High Cholesterol? Learn about treatments

Trandolapril / verapamil Disease Interactions

There are 20 disease interactions with trandolapril / verapamil:

Ace Inhibitors (Includes Trandolapril/verapamil) ↔ Angioedema

Severe Potential Hazard, Moderate plausibility

Applies to: Angioedema

Patients with a history of angioedema unrelated to ACE inhibitors may be at increased risk of angioedema while receiving an ACE inhibitor. Patients should be advised to immediately report any signs or symptoms suggestive of angioedema (swelling of face, extremities, eyes, lips, or tongue, or difficulty swallowing or breathing) and to stop taking the medication until otherwise directed by their physician. Emergency therapy and/or measures to prevent airway obstruction are required for angioedema involving the tongue, glottis, or larynx. Treatment with ACE inhibitors should be discontinued permanently if angioedema develops in association with therapy.

References

  1. Gianos ME, Klaustermeyer WB, Kurohara M, et al "Enalapril induced angioedema." Am J Emerg Med 8 (1990): 124-6
  2. Chin HL, Buchan DA "Severe angioedema after long-term use of an angiotensin-converting enzyme inhibitor ." Ann Intern Med 112 (1990): 312-3
  3. Seidman MD, Lewandowski CA, Sarpa JR, et al "Angioedema related to angiotensin-converting enzyme inhibitors." Otolaryngol Head Neck Surg 102 (1990): 727-31
View all 34 references

Ace Inhibitors (Includes Trandolapril/verapamil) ↔ Bone Marrow Suppression

Severe Potential Hazard, Low plausibility

Applies to: Bone Marrow Depression/Low Blood Counts, Renal Dysfunction, Collagen Vascular Disease

ACE inhibitors may cause bone marrow suppression, rarely in uncomplicated individuals but more frequently in patients with renal impairment, especially if they also have a collagen-vascular disease such as systemic lupus erythematosus or scleroderma. Neutropenia, agranulocytosis, aplastic anemia, hemolytic anemia, eosinophilia and thrombocytopenia have been reported, mostly with captopril. Therapy with ACE inhibitors should be administered cautiously in patients with preexisting blood dyscrasias or complications that may increase the risk of bone marrow depression during ACE inhibitor therapy. Monitoring of blood counts, particularly white blood cells, should be considered.

References

  1. Davies RO, Irvin JD, Kramsch PK, Walker JF, Moncloa F "Enalapril worldwide experience." Am J Med 77 (1984): 23-35
  2. Knapp LE, Frank GJ, McLain R, Rieger MM, Posvar E, Singer R "The safety and tolerability of quinapril." J Cardiovasc Pharmacol 15 (1990): s47-55
  3. "Product Information. Altace (ramipril)." Hoechst Marion-Roussel Inc, Kansas City, MO.
View all 38 references

Ace Inhibitors (Includes Trandolapril/verapamil) ↔ Chf

Severe Potential Hazard, High plausibility

Applies to: Congestive Heart Failure

ACE inhibitors can cause marked renal impairment in patients whose renal function depends on the activity of the renin-angiotensin-aldosterone system. In addition, symptomatic and sometimes excessive hypotension can occur in susceptible individuals, particularly during the initiation of treatment, which may compromise renal and myocardial perfusion. In patients with severe congestive heart failure (CHF), treatment with ACE inhibitors may be associated with oliguria and/or progressive azotemia and, rarely, renal failure, myocardial ischemia and death. Therapy with ACE inhibitors should be initiated under very close medical supervision in patients with severe CHF, especially when accompanied by volume and/or sodium depletion. Patients should be monitored closely for several hours after an initial dose until blood pressure has stabilized, and followed closely for the first 2 weeks of treatment and whenever the dosage of ACE inhibitor or diuretic is increased. If feasible, the risk of severe hypotension may be minimized by reducing or temporarily withholding the dosing of diuretics and/or liberalizing dietary sodium intake for 2 to 3 days prior to starting ACE inhibitor therapy. In patients who experience a worsening of renal function, discontinuation of ACE inhibitor therapy is usually not required provided there is symptomatic improvement of the heart failure and renal deterioration is well-tolerated. Transient hypotension is also not a contraindication to further treatment with ACE inhibitors. After blood pressure stabilizes, therapy can usually be reinstated with caution, although a lower dosage of the ACE inhibitor and/or dosage reduction or discontinuation of concomitantly administered diuretics may be necessary.

