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Cosopt Disease Interactions

There are 16 disease interactions with Cosopt (dorzolamide / timolol ophthalmic).

Major

Ophthalmic beta-blockers (applies to Cosopt) asthma/COPD

Major Potential Hazard, High plausibility. Applicable conditions: Chronic Obstructive Pulmonary Disease

Ophthalmic beta-adrenergic receptor blocking agents (aka beta-blockers) in general should not be used in patients with a current or past history of bronchial asthma or chronic obstructive pulmonary disease. Topically applied beta-blockers are systemically absorbed, with the potential for producing clinically significant systemic effects even at low or undetectable plasma levels. In the respiratory tract, beta blockade may adversely affect pulmonary function by counteracting the bronchodilation produced by catecholamine stimulation of beta-2 receptors. Although agents with beta-1 selectivity (e.g., betaxolol) are considered safer in patients with bronchospastic diseases, cardioselectivity is not absolute and may be lost with larger doses or higher plasma levels.

References

  1. Bateman ED, Jennings AA, Opie LH, van Zyl AI "Comparison of respiratory effects of two cardioselective beta-blockers, celiprolol and atenolol, in asthmatics with mild to moderate hypertension." Chest 95 (1989): 209-13
  2. Adam WR, Barter CE, Meagher EJ "Labetalol, beta blockers, and acute deterioration of chronic airway obstruction." Clin Exp Hypertens A A4 (1982): 1419-28
  3. Falliers CJ, Medakovic M, Vincent ME "Effect of single doses of labetalol, metoprolol, and placebo on ventilatory function in patients with bronchial asthma: interaction with isoproterenol." J Asthma 23 (1986): 251-60
  4. Joucken K, Durant PA "Bronchospasm and hypotension during cardiopulmonary bypass after preoperative cimetidine and labetalol therapy." Br J Anaesth 56 (1984): 917-20
  5. Palazzo MG, Kerr JH, Raine JM, Sleight P "Near-fatal bronchospasm after oral nadolol in a young asthmatic and response to ventilation with halothane." Br Med J 282 (1981): 548-9
  6. Stephen SA "Unwanted effects of propranolol." Am J Cardiol 18 (1966): 463-72
  7. Tuck J, Blasucci DJ, Chodosh S "The effects of dilevalol, metoprolol, and placebo on ventilatory function in asthmatics." J Cardiovasc Pharmacol 11 (1988): s18-24
  8. Morris R, Bulteau P "Respiratory arrest after beta-blocker in an asthmatic patient." Med J Aust 2 (1980): 576
  9. Charan NB, Lakshminarayan S "Pulmonary effects of topical timolol." Arch Intern Med 140 (1980): 843-4
  10. Coventry D, Mashford ML, Hecker R, et al. "Adverse Drug Reactions Advisory Committee: ADRAC report for 1980." Med J Aust 1 (1982): 416-9
  11. Laursen SO, Bjerrum P "Timolol eyedrop-induced severe bronchospasm." Acta Med Scand 211 (1982): 505-6
  12. Carliner NH, Prince DS "Respiratory arrest following first dose of timolol ophthalmic solution." Chest 84 (1983): 640-1
  13. Botet C, Benito P, Grau J, Coll J, Vivancos J "Timolol ophthalmic solution and respiratory arrest." Ann Intern Med 105 (1986): 306-7
  14. Gerber MJ, Dunn TL, Fernandez E, Shen AS, Iseman MD, Cherniak RM "The effect of topical ophthalmic instillation of timolol and betaxolol on lung function in asthmatic subjects." Am Rev Respir Dis 133 (1986): 264-8
  15. Bassan H, Odeh M, Oliven A "Timolol eyedrop-induced fatal bronchospasm in an asthmatic patient." J Fam Pract 32 (1991): 97-8
  16. Sudilovsky A, Croog SH, Schoenberger JA, et al. "Self-reported side effects from antihypertensive drugs: a clinical trial." Am J Hypertens 3 (1990): 123-32
  17. Armstrong J, Caterson R, Horvath JS, Woolcock AJ, Donnelly P, Tiller DJ "A comparison of metoprolol and propranolol on blood pressure and respiratory function in patients with hypertension." Aust N Z J Med 8 (1978): 1-6
  18. Berrill WT, Benson MK, Sterling GS, Cruickshank JM "A comparison of four B-adrenoceptor antagonists in patients with asthma." Br J Clin Pharmacol 5 (1978): 415-9
  19. Dufier JL, Munera Y, Hugues FC, Bringer L, Le Jeunne CL "Bronchial and cardiovascular effects of ocular topical B-antagonists in asthmatic subjects: comparison of timolol, carteolol, and metipranolol." J Clin Pharmacol 29 (1989): 97-101
  20. "Product Information. OptiPranolol (metipranolol)." Bausch and Lomb, Tampa, FL.
  21. Palkama A, Uusitalo RJ "Efficacy and safety of timolol pilocarpine combination drops in glaucoma patients." Acta Ophthalmol (Copenh) 72 (1994): 496-504
  22. Benjamin KW "Toxicity of ocular medications." Int Ophthalmol Clin 19 (1979): 199-255
  23. "Product Information. Betagan Liquifilm (levobunolol)." Allergan Inc, Irvine, CA.
  24. "Product Information. Betoptic (betaxolol ophthalmic)." Alcon Laboratories Inc (2001):
  25. "Product Information. Timoptic (timolol ophthalmic)." Merck & Company Inc (2001):
  26. "Product Information. Betaxon (levobetaxolol ophthalmic)." Alza (2001):
  27. "Product Information. Ocupress (carteolol ophthalmic)." Ciba Vision Ophthalmics (2001):
View all 27 references
Major

