP General Practitioner IM Intramuscular LFT Liver function tests MCV Mean Cell Volume mg milligram NSAID Non-Steroidal Anti Inflammatory Drug OCT Optical coherence topography RA Rheumatoid Arthritis SC Subcutaneous SPC Summary of Product Characteristic VZIG Varicella Zoster Immunoglobulin List all documents to be read in conjunction with this policy. • British National Formulary • Summary of Product Characteristics for all drugs included in this document.

Drug Interactions. Adrenoreceptor blocking agents (e.g. propanolol), lithium and α methyltyrosine may antagonise the effects of dexamfetamine. Disulfiram may inhibit metabolism and excretion. The concurrent use of tricyclic antidepressants may increase the risk of cardiovascular side effects.Concurrent use of MAOI’s or use within the preceding 14 days may precipitate a hypertensive crisis. Concurrent use of beta-blockers may result in severe hypertension and dexamfetamine may result in diminished effect of other anti-hypertensives such as guanethidine. Phenothiazines may inhibit the actions of dexamfetamine. Amfetamines may delay the absorption of ethosuximide, phenobarbital and phenytoin. Acute dystonia has been noted with concurrent administration of haloperidol. Haloperidol and Chlorpromazine block dopamine and norepinephrine re-uptake, thus inhibiting the central stimulant effects of amfetamines. The analgesic effect of morphine may be increased and its respiratory depressant effects decreased with concurrent use of morphine and dexamfetamine. Amfetamines potentiate the analgesic effects of meperidine. Concomitant administration of clonidine and dexamfetamine may result in an increased duration of action of dexamfetamine. Gastrointestinal acidifying agents (guanethidine, reserpine, glutamic acid HCl, ascorbic acid, fruit juices, etc.) lower absorption of dexamfetamine. Urinary acidifying agents (ammonium chloride, sodium acid phosphate, etc.) increase urinary excretion of dexamfetamine. Both groups of agents lower blood levels and efficacy of dexamfetamine. Gastrointestinal alkalizing agents (sodium bicarbonate, etc) increase the absorption of amfetamines. Urinary alkalizing agents (acetazolamide, some thiazides) increase the concentration of the non-ionized species of the amfetamine molecule, thereby decreasing urinary excretion. Both groups of agents increase blood levels and efficacy of amfetamines. Alcohol may exacerbate the CNS adverse reactions of psychoactive drugs, including dexamfetamine. It is therefore advisable for patients to abstain from alcohol during treatment.