References

  1. Moyses C, Higgins TJ "Safety of long-term use of lisinopril for congestive heart failure." Am J Cardiol 70 (1992): c91-7
  2. "Product Information. Altace (ramipril)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  3. "Product Information. Lotensin (benazepril)." Ciba Pharmaceuticals, Summit, NJ.
View all 21 references

Ace Inhibitors (Includes Trandolapril/verapamil) ↔ Hemodialysis

Severe Potential Hazard, Moderate plausibility

Applies to: hemodialysis

Anaphylactoid reactions have been reported in patients undergoing hemodialysis with high-flux polyacrylonitrile membranes and treated concomitantly with an ACE inhibitor. The frequency and mechanism of this interaction have not been established, and it is not known whether the interaction occurs with other membrane types. Therapy with ACE inhibitors should be administered cautiously in patients requiring hemodialysis.

References

  1. "Product Information. Capoten (captopril)." Bristol-Myers Squibb, Princeton, NJ.
  2. "Product Information. Lotensin (benazepril)." Ciba Pharmaceuticals, Summit, NJ.
  3. "Product Information. Altace (ramipril)." Hoechst Marion-Roussel Inc, Kansas City, MO.
View all 10 references

Ace Inhibitors (Includes Trandolapril/verapamil) ↔ Hyperkalemia

Severe Potential Hazard, High plausibility

Applies to: Hyperkalemia

In patients with hyperkalemia, especially that associated with impaired renal function or congestive heart failure, ACE inhibitors may further raise serum potassium levels. Therapy with ACE inhibitors should be administered cautiously in patients with or predisposed to hyperkalemia, and serum potassium levels should be carefully monitored. Risk factors for the development of hyperkalemia during ACE inhibitor therapy include renal insufficiency, diabetes mellitus, and the concomitant use of potassium-sparing diuretics, potassium supplements, and/or potassium-containing salt substitutes.

References

  1. "Product Information. Mavik (trandolapril)." Knoll Pharmaceutical Company, Whippany, NJ.
  2. Kostis JB, Shelton BJ, Yusuf S, Weiss MB, Capone RJ, Pepine CJ, Gosselin G, Delahaye F, Probstfield JL, Cahill L, Dutton D "Tolerability of enalapril initiation by patients with left ventricular dysfunction: results of the medication challenge phase of the studies of left ventricular dysfunction." Am Heart J 128 (1994): 358-64
  3. "Product Information. Vasotec (enalapril)." Merck & Co, Inc, West Point, PA.
View all 18 references

Ace Inhibitors (Includes Trandolapril/verapamil) ↔ Hypotension

Severe Potential Hazard, High plausibility

Applies to: Dehydration, hemodialysis, Hyponatremia, Ischemic Heart Disease, Diarrhea, Vomiting, Cerebrovascular Insufficiency

ACE inhibitors can cause symptomatic hypotension, most often during the initiation of therapy and in patients who are volume- and/or sodium-depleted or treated for congestive heart failure (CHF). Therapy with ACE inhibitors should be administered cautiously in such patients and in those predisposed to hypovolemic or hyponatremic states (e.g., patients on diuretic therapy, especially if it was recently instituted; those on dietary salt restriction; those with severe or prolonged diarrhea or vomiting; and renal dialysis patients). Volume and/or sodium depletion should be corrected prior to initiating therapy with ACE inhibitors, and the patient should be hemodynamically stable. If concomitant diuretics and/or dietary sodium restriction are employed, reducing or temporarily withholding the dosing of diuretics and/or liberalizing dietary sodium intake for 2 to 3 days in advance can help minimize the risk of severe hypotension in patients who are able to tolerate such adjustments. ACE inhibitors should also be used cautiously in patients in whom excessive hypotension may have serious consequences, such as patients with coronary or cerebrovascular insufficiency. Patients at risk for excessive hypotension should initiate ACE inhibitor therapy under very close medical supervision, and followed closely for the first 2 weeks of treatment and whenever the dosage of ACE inhibitor or diuretic is increased.