Ophthalmic beta-blockers (applies to Cosopt) bradycardia/AV block

Major Potential Hazard, High plausibility. Applicable conditions: Sinus Node Dysfunction, Heart Block

The use of ophthalmic beta-adrenergic receptor blocking agents (aka beta-blockers) is considered by manufacturers to be contraindicated in patients with sinus bradyarrhythmia or heart block greater than the first degree (unless a functioning pacemaker is present). Topically applied beta-blockers are systemically absorbed, with the potential for producing clinically significant systemic effects even at low or undetectable plasma levels. In cardiac tissues, beta blockade causes a reduction in inotropic as well as chronotropic activity, which may further depress cardiac function in such patients.

References

  1. Williams DO, Crean PA "Effect of intravenous and oral acebutolol in patients with bundle branch block." Int J Cardiol 10 (1986): 119-26
  2. Coventry D, Mashford ML, Hecker R, et al. "Adverse Drug Reactions Advisory Committee: ADRAC report for 1980." Med J Aust 1 (1982): 416-9
  3. Treseder AS, Thomas TP "Sinus arrest due to timolol eye drops." Br J Clin Pract 40 (1986): 256-8
  4. "Product Information. OptiPranolol (metipranolol)." Bausch and Lomb, Tampa, FL.
  5. Palkama A, Uusitalo RJ "Efficacy and safety of timolol pilocarpine combination drops in glaucoma patients." Acta Ophthalmol (Copenh) 72 (1994): 496-504
  6. Benjamin KW "Toxicity of ocular medications." Int Ophthalmol Clin 19 (1979): 199-255
  7. "Product Information. Betagan Liquifilm (levobunolol)." Allergan Inc, Irvine, CA.
  8. Edeki TI, He H, Wood AJ "Pharmacogenetic explanation for excessive B-blockade following timolol eye drops." JAMA 274 (1995): 1611-3
  9. Eisenberg MJ, Shiuey Y "Cardiovascular effects of commonly used ophthalmic medications." Clin Cardiol 19 (1996): 5-8
  10. "Product Information. Betoptic (betaxolol ophthalmic)." Alcon Laboratories Inc (2001):
  11. "Product Information. Timoptic (timolol ophthalmic)." Merck & Company Inc (2001):
  12. "Product Information. Betaxon (levobetaxolol ophthalmic)." Alza (2001):
  13. "Product Information. Ocupress (carteolol ophthalmic)." Ciba Vision Ophthalmics (2001):
View all 13 references
Major

Ophthalmic beta-blockers (applies to Cosopt) cardiogenic shock

Major Potential Hazard, High plausibility.

The use of ophthalmic beta-adrenergic receptor blocking agents (aka beta-blockers) is considered by manufacturers to be contraindicated in patients with cardiogenic shock. Topically applied beta-blockers are systemically absorbed, with the potential for producing clinically significant systemic effects even at low or undetectable plasma levels. In cardiac tissues, beta blockade causes a reduction in inotropic as well as chronotropic activity, which may further depress cardiac output and blood pressure in such patients.

