Skip to main content

Drug Interactions between droperidol and Epitol

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

Edit list (add/remove drugs)

Interactions between your drugs

Moderate

carBAMazepine droPERidol

Applies to: Epitol (carbamazepine) and droperidol

MONITOR: Theoretically, potent CYP450 3A4 inducers may decrease serum concentrations of butyrophenones such as benperidol or droperidol. This interaction has been reported for haloperidol. In an observational study of 12 schizophrenic patients taking oral haloperidol, the administration of rifampin for 28 days reduced haloperidol plasma levels by a mean of 70%, and scores in the Brief Psychiatric Rating Scale (BPRS) were increased. However, clinical data are lacking for benperidol or droperidol. In addition, butyrophenones may lower the seizure threshold. Central nervous system- and/or respiratory-depressant effects may also be additively or synergistically increased in patients taking droperidol or benperidol with certain other drugs that cause these effects, especially in elderly or debilitated patients.

MANAGEMENT: The potential for diminished neuroleptic effects of droperidol or benperidol should be considered during coadministration with potent CYP450 3A4 inducers. Pharmacologic response to these medications should be monitored more closely whenever a CYP450 3A4 inducer is added to or withdrawn from therapy, and the droperidol or benperidol dosage adjusted as necessary. Patients taking potent CYP450 3A4 inducers that are anticonvulsants should be monitored for loss of seizure control. Additionally, when droperidol or benperidol are used in combination with other drugs that cause CNS and/or respiratory depression, 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 doctor if they experience seizures or excessive CNS effects that interfere with their normal activities.

References

  1. Kidron R, Averbuch I, Klein E, Belmaker RH (1985) "Carbamazepine-induced reduction of blood levels of haloperidol in chronic schizophrenia." Biol Psychiatry, 20, p. 219-22
  2. Takeda M, Nishinuma K, Yamashita S, et al. (1986) "Serum haloperidol levels of schizophrenics receiving treatment for tuberculosis." Clin Neuropharmacol, 9, p. 386-97
  3. (2002) "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical
  4. (2001) "Product Information. Rifadin (rifampin)." Hoechst Marion Roussel
  5. Arana GW, Goff DC, Friedman H, et al. (1986) "Does carbamazepine-induced reduction of plasma haloperidol levels worsen psychotic symptoms?" Am J Psychiatry, 143, p. 650-1
  6. Jann MW, Ereshefsky L, Saklad SR, et al. (1985) "Effects of carbamazepine on plasma halopeidol levels." J Clin Pharmacol, 5, p. 106-9
  7. Kahn EM, Schulz SC, Perel JM, Alexander JE (1990) "Change in haloperidol level due to carbamazepine--a complicating factor in combined medication for schizophrenia." J Clin Psychopharmacol, 10, p. 54-7
  8. Kim YH, Cha IJ, Shim JC, Shin JG, Yoon YR, Kim YK, Kim JI, Park GH, Jang IJ, Woo JI, Shin SG (1996) "Effect of rifampin on the plasma concentration and the clinical effect of haloperidol concomitantly administered to schizophrenic patients." J Clin Psychopharmacol, 16, p. 247-52
  9. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  10. Cerner Multum, Inc. "Australian Product Information."
  11. Agencia Española de Medicamentos y Productos Sanitarios Healthcare (2008) Centro de información online de medicamentos de la AEMPS - CIMA. https://cima.aemps.es/cima/publico/home.html
View all 11 references

Switch to consumer interaction data

Drug and food interactions

Major

droPERidol food

Applies to: droperidol

MONITOR CLOSELY: The use of droperidol has been associated with QT interval prolongation, torsade de pointes and other serious arrhythmias, and sudden death. The concurrent administration of agents that can produce hypokalemia and/or hypomagnesemia (e.g., potassium-wasting diuretics, amphotericin B, cation exchange resins), drugs known to increase the QT interval (e.g., phenothiazines, tricyclic antidepressants, antiarrhythmic agents, etc.), certain other drugs (benzodiazepines, volatile anesthetics, intravenous opiates), or alcohol abuse may increase the risk of prolonged QT syndrome. In addition, central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking droperidol with certain other drugs that cause these effects, especially in elderly or debilitated patients.

MANAGEMENT: The manufacturer recommends extreme caution if droperidol must be given concomitantly with these agents. The dosage of droperidol should be individualized and titrated to the desired effect. Routine vital sign and ECG monitoring is recommended. When droperidol is used in combination with other drugs that cause CNS and/or respiratory depression, 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 doctor if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. (2001) "Product Information. Inapsine (droperidol)." Janssen Pharmaceuticals
  2. Glassman AH, Bigger JT Jr (2001) "Antipsychotic drugs: prolonged QTc interval, torsade de pointes, and sudden death." Am J Psychiatry, 158, p. 1774-82
  3. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  4. Canadian Pharmacists Association (2006) e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink
  5. Cerner Multum, Inc. "Australian Product Information."
  6. EMA. European Medicines Agency. European Union (2013) EMA - List of medicines under additional monitoring. http://www.ema.europa.eu/ema/index.jsp?curl=pages/regulation/document_listing/document_listing_000366.jsp&mid=WC0b01ac058067c852
View all 6 references

Switch to consumer interaction data

Moderate

carBAMazepine food

Applies to: Epitol (carbamazepine)

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of carbamazepine. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

In a small, randomized, crossover study, the administration of carbamazepine with grapefruit juice (compared to water) increased plasma drug concentrations by approximately 40%. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits.

MANAGEMENT: Patients receiving carbamazepine should be advised to avoid or limit consumption of alcohol. Given the drug's narrow therapeutic index, patients receiving carbamazepine therapy should preferably avoid the regular consumption of grapefruits and grapefruit juice to prevent any undue fluctuations in plasma drug levels. Patients should be advised to report signs of carbamazepine toxicity (nausea, visual disturbances, dizziness, or ataxia) to their physicians.

References

  1. (2002) "Product Information. Tegretol (carbamazepine)." Novartis Pharmaceuticals
  2. Garg SK, Kumar N, Bhargava VK, Prabhakar SK (1998) "Effect of grapefruit juice on carbamazepine bioavailability in patients with epilepsy." Clin Pharmacol Ther, 64, p. 286-8
  3. Bailey DG, Dresser GR, Kreeft JH, Munoz C, Freeman DJ, Bend JR (2000) "Grapefruit-felodipine interaction: Effect of unprocessed fruit and probable active ingredients." Clin Pharmacol Ther, 68, p. 468-77

Switch to consumer interaction data

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.

See also

Report options

Loading...
QR code containing a link to this page

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.

Medical Disclaimer