References

  1. "Product Information. Vasotec (enalapril)." Merck & Co, Inc, West Point, PA.
  2. Kostis JB, Shelton BJ, Yusuf S, Weiss MB, Capone RJ, Pepine CJ, Gosselin G, Delahaye F, Probstfield JL, Cahill L, Dutton D "Tolerability of enalapril initiation by patients with left ventricular dysfunction: results of the medication challenge phase of the studies of left ventricular dysfunction." Am Heart J 128 (1994): 358-64
  3. Alderman CP "Adverse effects of the angiotensin-converting enzyme inhibitors." Ann Pharmacother 30 (1996): 55-61
View all 32 references

Ccbs (Includes Trandolapril/verapamil) ↔ Aortic Stenosis

Severe Potential Hazard, High plausibility

Applies to: Aortic Stenosis

The use of some calcium channel blockers (CCBs) is contraindicated in patients with advanced aortic stenosis. CCBs whose pharmacologic effect is partially dependent on their ability to reduce afterload (e.g., diltiazem, nicardipine, nifedipine, verapamil) may be of less benefit in these patients due to a fixed impedance to flow across the aortic valve and may, in fact, worsen rather than improve myocardial oxygen balance. Rarely, heart failure has developed following the initiation of these CCBs, particularly in patients receiving concomitant beta-blocker therapy.

References

  1. "Product Information. Adalat (nifedipine)." Bayer, West Haven, CT.
  2. "Product Information. Cardene (nicardipine)." Syntex Laboratories Inc, Palo Alto, CA.
  3. "Product Information. Procardia (nifedipine)." Pfizer US Pharmaceuticals, New York, NY.

Ccbs (Includes Trandolapril/verapamil) ↔ Bradyarrhythmia/Av Block

Severe Potential Hazard, High plausibility

Applies to: Heart Block, Sinus Node Dysfunction

The use of some calcium channel blockers (CCBs) is contraindicated in patients with severe bradyarrhythmia, sick sinus syndrome (unless a functioning pacemaker is present), or heart block greater than the first degree (unless a functioning pacemaker is present). CCBs like bepridil, diltiazem and verapamil have a negative effect on AV conduction and the SA node and may exacerbate these conditions.

References

  1. Colombo G, Zucchella G, Planca E, Grieco A "Intravenous diltiazem in the treatment of unstable angina: a study of efficacy and tolerance." Clin Ther 9 (1987): 536-47
  2. Aromatorio GJ, Uretsky BF, Reddy PS "Hypotension and sinus arrest with nifedipine in pulmonary hypertension." Chest 87 (1985): 265-7
  3. Gobel EJAM, Hautvast RWM, Vangilst WH, Spanjaard JN, Hillege HL, Dejongste MJL, Molhoek GP, Lie KI "Randomised, double-blind trial of intravenous diltiazem versus glyceryl trinitrate for unstable angina pectoris." Lancet 346 (1995): 1653-7
View all 14 references

Ccbs (Includes Trandolapril/verapamil) ↔ Cardiogenic Shock/Hypotension

Severe Potential Hazard, High plausibility

Applies to: Cardiogenic Shock, Hypotension

In general, calcium channel blockers (CCBs) should not be used in patients with hypotension (systolic pressure < 90 mm Hg) or cardiogenic shock. Due to potential negative inotropic and peripheral vasodilating effects, the use of CCBs may further depress cardiac output and blood pressure, which can be detrimental in these patients. The use of verapamil and diltiazem is specifically contraindicated under these circumstances.