References

  1. Isles C, Kholeif M "Profound hypotension after atenolol in severe hypertension." Br Med J 298 (1989): 161-2
  2. Jones MK, Tirlapur VG, Evans PJ "Shock syndrome after acebutolol." Br J Clin Pract 40 (1986): 33-4
  3. "Product Information. OptiPranolol (metipranolol)." Bausch and Lomb, Tampa, FL.
  4. Palkama A, Uusitalo RJ "Efficacy and safety of timolol pilocarpine combination drops in glaucoma patients." Acta Ophthalmol (Copenh) 72 (1994): 496-504
  5. Benjamin KW "Toxicity of ocular medications." Int Ophthalmol Clin 19 (1979): 199-255
  6. "Product Information. Betagan Liquifilm (levobunolol)." Allergan Inc, Irvine, CA.
  7. Edeki TI, He H, Wood AJ "Pharmacogenetic explanation for excessive B-blockade following timolol eye drops." JAMA 274 (1995): 1611-3
  8. Eisenberg MJ, Shiuey Y "Cardiovascular effects of commonly used ophthalmic medications." Clin Cardiol 19 (1996): 5-8
  9. "Product Information. Betoptic (betaxolol ophthalmic)." Alcon Laboratories Inc (2001):
  10. "Product Information. Timoptic (timolol ophthalmic)." Merck & Company Inc (2001):
  11. "Product Information. Betaxon (levobetaxolol ophthalmic)." Alza (2001):
  12. "Product Information. Ocupress (carteolol ophthalmic)." Ciba Vision Ophthalmics (2001):
View all 12 references
Major

Ophthalmic beta-blockers (applies to Cosopt) CHF

Major Potential Hazard, High plausibility. Applicable conditions: Congestive Heart Failure

The use of ophthalmic beta-adrenergic receptor blocking agents (aka beta-blockers) is considered by manufacturers to be contraindicated in patients with overt congestive heart failure (CHF). Topically applied beta-blockers are systemically absorbed, with the potential for producing clinically significant systemic effects even at low or undetectable plasma levels. Since sympathetic stimulation may be important in maintaining the hemodynamic function in patients with CHF, beta blockade can worsen the heart failure. However, therapy with ophthalmic beta-blockers can be administered cautiously in some CHF patients provided they are well compensated and receiving digitalis, diuretics, an ACE inhibitor, and/or nitrates. Beta-blockers should be discontinued if cardiac failure develops or worsens during therapy.

References

  1. Altus P "Timolol-induced congestive heart failure." South Med J 74 (1981): 88
  2. Coventry D, Mashford ML, Hecker R, et al. "Adverse Drug Reactions Advisory Committee: ADRAC report for 1980." Med J Aust 1 (1982): 416-9
  3. "Product Information. OptiPranolol (metipranolol)." Bausch and Lomb, Tampa, FL.
  4. Palkama A, Uusitalo RJ "Efficacy and safety of timolol pilocarpine combination drops in glaucoma patients." Acta Ophthalmol (Copenh) 72 (1994): 496-504
  5. Benjamin KW "Toxicity of ocular medications." Int Ophthalmol Clin 19 (1979): 199-255
  6. "Product Information. Betagan Liquifilm (levobunolol)." Allergan Inc, Irvine, CA.
  7. Edeki TI, He H, Wood AJ "Pharmacogenetic explanation for excessive B-blockade following timolol eye drops." JAMA 274 (1995): 1611-3
  8. Eisenberg MJ, Shiuey Y "Cardiovascular effects of commonly used ophthalmic medications." Clin Cardiol 19 (1996): 5-8
  9. "Product Information. Betoptic (betaxolol ophthalmic)." Alcon Laboratories Inc (2001):
  10. "Product Information. Timoptic (timolol ophthalmic)." Merck & Company Inc (2001):
  11. "Product Information. Betaxon (levobetaxolol ophthalmic)." Alza (2001):
  12. "Product Information. Ocupress (carteolol ophthalmic)." Ciba Vision Ophthalmics (2001):
View all 12 references
Major

Ophthalmic beta-blockers (applies to Cosopt) diabetes

Major Potential Hazard, High plausibility. Applicable conditions: Diabetes Mellitus

Beta-adrenergic receptor blocking agents (aka beta-blockers) may mask symptoms of hypoglycemia such as tremors, tachycardia and blood pressure changes. In addition, the nonselective beta-blockers (e.g., timolol, carteolol) may inhibit catecholamine-mediated glycogenolysis, thereby potentiating insulin-induced hypoglycemia and delaying the recovery of normal blood glucose levels. Since topically applied beta-blockers are systemically absorbed and may produce clinically significant systemic effects even at low or undetectable plasma levels, therapy with ophthalmic beta-blockers should be administered cautiously in patients with diabetes or predisposed to spontaneous hypoglycemia.

