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Drug Interaction Report

30 potential interactions and/or warnings found for the following 17 drugs:

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Interactions between your drugs

Moderate

clonazePAM hydroCHLOROthiazide

Applies to: clonazepam, HydroDIURIL (hydrochlorothiazide)

HydroCHLOROthiazide and clonazePAM may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

aspirin omega-3 polyunsaturated fatty acids

Applies to: Aspir 81 (aspirin), Omega-3 (omega-3 polyunsaturated fatty acids)

Talk to your doctor before using omega-3 polyunsaturated fatty acids together with aspirin. Fish oil and other products containing omega-3 fatty acids may rarely increase the risk of bleeding when combined with other medications that can also cause bleeding such as aspirin. You should seek immediate medical attention if you experience any unusual bleeding or bruising, or have other signs and symptoms of bleeding such as dizziness; lightheadedness; red or black, tarry stools; coughing up or vomiting fresh or dried blood that looks like coffee grounds; severe headache; and weakness. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

levothyroxine estradiol

Applies to: levothyroxine, estradiol

Before taking estradiol, tell your doctor if you also use levothyroxine. You may need dose adjustments or special tests in order to safely take both medications together. If you are already taking estradiol and levothyroxine, your thyroid levels may need to be measured if your dose of estradiol is changed or stopped. You should notify your doctor if you have symptoms of low thyroid such as tiredness, feeling cold, constipation, unexplained weight gain, depression, joint or muscle pain, thinning hair or hair loss, dry skin, hoarseness, and abnormal menstrual periods. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

aspirin sertraline

Applies to: Aspir 81 (aspirin), Zoloft (sertraline)

Using sertraline together with aspirin may increase the risk of bleeding. The interaction may be more likely if you are elderly or have kidney or liver disease. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek immediate medical attention if you experience any unusual bleeding or bruising, or have other signs and symptoms of bleeding such as dizziness; lightheadedness; red or black, tarry stools; coughing up or vomiting fresh or dried blood that looks like coffee grounds; severe headache; and weakness. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

clonazePAM sertraline

Applies to: clonazepam, Zoloft (sertraline)

Using clonazePAM together with sertraline may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

hydroCHLOROthiazide sertraline

Applies to: HydroDIURIL (hydrochlorothiazide), Zoloft (sertraline)

Treatment with sertraline may occasionally cause blood sodium levels to get too low, a condition known as hyponatremia, and using it with hydroCHLOROthiazide can increase that risk. You should seek medical attention if you experience nausea, vomiting, headache, lethargy, irritability, difficulty concentrating, memory impairment, confusion, muscle spasm, weakness or unsteadiness, as these may be symptoms of hyponatremia. More severe cases may lead to hallucination, fainting, seizure, coma, and even death. Sertraline can also affect your blood pressure and heart rate. You may need a dose adjustment or more frequent monitoring of your blood pressure and pulse to safely use both medications. You should avoid rising abruptly from a sitting or lying position while taking these medications, especially at the beginning of treatment or after an increase in dose. Call your doctor if you experience dizziness, lightheadedness, fainting, or a rapid heart beat. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

levothyroxine sertraline

Applies to: levothyroxine, Zoloft (sertraline)

Consumer information for this interaction is not currently available.

MONITOR: Limited evidence suggests that sertraline may decrease levothyroxine efficacy in treating hypothyroidism. A study of 9 patients treated with levothyroxine and sertraline, found that the combination was related to elevated serum thyrotropin (TSH) concentrations. However, in another study involving 15 patients treated with levothyroxine and sertraline, no changes were observed in thyrotropin (TSH), thyroxine (T4), free thyroxine and triiodothyronine (T3) parameters as compared to patients who only took levothyroxine. The mechanism of this interaction is not known.

MANAGEMENT: Clinical monitoring of patient response, including laboratory serum TSH concentrations, is recommended. Adjustment of thyroid replacement dosage may be indicated when initiating or discontinuing sertraline therapy.

