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Drug Interactions between Aridol and glycopyrrolate / indacaterol

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

mannitol indacaterol

Applies to: Aridol (mannitol) and glycopyrrolate / indacaterol

MONITOR: Coadministration with beta-2 adrenergic agonists may potentiate the hypokalemic effects of potassium-wasting diuretics. Beta-2 agonists can cause clinically significant but usually transient decreases in serum potassium concentrations. Since QT prolongation is a possible side effect of beta-2 agonists, exacerbation of hypokalemia may increase the risk of torsade de pointes and other serious arrhythmias. The interaction may be more likely with systemic or nebulized formulations of beta-2 agonists, high dosages of inhaled beta-2 agonists, or concomitant theophylline or corticosteroid therapy.

MANAGEMENT: Caution is advised when beta-2 agonists are used with potassium-wasting diuretics. Serum potassium level and cardiovascular status should be monitored, especially if the beta-2 agonist is administered systemically or by nebulizer. Patients should be advised to notify their physician if they experience potential signs and symptoms of hypokalemia such as fatigue, weakness, myalgia, muscle cramps, numbness, tingling, abdominal pain, constipation, palpitation, and irregular heartbeat.

References

  1. Lipworth BJ, McDevitt DG, Struthers AD "Prior treatment with diuretic augments the hypokalemic and electrocardiographic effects of inhaled albuterol." Am J Med 86 (1989): 653-7
  2. "Product Information. Proventil (albuterol)." Schering Corporation PROD (2002):
  3. "Product Information. Brethaire (terbutaline)." Novartis Pharmaceuticals PROD (2001):
  4. "Product Information. Combivent (albuterol-ipratropium)." Boehringer-Ingelheim PROD (2001):
  5. "Product Information. Brovana (arformoterol)." Sepracor Inc (2006):
  6. "Product Information. Arcapta Neohaler (indacaterol)." Novartis Pharmaceuticals (2011):
  7. "Product Information. Breo Ellipta (fluticasone-vilanterol)." GlaxoSmithKline (2013):
  8. "Product Information. Striverdi Respimat (olodaterol)." Boehringer Ingelheim (2014):
View all 8 references

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Drug and food interactions

Moderate

glycopyrrolate food

Applies to: glycopyrrolate / indacaterol

GENERALLY AVOID: Use of anticholinergic agents with alcohol may result in sufficient impairment of attention so as to render driving and operating machinery more hazardous. In addition, the potential for abuse may be increased with the combination. The mechanism of interaction is not established but may involve additive depressant effects on the central nervous system. No effect of oral propantheline or atropine on blood alcohol levels was observed in healthy volunteers when administered before ingestion of a standard ethanol load. However, one study found impairment of attention in subjects given atropine 0.5 mg or glycopyrrolate 1 mg in combination with alcohol.

MANAGEMENT: Alcohol should generally be avoided during therapy with anticholinergic agents. Patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them.

References

  1. Linnoila M "Drug effects on psychomotor skills related to driving: interaction of atropine, glycopyrrhonium and alcohol." Eur J Clin Pharmacol 6 (1973): 107-12

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.