References

  1. "Product Information. Calan (verapamil)." Searle, Skokie, IL.
  2. Stehle G, Buss J, Eibach J, et al "Cardiogenic shock associated with verapamil in a patient with liver cirrhosis." Lancet 336 (1990): 1079
  3. "Product Information. Vascor (bepridil)." McNeil Pharmaceutical, Raritan, NJ.
View all 6 references

Ccbs (Includes Trandolapril/verapamil) ↔ Coronary Artery Disease

Severe Potential Hazard, Low plausibility

Applies to: Ischemic Heart Disease

Increased frequency, duration, and/or severity of angina, as well as acute myocardial infarction, have rarely developed during initiation or dosage increase of calcium channel blockers (CCBs), particularly in patients with severe obstructive coronary artery disease and those treated with immediate-release formulations. The mechanism of this effect is not established. Therapy with CCBs should be administered cautiously in patients with significant coronary artery disease.

References

  1. Myrhed M, Wiholm B-E "Nifedipine: a survey of adverse effects." Acta Pharmacol Toxicol (Copenh) 58 (1986): 133-6
  2. Thomassen AR, Bagger JP, Nielsen TT "Hemodynamic and cardiac metabolic changes during nicardipine-induced myocardial ischemia." Cathet Cardiovasc Diagn 14 (1988): 41-3
  3. Kloner RA "Nifedipine in ischemic heart disease." Circulation 92 (1995): 1074-8
View all 15 references

Ccbs (Includes Trandolapril/verapamil) ↔ Liver Disease

Severe Potential Hazard, High plausibility

Applies to: Liver Disease

Calcium channel blockers (CCBs) are extensively metabolized by the liver. The half-lives of CCBs may be prolonged substantially in patients with severe hepatic impairment, with the potential for significant drug accumulation. In addition, the use of some CCBs has been associated with elevations in serum transaminases, both with and without concomitant elevations in alkaline phosphatase and bilirubin. While these effects may be transient and reversible, several patients have developed cholestasis or hepatocellular injury that was proven by rechallenge. Therapy with CCBs should be administered cautiously and often at reduced dosages in patients with significantly impaired hepatic function. Periodic monitoring of liver function and for excessive pharmacologic effects (e.g., abnormal prolongation of PR interval) is advised, and the dosage adjusted if necessary.

References

  1. Stern EH, Pitchon R, King BD, Wiener I "Possible hepatitis from verapamil." N Engl J Med 306 (1982): 612-3
  2. Giacomini KM, Massoud N, Wong FM, Giacomini JC "Decreased binding of verapamil to plasma proteins in patients with liver disease." J Cardiovasc Pharmacol 6 (1984): 924-8
  3. Graham D, Dow R, Hall D, Alexander O, Mroszczak E, Freedman A "The metabolism and pharmacokinetics of nicardipine hydrochloride in man." Br J Clin Pharmacol 20 (1985): s23-8
View all 53 references

Diltiazem/Verapamil Iv (Includes Trandolapril/verapamil) ↔ Ventricular Tachycardia

Severe Potential Hazard, High plausibility

Applies to: Ventricular Arrhythmia

The use of intravenous diltiazem or verapamil is contraindicated in patients with ventricular tachycardia. IV administration of a calcium channel blocker can precipitate cardiac arrest in such patients. Marked hemodynamic deterioration and ventricular fibrillation have occurred in patients with wide-complex ventricular tachycardia (QRS >= 0.12 seconds) treated with IV verapamil.

References

  1. "Product Information. Calan (verapamil)." Searle, Skokie, IL.
  2. Winters SL, Schweitzer P, Kupersmith J, Gomes JA "Verapamil-induced polymorphous ventricular tachycardia." J Am Coll Cardiol 6 (1985): 257-9
  3. Buxton AE, Marchlinski FE, Doherty JU, et al "Hazards of intravenous verapamil for sustained ventricular tachycardia." Am J Cardiol 59 (1987): 1107-10
View all 4 references

Trandolapril (Includes Trandolapril/verapamil) ↔ Cirrhosis

Severe Potential Hazard, Moderate plausibility

Applies to: Liver Disease

The clearance of trandolapril and its active metabolite, trandolaprilat, may be decreased in patients with hepatic cirrhosis. Following oral administration in patients with mild to moderate alcoholic cirrhosis, plasma concentrations of trandolapril and trandolaprilat were 9-fold and 2-fold greater, respectively, than in normal subjects. However, the inhibition of ACE activity was not affected. The manufacturer states that lower initial dosages should be considered in patients with hepatic insufficiency.