Moderate

hydroCHLOROthiazide cholecalciferol

Applies to: HydroDIURIL (hydrochlorothiazide), Vitamin D3 (cholecalciferol)

Using hydroCHLOROthiazide together with cholecalciferol can cause your blood calcium levels to become too high. Contact your doctor if you experience symptoms such as dizziness, drowsiness, weakness, lethargy, headache, nausea, vomiting, or seizures. You may need a dose adjustment or special test if you use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

magnesium sulfate cholecalciferol

Applies to: magnesium sulfate, Vitamin D3 (cholecalciferol)

Using cholecalciferol together with magnesium sulfate can lead to elevated magnesium blood levels, particularly in individuals with reduced kidney function. Symptoms of high magnesium levels may include nausea, vomiting, flushing, drowsiness, dizziness, confusion, muscle weakness, reduced reflexes, low blood pressure, slow heart rate, and impaired breathing. You should seek medical attention if you experience these symptoms. If you are on dialysis and treated with cholecalciferol or other vitamin D medications, you should generally avoid taking products that contain magnesium without first talking to your doctor, as high levels of magnesium over time can lead to bone problems. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

clonazePAM lamoTRIgine

Applies to: clonazepam, Lamictal (lamotrigine)

Using clonazePAM together with lamoTRIgine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

estradiol lamoTRIgine

Applies to: estradiol, Lamictal (lamotrigine)

Talk to your doctor before using lamoTRIgine together with estradiol. Combining these medications may reduce the blood levels and effects of lamoTRIgine. You may need a dose adjustment if you have been taking lamoTRIgine and are starting treatment with estradiol. Similarly, if estradiol is discontinued, your dosage of lamoTRIgine may need to be readjusted. Contact your doctor if your condition changes or you experience loss of seizure control during treatment with these medications. When estradiol is stopped or interrupted briefly, be alert to potentially increased side effects of lamoTRIgine such as dizziness, drowsiness, nausea, vomiting, diarrhea, blurred vision, incoordination, tremor, restlessness, irritability, depression, anxiety, and mood or behavior changes. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

sertraline lamoTRIgine

Applies to: Zoloft (sertraline), Lamictal (lamotrigine)

Treatment with sertraline may occasionally cause blood sodium levels to get too low, a condition known as hyponatremia, and using it with some anticonvulsants can increase that risk. In addition, sertraline can cause seizures in susceptible patients, which may reduce the effectiveness of medications that are used to control seizures such as lamoTRIgine. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. You should seek medical attention if you experience nausea, vomiting, headache, lethargy, irritability, difficulty concentrating, memory impairment, confusion, muscle spasm, weakness or unsteadiness, as these may be symptoms of hyponatremia. More severe cases may lead to hallucination, fainting, seizure, coma, and even death. Also let your doctor know if you develop seizures or experience an increase in seizures during treatment with sertraline. Additionally, because these medications may cause dizziness, drowsiness, and impairment in judgment, reaction speed and motor coordination, you should avoid driving or operating hazardous machinery until you know how they affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

levothyroxine conjugated estrogens topical

Applies to: levothyroxine, Premarin Vaginal (conjugated estrogens topical)

Before taking conjugated estrogens topical, tell your doctor if you also use levothyroxine. You may need dose adjustments or special tests in order to safely take both medications together. If you are already taking conjugated estrogens topical and levothyroxine, your thyroid levels may need to be measured if your dose of conjugated estrogens topical is changed or stopped. You should notify your doctor if you have symptoms of low thyroid such as tiredness, feeling cold, constipation, unexplained weight gain, depression, joint or muscle pain, thinning hair or hair loss, dry skin, hoarseness, and abnormal menstrual periods. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

lamoTRIgine conjugated estrogens topical

Applies to: Lamictal (lamotrigine), Premarin Vaginal (conjugated estrogens topical)

Talk to your doctor before using lamoTRIgine together with conjugated estrogens topical. Combining these medications may reduce the blood levels and effects of lamoTRIgine. You may need a dose adjustment if you have been taking lamoTRIgine and are starting treatment with conjugated estrogens topical. Similarly, if conjugated estrogens topical is discontinued, your dosage of lamoTRIgine may need to be readjusted. Contact your doctor if your condition changes or you experience loss of seizure control during treatment with these medications. When conjugated estrogens topical is stopped or interrupted briefly, be alert to potentially increased side effects of lamoTRIgine such as dizziness, drowsiness, nausea, vomiting, diarrhea, blurred vision, incoordination, tremor, restlessness, irritability, depression, anxiety, and mood or behavior changes. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Minor

potassium chloride cyanocobalamin

Applies to: Klor-Con 8 (potassium chloride), Vitamin B12 (cyanocobalamin)

Information for this minor interaction is available on the professional version.