References

  1. Darga LL, Franklin BA, Hakim MJ, Lucas CP "Comparison of the effects of guanadrel sulfate and propranolol on blood pressure, functional capacity, serum lipoproteins and glucose in systemic hypertension." Am J Cardiol 67 (1991): 590-6
  2. Aro A, Pietikainen M, Uusitupa M "Severe hypoglycaemia caused by physical strain and pindolol therapy." Ann Clin Res 12 (1980): 25-7
  3. Velde TM, Kaiser FE "Ophthalmic timolol treatment causing altered hypoglycemic response in a diabetic patient." Arch Intern Med 143 (1983): 1627
  4. Delas B, Bennett P, Grimaldi A, et al. "Beta-blockers and hypoglycaemia: assessment of cardioselective and intrinsic sympathomimetic properties in relation to severity of hypoglycaemia." Curr Ther Res Clin Exp 36 (1984): 361-73
  5. "Product Information. OptiPranolol (metipranolol)." Bausch and Lomb, Tampa, FL.
  6. Benjamin KW "Toxicity of ocular medications." Int Ophthalmol Clin 19 (1979): 199-255
  7. "Product Information. Betagan Liquifilm (levobunolol)." Allergan Inc, Irvine, CA.
  8. "Product Information. Betoptic (betaxolol ophthalmic)." Alcon Laboratories Inc (2001):
  9. Acampora R, DeAngelis L, Ragone R, Ziccardi P, DeRosa N, DOnofrio F, Giugliano D, Marfella R "Metabolic and cardiovascular effects of carvedilol and atenolol in non-insulin-dependent diabetes mellitus and hypertension - A randomized, controlled trial." Ann Intern Med 126 (1997): 955-9
  10. "Product Information. Timoptic (timolol ophthalmic)." Merck & Company Inc (2001):
  11. "Product Information. Betaxon (levobetaxolol ophthalmic)." Alza (2001):
  12. "Product Information. Ocupress (carteolol ophthalmic)." Ciba Vision Ophthalmics (2001):
View all 12 references
Major

Ophthalmic beta-blockers (applies to Cosopt) hypersensitivity

Major Potential Hazard, High plausibility. Applicable conditions: Allergies

Topically applied beta-adrenergic receptor blocking agents (aka beta-blockers) are systemically absorbed, with the potential for producing clinically significant systemic effects even at low or undetectable plasma levels. The use of beta-blockers in patients with a history of allergic reactions or anaphylaxis may be associated with heightened reactivity to culprit allergens. The frequency and/or severity of attacks may be increased during beta-blocker therapy. In addition, these patients may be refractory to the usual doses of epinephrine used to treat acute hypersensitivity reactions and may require a beta-agonist such as isoproterenol.

References

  1. "Product Information. OptiPranolol (metipranolol)." Bausch and Lomb, Tampa, FL.
  2. "Product Information. Betagan Liquifilm (levobunolol)." Allergan Inc, Irvine, CA.
  3. "Product Information. Betoptic (betaxolol ophthalmic)." Alcon Laboratories Inc (2001):
  4. "Product Information. Timoptic (timolol ophthalmic)." Merck & Company Inc (2001):
  5. "Product Information. Betaxon (levobetaxolol ophthalmic)." Alza (2001):
  6. "Product Information. Ocupress (carteolol ophthalmic)." Ciba Vision Ophthalmics (2001):
View all 6 references
Major

Ophthalmic beta-blockers (applies to Cosopt) hyperthyroidism

Major Potential Hazard, High plausibility.

Beta-adrenergic receptor blocking agents (aka beta-blockers) may mask some symptoms of hyperthyroidism such as tachycardia, anxiety, tremor, and heat intolerance. Abrupt withdrawal of beta-blocker therapy in thyrotoxic patients may exacerbate symptoms of hyperthyroidism or precipitate a thyroid storm. Since topically applied beta-blockers are systemically absorbed and may produce clinically significant systemic effects even at low or undetectable plasma levels, therapy with ophthalmic beta-blockers should be administered cautiously in patients with or suspected of having hyperthyroidism. Cessation of beta-blocker therapy, when necessary, should occur gradually over a period of 1 to 2 weeks. Patients should be advised not to discontinue treatment without first consulting with the physician. Close monitoring is recommended during and after therapy withdrawal.

References

  1. "Product Information. OptiPranolol (metipranolol)." Bausch and Lomb, Tampa, FL.
  2. "Product Information. Betagan Liquifilm (levobunolol)." Allergan Inc, Irvine, CA.
  3. "Product Information. Betoptic (betaxolol ophthalmic)." Alcon Laboratories Inc (2001):
  4. "Product Information. Timoptic (timolol ophthalmic)." Merck & Company Inc (2001):
  5. "Product Information. Betaxon (levobetaxolol ophthalmic)." Alza (2001):
  6. "Product Information. Ocupress (carteolol ophthalmic)." Ciba Vision Ophthalmics (2001):
View all 6 references
Major