References

  1. "Product Information. Mavik (trandolapril)." Knoll Pharmaceutical Company, Whippany, NJ.

Verapamil (Includes Trandolapril/verapamil) ↔ Accessory Av Tracts

Severe Potential Hazard, High plausibility

Applies to: Preexcitation Syndrome

The use of verapamil is contraindicated for the management of atrial flutter or fibrillation in patients with an accessory AV tract (e.g., those with Wolff-Parkinson-White or Lown-Ganong-Levine syndrome). Intravenous verapamil has been reported to cause ventricular fibrillation and cardiac arrest in such patients, the mechanism of which is related to the drug's ability to shorten the refractory period and accelerate antegrade conduction within the accessory pathway. Although these events have not been associated with chronic use of oral verapamil, a similar risk may exist.

References

  1. Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, eds. "Harrison's Principles of Internal Medicine. 14th ed." New York, NY: McGraw-Hill Health Professionals Division (1998):
  2. Jacob AS, Nielsen DH, Gianelly RE "Fatal ventricular fibrillation following verapamil in Wolff-Parkinson-White syndrome with atrial fibrillation." Ann Emerg Med 14 (1985): 159-60
  3. Hame A, Peter T, Platt M, Mandel WJ "Effects of verapamil on supraventricular tachycardia in patients with overt and concealed wolff-parkinson-white syndrome." Am Heart J 101 (1981): 600-12
View all 8 references

Verapamil (Includes Trandolapril/verapamil) ↔ Chf/Ami

Severe Potential Hazard, High plausibility

Applies to: Congestive Heart Failure, Myocardial Infarction

The use of verapamil is contraindicated in patients with severe left ventricular dysfunction (e.g., ejection fraction < 30%) or moderate to severe symptoms of cardiac failure and in patients with any degree of ventricular dysfunction if they are receiving a beta-adrenergic blocker. Likewise, verapamil should not be given to patients with acute myocardial infarction and pulmonary congestion documented by X-ray on admission, since associated heart failure may be acutely worsened. Verapamil has a negative inotropic effect, which in most patients is compensated by a simultaneous reduction in afterload (i.e. decreased systemic vascular resistance) without a net impairment of ventricular performance. However, congestive heart failure or pulmonary edema have developed in approximately 2% of patients treated with verapamil. Mild symptoms of cardiac failure should be under control, if possible, prior to initiating verapamil therapy.

References

  1. Shimoni A, Maorkendler Y, Neuman Y "Verapamil-induced acute right heart failure." Am Heart J 132 (1996): 193-4
  2. Baky SH, Singh BN "Verapamil hydrochloride: pharmacological properties and role in cardiovascular therapeutics." Pharmacotherapy 2 (1982): 328-50
  3. Pollak A, Falk RH "Left ventricular systolic dysfunction precipitated by verapamil in cardiac amyloidosis." Chest 104 (1993): 618-20
View all 4 references

Verapamil (Includes Trandolapril/verapamil) ↔ Hypertrophic Cardiomyopathy

Severe Potential Hazard, Moderate plausibility

Applies to: Hypertrophic Cardiomyopathy

The use of verapamil in patients with hypertrophic cardiomyopathy, or idiopathic hypertrophic subaortic stenosis, has been associated with serious side effects such as pulmonary edema, severe hypotension, sinus bradycardia, AV block, sinus arrest, and death. However, a causal relationship has not been established. Therapy with verapamil should be administered cautiously in patients with hypertrophic cardiomyopathy. Dosage reduction or drug discontinuation may be required if severe adverse effects occur.

References

  1. "Product Information. Calan (verapamil)." Searle, Skokie, IL.