Minor

ascorbic acid estradiol

Applies to: Vitamin C (ascorbic acid), estradiol

Information for this minor interaction is available on the professional version.

No other interactions were found between your selected drugs. However, this does not necessarily mean no other interactions exist. Always consult your healthcare provider.

Drug and food interactions

Moderate

levothyroxine food

Applies to: levothyroxine

The timing of meals relative to your oral levothyroxine dose can affect the absorption of the medication. Therefore, levothyroxine should be taken on a consistent schedule with regard to time of day and relation to meals to avoid large fluctuations in blood levels, which may alter its effects. In addition, absorption of levothyroxine may be decreased and/or delayed by foods such as soybean flour, cotton seed meal, walnuts, dietary fiber, calcium, calcium fortified juices and grapefruit or grapefruit juice. These foods should be avoided within several hours of dosing if possible. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

sertraline food

Applies to: Zoloft (sertraline)

You should avoid or limit the use of alcohol while being treated with sertraline. Alcohol can increase the nervous system side effects of sertraline such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. Talk to your doctor or pharmacist if you have any questions or concerns.

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Moderate

lamoTRIgine food

Applies to: Lamictal (lamotrigine)

Alcohol can increase the nervous system side effects of lamoTRIgine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with lamoTRIgine. Do not use more than the recommended dose of lamoTRIgine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

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Moderate

aspirin food

Applies to: Aspir 81 (aspirin)

Ask your doctor before using aspirin together with ethanol. Do not drink alcohol while taking aspirin. Alcohol can increase your risk of stomach bleeding caused by aspirin. Call your doctor at once if you have symptoms of bleeding in your stomach or intestines. This includes black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

clonazePAM food

Applies to: clonazepam

Using clonazePAM together with ethanol can increase nervous system side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with clonazePAM. Do not use more than the recommended dose of clonazePAM, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medication without first talking to your doctor.

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Moderate

hydroCHLOROthiazide food

Applies to: HydroDIURIL (hydrochlorothiazide)

HydroCHLOROthiazide and ethanol may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

levothyroxine food

Applies to: levothyroxine

Using multivitamin with minerals together with levothyroxine may decrease the effects of levothyroxine. You should separate the administration of levothyroxine and multivitamin with minerals by at least 4 hours. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Minor

estradiol food

Applies to: estradiol

Information for this minor interaction is available on the professional version.

Minor

aspirin food

Applies to: Aspir 81 (aspirin)

Information for this minor interaction is available on the professional version.

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

CNS drugs

Therapeutic duplication

The recommended maximum number of medicines in the 'CNS drugs' category to be taken concurrently is usually three. Your list includes four medicines belonging to the 'CNS drugs' category:

  • clonazepam
  • magnesium sulfate
  • Lamictal (lamotrigine)
  • Zoloft (sertraline)

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

Duplication

Nutritionals

Therapeutic duplication

The recommended maximum number of medicines in the 'nutritionals' category to be taken concurrently is usually three. Your list includes eight medicines belonging to the 'nutritionals' category:

  • biotin
  • magnesium sulfate
  • Klor-Con 8 (potassium chloride)
  • Omega-3 (omega-3 polyunsaturated fatty acids)
  • Vitamin B1 (thiamine)
  • Vitamin B12 (cyanocobalamin)
  • Vitamin C (ascorbic acid)
  • Vitamin D3 (cholecalciferol)

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

Duplication

Vitamins and minerals

Therapeutic duplication

The recommended maximum number of medicines in the 'vitamins and minerals' category to be taken concurrently is usually three. Your list includes five medicines belonging to the 'vitamins and minerals' category:

  • biotin
  • Vitamin B1 (thiamine)
  • Vitamin B12 (cyanocobalamin)
  • Vitamin C (ascorbic acid)
  • Vitamin D3 (cholecalciferol)

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

Duplication

Vitamins

Therapeutic duplication

The recommended maximum number of medicines in the 'vitamins' category to be taken concurrently is usually three. Your list includes four medicines belonging to the 'vitamins' category:

  • biotin
  • Vitamin B1 (thiamine)
  • Vitamin B12 (cyanocobalamin)
  • Vitamin C (ascorbic acid)

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

Duplication

Estrogens

Therapeutic duplication

The recommended maximum number of medicines in the 'estrogens' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'estrogens' category:

  • estradiol
  • Premarin Vaginal (conjugated estrogens topical)

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.


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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.