Ophthalmic beta-blockers (applies to Cosopt) PVD

Major Potential Hazard, Moderate plausibility. Applicable conditions: Cerebrovascular Insufficiency, Peripheral Arterial Disease

Due to their negative inotropic and chronotropic effects on the heart, beta-adrenergic receptor blocking agents (aka beta-blockers) reduce cardiac output and may precipitate or aggravate symptoms of arterial insufficiency in patients with peripheral vascular disease. In addition, the nonselective beta-blockers (e.g., timolol, carteolol) may attenuate catecholamine-mediated vasodilation during exercise by blocking beta-2 receptors in peripheral vessels. Since topically applied beta-blockers are systemically absorbed and may produce clinically significant systemic effects even at low or undetectable plasma levels, therapy with ophthalmic beta-blockers should be administered cautiously in patients with peripheral vascular disease. Close monitoring for progression of arterial obstruction is advised.

References

  1. Danielson M, Eliasson K, Hylander B, Lindblad LE "Raynaud's phenomenon caused by beta-receptor blocking drugs." Acta Med Scand 215 (1984): 333-9
  2. Eliasson K, Sundqvist K, Lins L-E "Peripheral vasospasm during beta-receptor blockade: a comparison between metoprolol and pindolol." Acta Med Scand 665 (1982): 109-12
  3. Lepantalo M "Beta blockade and intermittent claudication." Acta Med Scand 700 (1985): 1-48
  4. Coventry D, Mashford ML, Hecker R, et al. "Adverse Drug Reactions Advisory Committee: ADRAC report for 1980." Med J Aust 1 (1982): 416-9
  5. Coppeto JR "Transient ischemic attacks and amaurosis fugax from timolol." Ann Ophthalmol 17 (1985): 64-5
  6. Jesek JK, Thomas EL, Wambsgans KC, Wilmore JH, Broeder CE, Hofman Z, Martin NB, Scruggs KD "Effects of propranolol and pindolol on cardiac output during extended periods of low-intensity physical activity." Am J Cardiol 72 (1993): 1188-95
  7. Holti G "A double-blind study of the peripheral vasoconstrictor effects of the beta-blocking drug penbutolol in patients with Raynaud's phenomenon." Curr Med Res Opin 6 (1979): 267-70
  8. "Product Information. OptiPranolol (metipranolol)." Bausch and Lomb, Tampa, FL.
  9. Palkama A, Uusitalo RJ "Efficacy and safety of timolol pilocarpine combination drops in glaucoma patients." Acta Ophthalmol (Copenh) 72 (1994): 496-504
  10. Benjamin KW "Toxicity of ocular medications." Int Ophthalmol Clin 19 (1979): 199-255
  11. "Product Information. Betagan Liquifilm (levobunolol)." Allergan Inc, Irvine, CA.
  12. Breckenridge A, Roberts DH "Antihypertensive treatment in concomitant peripheral vascular disease: current experience and the potential of carvedilol." J Cardiovasc Pharmacol 18 Suppl 4 (1991): s78-81
  13. Edeki TI, He H, Wood AJ "Pharmacogenetic explanation for excessive B-blockade following timolol eye drops." JAMA 274 (1995): 1611-3
  14. Eisenberg MJ, Shiuey Y "Cardiovascular effects of commonly used ophthalmic medications." Clin Cardiol 19 (1996): 5-8
  15. "Product Information. Betoptic (betaxolol ophthalmic)." Alcon Laboratories Inc (2001):
  16. "Product Information. Timoptic (timolol ophthalmic)." Merck & Company Inc (2001):
  17. "Product Information. Betaxon (levobetaxolol ophthalmic)." Alza (2001):
  18. "Product Information. Ocupress (carteolol ophthalmic)." Ciba Vision Ophthalmics (2001):
View all 18 references
Major

Topical sulfonamides (applies to Cosopt) hematologic toxicity

Major Potential Hazard, Low plausibility. Applicable conditions: Bone Marrow Depression/Low Blood Counts

Sulfonamides may be systemically absorbed when applied to the skin, eye, or mucosal membranes. The use of sulfonamides has been associated with hematologic toxicity, including methemoglobinemia, sulfhemoglobinemia, leukopenia, granulocytopenia, eosinophilia, hemolytic anemia, aplastic anemia, purpura, clotting disorder, thrombocytopenia, hypofibrinogenemia, and hypoprothrombinemia. Therapy with topical sulfonamides should be administered cautiously in patients with preexisting blood dyscrasias or bone marrow suppression. Complete blood counts should be obtained regularly during prolonged therapy (>2 weeks), and patients should be instructed to immediately report any signs or symptoms suggestive of blood dyscrasia such as fever, sore throat, local infection, bleeding, pallor, dizziness, or jaundice.

