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Drug Interactions between heparin and Minitran

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

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Interactions between your drugs

Moderate

heparin nitroglycerin

Applies to: heparin and Minitran (nitroglycerin)

MONITOR: The concurrent administration of heparin and intravenous nitroglycerin may lead to a decreased anticoagulant effect. Data are conflicting and the mechanism is unknown.

MANAGEMENT: If these agents are coadministered or if the nitroglycerin is discontinued, consider close evaluation of the coagulation status of the patient and titrate the heparin dose as needed.

References

  1. Raschke R, Guidry J, Laufer N, Peirce J (1991) "Nitroglycerin-induced heparin resistance." Am Heart J, 121, p. 1849-50
  2. Habbab MA, Haft JI (1986) "Intravenous nitroglycerin and heparin resistance." Ann Intern Med, 105, p. 305
  3. Bushe C, Wales E (1991) "A possible interaction between heparin and intravenous nitroglycerin." Am J Cardiol, 68, p. 290
  4. Barnette RE, Brister NW (1989) "Heparin nitroglycerin interaction." Anesthesiology, 71, p. 991
  5. Gonzalez ER, Jones HD, Graham S, Elswick RK (1992) "Assessment of the drug interaction between intravenous nitroglycerin and heparin." Ann Pharmacother, 26, p. 1512-4
  6. Nottestad SY, Mascette AM (1994) "Nitroglycerin-induced heparin resistance - absence of interaction at clinically relevant doses." Mil Med, 159, p. 569-71
View all 6 references

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Drug and food interactions

Moderate

nitroglycerin food

Applies to: Minitran (nitroglycerin)

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

See also

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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.

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