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Drug Interactions between Avalide and Sandimmune

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

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Interactions between your drugs

Moderate

cycloSPORINE hydroCHLOROthiazide

Applies to: Sandimmune (cyclosporine) and Avalide (hydrochlorothiazide / irbesartan)

Using cycloSPORINE together with hydroCHLOROthiazide can increase your magnesium and uric acid blood levels. Using these medications together can also damage your kidneys. Symptoms of kidney damage include swelling, weight gain, feeling short of breath, drowsiness, confusion, mood changes, increased thirst, loss of appetite, nausea and vomiting, pain in your lower back, and urinating more or less than usual or not at all. If you take both medications together, tell your doctor if you have any of these symptoms. You may need a dose adjustment or special tests to safely use these medications together. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

cycloSPORINE irbesartan

Applies to: Sandimmune (cyclosporine) and Avalide (hydrochlorothiazide / irbesartan)

Using cycloSPORINE together with irbesartan may increase potassium levels in the blood. High levels of potassium can develop into a condition known as hyperkalemia, which in severe cases can lead to kidney failure, muscle paralysis, irregular heart rhythm, and cardiac arrest. You may be more likely to develop hyperkalemia while using these medications if you are elderly, dehydrated, or have kidney disease, diabetes, or advanced heart failure. Regular or long-term use of nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen (Aleve) may also increase your risk. It is important that you maintain adequate fluid intake during treatment with these medications, especially if you are using them for prolonged periods. In addition, talk to your doctor to see if you should limit consumption of potassium-rich foods such as tomatoes, raisins, figs, potatoes, lima beans, bananas, plantains, papayas, pears, cantaloupes, mangoes, and potassium-containing salt substitutes. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should seek medical attention if you experience nausea, vomiting, weakness, confusion, tingling of the hands and feet, feelings of heaviness in the legs, a weak pulse, or a slow or irregular heartbeat, as these may be symptoms of hyperkalemia. Also contact your doctor if you develop symptoms that may suggest kidney damage such as loss of appetite, increased or decreased urination, sudden weight gain or weight loss, fluid retention, swelling, shortness of breath, muscle cramps, tiredness, weakness, dizziness, and irregular heart rhythm. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Drug and food interactions

Moderate

cycloSPORINE food

Applies to: Sandimmune (cyclosporine)

Grapefruit and grapefruit juice can increase the levels of cycloSPORINE in your body and should generally not be consumed during treatment. High blood levels of cycloSPORINE can lead to increased risk of serious side effects on kidney, liver, and nervous system functions. If you regularly consume grapefruits or grapefruit juice, you should be monitored for side effects and/or changes in cycloSPORINE levels. However, do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor. You should also take cycloSPORINE on a consistent schedule with regard to time of day and relation to meals. Let your doctor know if you experience fever, rash, nausea, vomiting, abdominal pain, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes), decreased urination, excessive thirst, swelling, weight gain, dizziness, fatigue, weakness, headache, blurred vision, numbness/burning/tingling in the hand and feet, tremors, or convulsions, as they may be symptoms caused by excessive effects of cycloSPORINE.

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Moderate

irbesartan food

Applies to: Avalide (hydrochlorothiazide / irbesartan)

If you are taking irbesartan you should avoid potassium-containing salt substitutes or over-the-counter potassium supplements without first talking to your doctor. This can cause high levels of potassium in your blood. High levels of potassium can cause weakness, irregular heartbeat, confusion, tingling of the extremities, or feelings of heaviness in the legs. Call your doctor at once if you have any of these symptoms.

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Moderate

hydroCHLOROthiazide food

Applies to: Avalide (hydrochlorothiazide / irbesartan)

HydroCHLOROthiazide and ethanol may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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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.