References

  1. Bar A, Barak S, Shaked Y, Samra Y "Drug-induced post-surgical hemorrhage resulting from trimethoprim-sulphamethoxazole." Int J Oral Maxillofac Surg 18 (1989): 206-7
  2. Beale D, Chan M, Moorhead J "Acute megaloblastosis due to cotrimoxazole." Br J Clin Pract 34 (1980): 87-8
  3. Abadie J, Damergis J, Stoker J "Methemoglobinemia after sulfamethoxazole and trimethoprim therapy." JAMA 249 (1983): 590-1
  4. Hazenberg BP, Kuipers EJ, de Wolf JT, Vellenga E "Sulfasalazine induced agranulocytosis treated with GM-CSF." J Rheumatol 19 (1992): 621-2
  5. Youssef PP, Bertouch JV "Sulphasalazine induced aplastic anaemia." Aust N Z J Med 22 (1992): 391-2
  6. Keisu M, Ekman E "Sulfasalazine associated agranulocytosis in sweden 1972-1989: clinical features, and estimation of its incidence." Eur J Clin Pharmacol 43 (1992): 215-8
  7. Blyden GT, Kelsey PB, Isselbacher KJ, Demirjian ZN, Jacobson IM "Sulfasalazine-induced agranulocytosis." Am J Gastroenterol 80 (1985): 118-21
  8. Cooper B, Wheelan KR, Stone MJ "Multiple haematologic abnormalities associated with sulfasalazine." Ann Intern Med 97 (1982): 726-7
  9. Barbado FJ, Pena JM, Garcia-Alegria J, Gonzalez-Garcia JJ, Vazquez JJ "Thrombocytopenia and sulfasalazine." Ann Intern Med 102 (1985): 277-8
  10. Davies GE, Palek J "Selective erythroid and magakaryocytic aplasia after sulfasalazine administration." Arch Intern Med 140 (1980): 1122
  11. Aussedat R, Guerci A, Guillemin F, Trechot P, Lederlin P, Pourel J "Fatal agranulocytosis in sulfasalazine treated rheumatoid arthritis." J Rheumatol 16 (1989): 1166-7
  12. Mitrane MP, Singh A, Seibold JR "Cholestasis and fatal agranulocytosis complicating sulfasalazine therapy: case report and review of the literature." J Rheumatol 13 (1986): 969-72
  13. Mechanick JI "Coombs' positive hemolytic anemia following sulfasalazine therapy in ulcerative colitis: case reports, review, and discussion of pathogenesis." Mt Sinai J Med 52 (1985): 667-70
  14. Betkowski AS, Lubin A "Sulfamethoxazole-related antiplatelet antibody." Blood 82 (1993): 1683
  15. Gales BJ, Gales MA "Granulocyte-colony stimulating factor for sulfasalazine-induced agranulocytosis." Ann Pharmacother 27 (1993): 1052-4
  16. "Product Information. Gantrisin (sulfisoxazole ophthalmic)." Roche Laboratories, Nutley, NJ.
  17. "Product Information. Azopt (brinzolamide ophthalmic)." Alcon Laboratories Inc (2001):
  18. "Product Information. Trusopt (dorzolamide ophthalmic)." Merck & Company Inc (2001):
  19. "Product Information. Klaron (sulfacetamide sodium topical)." Dermik Laboratories/Aventis (2001):
  20. "Product Information. Sulamyd Ophthalmic Solution (sodium sulfacetamide ophthalmic)." Schering Corporation, Kenilworth, NJ.
  21. "Product Information. Sultrin (triple sulfa topical)" Janssen Pharmaceuticals, Titusville, NJ.
  22. "Product Information. Sulfacet-R (sulfacetamide sodium topical)." Dermik Laboratories/Aventis (2001):
  23. "Product Information. AVC Cream (sulfanilamide topical)" Aventis Pharmaceuticals, Swiftwater, PA.
View all 23 references
Major

Topical sulfonamides (applies to Cosopt) hypersensitivity reactions

Major Potential Hazard, Moderate plausibility. Applicable conditions: Allergies, Asthma, HIV Infection

Sulfonamides may be systemically absorbed when applied to the skin, eye, or mucosal membranes. The use of sulfonamides is associated with large increases in the risk of Stevens-Johnson syndrome, toxic epidermal necrolysis and other serious dermatologic reactions, although these phenomena are rare as a whole. Hepatitis, pneumonitis, and interstitial nephritis have also occurred in association with sulfonamide hypersensitivity. Therapy with topical sulfonamides should be administered cautiously in patients with severe allergies, bronchial asthma or AIDS, since these patients may be at increased risk for potentially severe hypersensitivity reactions. Patients should be instructed to promptly report signs and symptoms that may precede the onset of cutaneous manifestations of the Stevens-Johnson syndrome, such as high fever, severe headache, stomatitis, conjunctivitis, rhinitis, urethritis, and balanitis. Sulfonamide therapy should be stopped at once if a rash develops.

