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Drug Interactions between Ethyol and Isochron

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

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Interactions between your drugs

Moderate

isosorbide dinitrate amifostine

Applies to: Isochron (isosorbide dinitrate) and Ethyol (amifostine)

MONITOR: Concomitant use with antihypertensive agents or drugs with hypotensive effects may increase the risk and severity of hypotension associated with amifostine. Hypotension has been reported frequently in patients treated with amifostine. It is usually transient (lasting from 5 to 15 minutes) and closely associated with amifostine administration, but may persist or become evident hours after administration. Moreover, hypotension can occur despite adequate hydration and positioning of the patient. Significant drops in systolic blood pressure have been reported, in some cases resulting in premature termination of amifostine infusion. In rare cases, sometimes during or after hypotension, patients have experienced tachycardia, bradycardia, dyspnea, apnea, hypoxia, chest pain, myocardial ischemia, renal failure, myocardial infarction, convulsions, unconsciousness, respiratory arrest, and cardiac arrest.

MANAGEMENT: If medically feasible, antihypertensive medications should be interrupted 24 hours prior to amifostine administration. Blood pressure should be closely monitored during and after treatment. In addition to hypotension, transient hypertension or exacerbation of preexisting hypertension may occur from intravenous hydration, discontinuation of antihypertensive medications, or other causes. Patients who continue their hypotensive medication(s) during amifostine therapy should be carefully monitored for the development of hypotension. Clinical symptoms of hypotension are usually quickly reversed by fluid infusion and postural management.

References

  1. "Product Information. Ethyol (amifostine)." Alza PROD (2001):
  2. "Product Information. Xatral (alfuzosin)." Sanofi-Synthelabo Canada Inc (2002):

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Drug and food interactions

Moderate

isosorbide dinitrate food

Applies to: Isochron (isosorbide dinitrate)

MONITOR: Many psychotherapeutic and CNS-active agents (e.g., anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics, opioids, alcohol, muscle relaxants) exhibit hypotensive effects, especially during initiation of therapy and dose escalation. Coadministration with antihypertensives and other hypotensive agents, in particular vasodilators and alpha-blockers, may result in additive effects on blood pressure and orthostasis.

MANAGEMENT: Caution and close monitoring for development of hypotension is advised during coadministration of these agents. Some authorities recommend avoiding alcohol in patients receiving vasodilating antihypertensive drugs. Patients should be advised to avoid rising abruptly from a sitting or recumbent position and to notify their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia.

References

  1. Sternbach H "Fluoxetine-associated potentiation of calcium-channel blockers." J Clin Psychopharmacol 11 (1991): 390-1
  2. Shook TL, Kirshenbaum JM, Hundley RF, Shorey JM, Lamas GA "Ethanol intoxication complicating intravenous nitroglycerin therapy." Ann Intern Med 101 (1984): 498-9
  3. Feder R "Bradycardia and syncope induced by fluoxetine." J Clin Psychiatry 52 (1991): 139
  4. Ellison JM, Milofsky JE, Ely E "Fluoxetine-induced bradycardia and syncope in two patients." J Clin Psychiatry 51 (1990): 385-6
  5. Rodriguez de la Torre B, Dreher J, Malevany I, et al. "Serum levels and cardiovascular effects of tricyclic antidepressants and selective serotonin reuptake inhibitors in depressed patients." Ther Drug Monit 23 (2001): 435-40
  6. Cerner Multum, Inc. "Australian Product Information." O 0
  7. Pacher P, Kecskemeti V "Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns?" Curr Pharm Des 10 (2004): 2463-75
  8. Andrews C, Pinner G "Postural hypotension induced by paroxetine." BMJ 316 (1998): 595
View all 8 references

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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.