Drug Interactions. Methylphenidate, dexamfetamine and lisdexamfetamine:
Drug Interactions. For full detail of drug interactions please refer to the current Summary of Product Characteristics (SPC) available at xxx.xxxxxxxxx.xxx.xx
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. 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.
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 Xxxxxxx - Xxxx 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. Concomitant treatment with sympathomimetics and other vasoconstrictive substances such as reserpine, guanethidine, tricyclic antidepressants, antihistamines, thyroid hormones and MAO-inhibitors, including treatments that are available without prescription, should be avoided as a pronounced increase in blood pressure may occur. As with other specific α-adrenergic agonists, the effect of midodrine is blocked by α- adrenergic antagonists such as prazosin and phentolamine. Monitoring is recommended if midodrine is combined with other drugs that directly or indirectly reduce the heart rate. For example, beta blockers and rate-limiting calcium channel blockers. Simultaneous use of digitalis preparations is not recommended, as the heart rate reducing effect may be potentiated by midodrine and heart block may occur. Midodrine may potentiate or enhance the hypertensive effects of corticosteroid preparations. Treatment with midodrine in combination with mineralocorticoids or glucocorticoids (e.g. fludrocortisone) may increase the risk of glaucoma/increased intraocular pressure, and should be carefully monitored. The potential for pharmacokinetic interaction is limited as the metabolic pathways do not involve cytochrome P450 enzymes. However, decreased clearance of medicinal products metabolised by CYP2D6 (e.g. promethazine) has been reported. This list is not exhaustive. The manufacturer’s summary of product characteristics (SPC) and the most current edition of the British National Formulary should be consulted for full information on contra-indications, warnings, side-effects and drug interactions.
Drug Interactions. Reactivity to the test may be depressed or suppressed in individuals who are receiving corticosteroids or immunosuppressive agents. Reactivity to PPD may be temporarily depressed by certain live virus vaccines (measles, mumps, rubeola). Therefore, if a tuberculin test is to be performed, it should be administered either before or simultaneously with the injection of measles, mumps and rubeola vaccines in combined form or as separate antigens (see also PRECAUTIONS). Adverse Reactions In highly sensitized individuals, strongly positive reactions including vesiculation, ulceration or necrosis may occur at the test site. Cold packs or topical steroid preparations may be employed for symptomatic relief of the associated pain, pruritus and discomfort. Strongly positive reactions may result in scarring at the test site. Immediate erythematous or other reactions may occur at the injection site. The reason(s) for these infrequent occurrences are presently unknown.
Drug Interactions. EXPAREL can be administered in the ready to use suspension or diluted to a concentration of up to 0.89 mg/mL (i.e., 1:14 dilution by volume) with normal (0.9%) saline or lactated Ringer’s solution. EXPAREL must not be diluted with water or other hypotonic agents as it will result in disruption of the liposomal particles. EXPAREL should not be admixed with local anesthetics other than bupivacaine. Non- bupivacaine based local anesthetics, including lidocaine, may cause an immediate release of bupivacaine from EXPAREL if administered together locally. The administration of EXPAREL may follow the administration of lidocaine after a delay of 20 minutes or more. Bupivacaine HCl administered together with EXPAREL may impact the pharmacokinetic and/or physicochemical properties of EXPAREL, and this effect is concentration dependent. Therefore, bupivacaine HCl and EXPAREL may be administered simultaneously in the same syringe, and bupivacaine HCl may be injected immediately before EXPAREL as long as the ratio of the milligram dose of bupivacaine HCl solution to EXPAREL does not exceed 1:2. The toxic effects of these drugs are additive and their administration should be used with caution including monitoring for neurologic and cardiovascular effects related to toxicity [See Dosage and Administration (2.2), Warnings and Precautions (5.1) and Overdosage (10)]. Other than bupivacaine as noted above, EXPAREL should not be admixed with other drugs prior to administration.
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).
