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Drug Interaction Report

3 potential interactions and/or warnings found for the following 2 drugs:

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Interactions between your drugs

Major

mesoridazine rOPINIRole

Applies to: mesoridazine, Requip (ropinirole)

GENERALLY AVOID: Agents with central antidopaminergic activity such as phenothiazines, neuroleptics, and certain antiemetics may antagonize the pharmacologic effects of dopaminergic drugs, and vice versa. Phenothiazines and older neuroleptic agents may cause extrapyramidal reactions (i.e., acute dystonic reactions, tardive dyskinesia, akathisia, Parkinson-like symptoms) due to additive antidopaminergic effects. In addition, the central nervous system depressant and hypotensive effects of these agents may be additively or synergistically increased when taken together.

MANAGEMENT: Concomitant use of dopaminergic drugs with antidopaminergic agents should generally be avoided. Some manufacturers consider concomitant use as contraindicated. Consult the manufacturer's labeling for specific recommendations. If coadministration is necessary, patients should be alerted to the possibility of excessive drowsiness and monitored for potentially diminished therapeutic response to both treatments. Patients treated for Parkinson's disease should generally avoid antidopaminergic agents, particularly phenothiazines and older neuroleptic agents, since these agents may cause extrapyramidal reactions and exacerbate the symptoms of Parkinson's disease. When treatment for neuroleptic-induced extrapyramidal symptoms is required, anticholinergic anti-parkinsonian agents should be used in preference to levodopa. Likewise, patients with a major psychotic disorder should ordinarily not be treated with dopaminergic drugs because of the risk of exacerbating the psychosis with an increase in central dopaminergic tone.

References

  1. Robbins RJ, Kern PA, Thompson TL (1984) "Interactions between thioridazine and bromocriptine in a patient with a prolactin-secreting pituitary adenoma." Am J Med, 76, p. 921-3
  2. Weingarten JC, Thompson TL (1985) "The effect of thioridazine on prolactinoma growth in a schizophrenic man: case report." Gen Hosp Psychiatry, 7, p. 364-6
  3. Mims RB, Scott CL, Modebe O, Bethune JE (1975) "Inhibition of L-dopa-induced growth hormone stimulation by pyridoxine and chlorpromazine." J Clin Endocrinol Metab, 40, p. 256-9
  4. Yahr MD, Duvoisin RC (1972) "Drug therapy of parkinsonism." N Engl J Med, 287, p. 20-4
  5. (2001) "Product Information. Risperdal (risperidone)." Janssen Pharmaceuticals
  6. (2001) "Product Information. Reglan (metoclopramide)." Wyeth-Ayerst Laboratories
  7. (2001) "Product Information. Parlodel (bromocriptine)." Sandoz Pharmaceuticals Corporation
  8. (2001) "Product Information. Permax (pergolide)." Athena Neurosciences Inc
  9. (2001) "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company
  10. (2001) "Product Information. Dostinex (cabergoline)." Pharmacia and Upjohn
  11. (2001) "Product Information. Mirapex (pramipexole)." Boehringer Ingelheim
  12. (2001) "Product Information. Requip (ropinirole)." SmithKline Beecham
  13. (2001) "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals
  14. (2001) "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals
  15. (2004) "Product Information. Norprolac (quinagolide)." Ferring Inc
  16. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
  17. (2023) "Product Information. Prochlorperazine Maleate (prochlorperazine)." Bionpharma Inc.
  18. (2023) "Product Information. Stemetil (proCHLORPERazine)." Sanofi-Aventis Australia Pty Ltd
  19. (2022) "Product Information. Stemetil (prochlorperazine)." Sanofi
  20. (2023) "Product Information. Odan-Prochlorperazine (prochlorperazine)." Odan Laboratories Ltd
View all 20 references

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Drug and food interactions

Moderate

rOPINIRole food

Applies to: Requip (ropinirole)

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

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
  3. (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
  4. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
View all 4 references

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Moderate

mesoridazine food

Applies to: mesoridazine

GENERALLY AVOID: Concurrent use of ethanol and phenothiazines may result in additive CNS depression and psychomotor impairment. Also, ethanol may precipitate dystonic reactions in patients who are taking phenothiazines. The two drugs probably act on different sites in the brain, although the exact mechanism of the interaction is not known.

MANAGEMENT: Patients should be advised to avoid alcohol during phenothiazine therapy.

References

  1. Lutz EG (1976) "Neuroleptic-induced akathisia and dystonia triggered by alcohol." JAMA, 236, p. 2422-3
  2. Freed E (1981) "Alcohol-triggered-neuroleptic-induced tremor, rigidity and dystonia." Med J Aust, 2, p. 44-5

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Therapeutic duplication warnings

No duplication 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.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.