I have a horrible toe nail fungus on two left toes and have been taking it for almost 2 weeks and have 10 to go. I also take Seroquel 800 mg,Triepetal 2400 mg and Klonopin 2 mgs 3 per day for Anxiety and Bipolar Disorder I. Are there any interactions? I emailed my psychiatrist about this and am still waiting to hear a response from him. Another doctor prescribed Lamisil 250 mg tablets.
5 Apr 2011
Geer you are taking high level medications here, talk to you doctors about any effects i would not waste time emailing him/her.. Gather all your bottles then make an appointment take them to your appointment and discussed the entire issue of interactions with the combinations and take the new drug from the other doctor. He will discuss side effects and you decide whether you will risks having the side effects in your life if you think it is worth it, or you can simply tell your doctor. Hey!!! too many too much medication lets downsize to just 1 or 2 pills and compare the side effects with the two pills to make sure you can handle the way you feel along with any light side effects that come with it... Put all of your meds on the mednotes, and interactive list on this site and take it with you to your appointment and express to your doctor that you are concerned about the combination... vtech10
5 Apr 2011
Here ya go:
Interactions between your selected drugs
clonazepam ↔ quetiapine
Applies to: Klonopin (clonazepam), Seroquel (quetiapine)
MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.
MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
clonazepam ↔ oxcarbazepine
Applies to: Klonopin (clonazepam), Trileptal (oxcarbazepine)
MONITOR: Coadministration with oxcarbazepine may decrease the plasma concentrations of drugs that are substrates of the CYP450 3A4 isoenzyme. The mechanism is accelerated clearance due to induction of CYP450 3A4 activity by oxcarbazepine. In one study, administration of a single 600 mg dose of oxcarbazepine to eight healthy male volunteers had no effect on the pharmacokinetics of felodipine, a CYP450 3A4 substrate, while repeated doses (450 mg twice a day) decreased the peak plasma concentration and area under the concentration-time curve of felodipine (10 mg once daily) by 34% and 28%, respectively. Likewise, in a case study of a kidney transplant patient receiving cyclosporine 270 mg/day, investigators reported that cyclosporine trough concentrations declined to subtherapeutic levels approximately two weeks after the addition of oxcarbazepine. Trough concentrations returned to therapeutic range following an increase of the cyclosporine dosage to 290 mg/day and a reduction of the oxcarbazepine dosage from 750 mg/day to 600 mg/day. These results indicate that enzymatic induction occurs after multiple doses of oxcarbazepine.
MANAGEMENT: Caution is advised if oxcarbazepine must be used concurrently with medications that undergo metabolism by CYP450 3A4, particularly those with a narrow therapeutic range. Dosage adjustments as well as clinical and laboratory monitoring may be appropriate for some drugs whenever oxcarbazepine is added to or withdrawn from therapy.
quetiapine ↔ oxcarbazepine
Applies to: Seroquel (quetiapine), Trileptal (oxcarbazepine)
MONITOR: Coadministration with drugs that are inducers of CYP450 3A4 may decrease the plasma concentrations of quetiapine, which is primarily metabolized by the isoenzyme. In ten subjects with various affective disorders, the 3A4 inducer phenytoin (100 mg orally three times a day) decreased the mean steady-state peak plasma concentration (Cmax), trough plasma concentration (Cmin) and area under the concentration-time curve (AUC) of quetiapine (250 mg orally three times a day) by 66%, 89% and 80%, respectively. The mean oral clearance increased by 5.5-fold. The interaction has not been studied with other 3A4 inducers. However, the possibility of a diminished therapeutic response to quetiapine should be considered in patients receiving concomitant therapy with these agents.
MANAGEMENT: Pharmacologic response to quetiapine should be monitored more closely whenever a CYP450 3A4 inducer is added to or withdrawn from therapy, and the quetiapine dosage adjusted as necessary. Patients should be advised to notify their physician if they experience a worsening of their symptoms or an increase in side effects
There are no interactions between your drugs and the Lamisil. The interactions that do exist are relatively minor and I'm sure your psychiatrist is aware of them and prescribing these meds accordingly.
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