References

  1. Goodwin D, Johnson M, Shands J "Trimethoprim-sulfamethoxazole anaphylactoid reactions in patients with AIDS: case reports and literature review." Pharmacotherapy 10 (1990): 413-16
  2. Weigand K, Becker EW, Berg PA, Hofer T "Demonstration of sensititzed lymphocytes to trimethoprim/sulfamethoxazole and ofloxacin in a patient with cholestatic hepatitis." J Hepatol 15 (1992): 262-3
  3. Christie D, Haas J, Stevenson D "Hepatic injury in a child caused by trimethoprim-sulfamethoxazole." Pediatrics 61 (1978): 864-6
  4. Filo R, Smith E, Light J, Yum M "Interstitial nephritis caused by trimethoprim-sulfamethoxazole in renal transplant recipients." JAMA 244 (1980): 360-1
  5. Whittington R "Toxic epidermal necrolysis and co-trimoxazole." Lancet 2 (1989): 574
  6. Dooley D, Kelly W, Lattuada C, Smith C "A severe, unusual reaction to trimethoprim-sulfamethoxazole in patients infected with human immunodeficiency virus." Clin Infect Dis 14 (1992): 1034-9
  7. Mertl L, Horak J, Hrabal P "Severe liver injuries due to sulfamethoxazole-trimethoprim and sulfamethoxydiazine." Hepatogastroenterology 31 (1984): 199-200
  8. Gibson J "Recurrent trimethoprim-associated fixed skin eruption." Br Med J 284 (1982): 1529-30
  9. Holdcroft C, Ellison R "Trimethoprim-sulfamethoxazole reaction simulating pneumocystis carinii pneumonia." AIDS 5 (1991): 1029-42
  10. Steinbrecher U, Mishkin S "Sulfamethoxazole-induced hepatic injury." Dig Dis Sci 26 (1981): 756-9
  11. Evans A, Webb D, Rudra T "Acute tubular necrosis following co-trimoxazole therapy." Nephron 53 (1989): 85-6
  12. Cutcher AB, Galgiani JN, Ampel N, Shon B, Ulstad D "Reaction after re-exposure to trimethoprim-sulfamethoxazole." Chest 95 (1989): 937-8
  13. Burger H, Heer M, Altorfer J, Walti M "Bullous esophageal lesions due to co-trimoxazole: an immune-mediated process?" Gastroenterology 88 (1985): 1954-7
  14. Pisanty S, Brayer L "Erythema multiforme-like eruption due to sulfadiazine." J Dent Med 20 (1965): 154-7
  15. Levi J, Robson M, Rosenfeld J, Dolberg L "Acute tubulo-interstitial nephritis following sulfadiazine therapy." Isr J Med Sci 6 (1970): 561-6
  16. Donaghy A, Wakefield D, Goadsby P, Lloyd A "Acquired immunodeficiency syndrome (AIDS) and sulfadiazine-associated acute renal failure." Ann Intern Med 107 (1987): 783-4
  17. Bendixen B, Carbone L, Appel G "Sulfadiazine-associated obstructive nephropathy occurring in a patient with the acquired immunodeficiency syndrome." Am J Kidney Dis 12 (1988): 72-5
  18. Carey D, Boyle M, Tenant-Flowers M, et al. "Sulphadiazine desenitization in patients with AIDS and cerebral toxoplasmosis." AIDS 5 (1991): 311-5
  19. Blotman F, Leroux JL, Chertok P, Ghezail M "Hypersensitivity reactions to sulfasalazine: skin rash, fever, hepatitis and activated lymphocytes." Clin Exp Rheumatol 10 (1992): 427
  20. Tedesco FJ, Kalser MH, Kanner RS "Azulfidine- (sulfasalazine-) induced hepatic injury." Am J Dig Dis 23 (1978): 956-8
  21. Losek JD, Werlin SL "Sulfasalazine hepatotoxicity." Am J Dis Child 135 (1981): 1070-2
  22. Braverman D, Rachmilewitz D, Schwartz J, Fich A, Zifroni A "Sulfasalazine hepatotoxicity." Am J Gastroenterol 79 (1984): 401-2
  23. Korelitz BI, Yaffe BH "Sulfasalazine pneumonitis." Am J Gastroenterol 78 (1983): 493-4
  24. LeLeiko NS, Ribe J, Benkov KJ, Shen SC, Thung SN "Fatal massive hepatic necrosis: a probable hypersensitivity reaction to sulfasalazine." Am J Gastroenterol 81 (1986): 205-8