Ace Inhibitors (Includes Trandolapril/verapamil) ↔ Renal Dysfunction

Moderate Potential Hazard, High plausibility

Applies to: Renal Dysfunction

With the exception of fosinopril, ACE inhibitors (and/or their active metabolites in some cases) are primarily eliminated by the kidney and may accumulate in patients with renal impairment. ACE inhibitors can also worsen renal function in some patients by blocking the effect of angiotensin II-mediated efferent arteriolar vasoconstriction, thereby decreasing glomerular filtration. Therapy with ACE inhibitors should be administered cautiously in patients with preexisting renal dysfunction, particularly those with renovascular disease. Patients with moderate to severe renal impairment usually require lower or less frequent doses and smaller increments in dose. In addition, a dosage reduction or discontinuation of any concomitantly administered diuretics may be helpful. Fosinopril probably does not require dosage adjustments unless hepatic function is also significantly impaired.
<br />
<br />In patients with bilateral renal artery stenosis or renal artery stenosis in a solitary kidney, ACE inhibitors may reduce renal perfusion to a critically low level. Renal function should be monitored closely for the first few weeks of therapy.

References

  1. Champ JD "Case report: azotemia secondary to enalapril and diuretic use and the diagnosis of renovascular hypertension." Am J Med Sci 305 (1993): 25-7
  2. "Moexipril: another ace inhibitor for hypertension." Med Lett Drugs Ther 37 (1995): 75-6
  3. Ljungman S, Kjekshus J, Swedberg K "Renal function in severe congestive heart failure during treatment with enalapril." Am J Cardiol 70 (1992): 479-87
View all 32 references

Verapamil (Includes Trandolapril/verapamil) ↔ Neuromuscular Transmission

Moderate Potential Hazard, Moderate plausibility

Applies to: Myopathy, Myoneural Disorder

Verapamil has been reported to decrease neuromuscular transmission in patients with Duchenne's muscular dystrophy and to prolong recovery from the neuromuscular blocking agent, vecuronium. Therapy with verapamil should be administered cautiously in patients with attenuated neuromuscular transmission or myopathy, since these conditions may be exacerbated. A reduced dosage may be appropriate.

References

  1. "Product Information. Calan (verapamil)." Searle, Skokie, IL.
  2. Reverte M "Adverse effect of verapamil in myasthenia gravis: an additional comment." Muscle Nerve 16 (1993): 879-81
  3. "Product Information. Isoptin (verapamil)." Knoll Pharmaceutical Company, Whippany, NJ.

Verapamil (Includes Trandolapril/verapamil) ↔ Renal Dysfunction

Moderate Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Approximately 70% of an administered dose of verapamil is excreted as metabolites in the urine. The primary metabolite, norverapamil, has about 20% the cardiovascular activity and can reach steady-state plasma concentrations approaching those of the parent drug. Patients with impaired renal function may be at greater risk for adverse effects due to drug and metabolite accumulation. Therapy with verapamil should be administered cautiously in such patients, with appropriate monitoring for excessive pharmacologic effects (e.g., abnormal prolongation of PR interval) and the dosage adjusted accordingly as necessary.

References

  1. Kates RE "Calcium antagonists: pharmacokinetic properties." Drugs 25 (1983): 113-24
  2. "Product Information. Calan (verapamil)." Searle, Skokie, IL.
  3. McAllister RG Jr, Hamann SR, Blouin RA "Pharmacokinetics of calcium-entry blockers." Am J Cardiol 55 (1985): b30-40
View all 9 references

Verapamil Hs (Includes Trandolapril/verapamil) ↔ Gi Narrowing

Moderate Potential Hazard, Moderate plausibility

Applies to: Gastrointestinal Obstruction

The controlled-onset, extended-release formulation of verapamil (Covera-HS) contains a non-deformable material. There have been rare reports of obstructive symptoms in patients with known strictures following the ingestion of similar sustained-release products. Therapy with the controlled-onset, extended-release formulation of verapamil should be administered cautiously in patients with preexisting severe gastrointestinal narrowing or obstruction, whether pathologic or iatrogenic.

References

  1. "Product Information. Covera-HS (verapamil)." Searle, Skokie, IL.

You should also know about...

trandolapril / verapamil drug Interactions

There are 911 drug interactions with trandolapril / verapamil

trandolapril / verapamil alcohol/food Interactions

There are 4 alcohol/food interactions with trandolapril / verapamil

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2014 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

Hide
(web2)