Drug interactions between Inderide and Maxalt-MLT
| Results for the following 2 drugs: |
|---|
| Inderide (hydrochlorothiazide/propranolol) |
| Maxalt-MLT (rizatriptan) |
Interactions between your selected drugs
propranolol ↔ rizatriptan
Applies to:Inderide (hydrochlorothiazide/propranolol) and Maxalt-MLT (rizatriptan)
ADJUST DOSE: Coadministration with propranolol may increase the plasma concentrations of rizatriptan. The exact mechanism is unknown but may involve propranolol inhibition of rizatriptan metabolism via monoamine oxidase, subtype A. In 11 healthy subjects, propranolol (120 mg orally every 12 hours for 7 days) increased the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of rizatriptan (10 mg single dose) by 75% and 67%, respectively, compared to placebo. A 4-fold increase in rizatriptan AUC was observed in one case. In 20 healthy subjects, reducing the dosage of propranolol (60 mg twice daily for 7 days) and/or staggering the time of administration (1 to 2 hours) lessened somewhat but did not eliminate the effect on rizatriptan pharmacokinetics. In contrast, 25 healthy subjects given a single 10 mg dose of rizatriptan following nadolol (80 mg every 12 hours) or metoprolol (100 mg every 12 hours) for 7 days demonstrated no evidence of a significant pharmacokinetic interaction. No adverse effects were attributed to any of the drug combinations in the studies, and no effect on the active N-monodesmethyl metabolite of rizatriptan was reported.
MANAGEMENT: Caution is advised if rizatriptan must be used with propranolol. Patients treated with propranolol should not receive greater than 5 mg of rizatriptan as a single dose, nor more than a maximum of 3 doses in any 24-hour period. It appears that the full range of rizatriptan dose may be used during coadministration with atenolol, metoprolol, nadolol, or timolol.
See also...
Drug Interaction Classification
The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
| 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. |
Do not stop taking any medications without consulting your healthcare provider.
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