  25. Hallak A, Averbuch M, Halpern Z, Levo Y, Topilsky M "Sulfasalazine pneumonitis." Am J Gastroenterol 80 (1985): 343-5
  26. Machishi M, Kitagawa T, Yamakami T, Suzuki S, Yamamoto J, Gabazza EC, Ibata H, Taguchi O, Matsumoto K "Pulmonary infiltrates and skin pigmentation associated with sulfasalazine." Am J Gastroenterol 87 (1992): 1654-7
  27. Love KR, Poland GA "Marked atypical lymphocytosis, hepatitis, and skin rash in sulfasalazine drug allergy." Am J Med 81 (1986): 707-8
  28. Atkinson J, Smith LJ, Hamadeh MA "Sulfasalazine-induced pulmonary disease." Chest 101 (1992): 1033-7
  29. Eidus L, Thomas P, Williams T "Fibrosing alveolitis, bronchiolitis obliterans, and sulfasalazine therapy." Chest 81 (1982): 766-8
  30. Van der Straeten M, Valcke Y, Pauwels R "Bronchoalveolar lavage in acute hypersensitivity pneumonitis caused by sulfasalazine." Chest 92 (1987): 572-3
  31. Das KM, Taffet SL "Sulfasalazine. Adverse effects and desensitization." Dig Dis Sci 28 (1983): 833-42
  32. Abcarian H, Pearl RK, Nelson RL, Orsay CP, Prasad ML "Serious complications of sulfasalazine." Dis Colon Rectum 29 (1986): 201-2
  33. Sotolongo RP, Rudzki C, Ishak KG, Neefe LI "Hypersensitivity reaction to sulfasalazine with severe hepatotoxicity." Gastroenterology 75 (1978): 95-9
  34. Bowyer BA, Schroeder KW, Fleming CR, Wang KK "Pulmonary infiltrates and eosinophilia associated with sulfasalazine." Mayo Clin Proc 59 (1984): 343-6
  35. Jr, Haines JD "Hepatotoxicity after treatment with sulfasalazine." Postgrad Med 79 (1986): 193-4,
  36. Machado MC, Faintuch J, Mott CB "Pancreatitis and pancreatic necrosis during sulfasalazine therapy." Int Surg 70 (1985): 271-2
  37. Painter DM, Marinos G, Riley J, McCaughan GW "Sulfasalazine-induced fulminant hepatic failure." J Clin Gastroenterol 14 (1992): 132-5
  38. Donowitz M, Namias A, Bhalotra R "Reversible sulfasalazine-induced granulomatous hepatitis." J Clin Gastroenterol 3 (1981): 193-8
  39. Bancroft J, Moyer MS, Gremse DA "Sulfasalazine hypersensitivity with hepatotoxicity, thrombocytopenia, and erythroid hypoplasia." J Pediatr Gastroenterol Nutr 9 (1989): 261-3
  40. Marinac JS, Stanford JF "A severe hypersensitive reaction to trimethoprim-sulfamethoxazole in a patient infected with human immunodeficiency virus." Clin Infect Dis 16 (1993): 178-9
  41. Rubin R "Sulfasalazine-induced fulminant hepatic failure and necrotizing pancreatitis." Am J Gastroenterol 89 (1994): 789-91
  42. Naldi L, Roujeau JC, Kelly JP, et al. "Medication use and the risk of Stevens-Johnson syndrome or toxic epidermal necrolysis." N Engl J Med 333 (1995): 1600-7
  43. Hiruma M, Ishibashi A, Marshall J, Kobayashi T, Noguchi H, Kawada A "Fixed drug eruption induced by sulfasalazine." Contact Dermatitis 34 (1996): 155-6
  44. "Product Information. Gantrisin (sulfisoxazole ophthalmic)." Roche Laboratories, Nutley, NJ.
  45. "Product Information. Azopt (brinzolamide ophthalmic)." Alcon Laboratories Inc (2001):
  46. "Product Information. Trusopt (dorzolamide ophthalmic)." Merck & Company Inc (2001):
  47. "Product Information. Klaron (sulfacetamide sodium topical)." Dermik Laboratories/Aventis (2001):
  48. "Product Information. Sulamyd Ophthalmic Solution (sodium sulfacetamide ophthalmic)." Schering Corporation, Kenilworth, NJ.
  49. "Product Information. Sultrin (triple sulfa topical)" Janssen Pharmaceuticals, Titusville, NJ.
  50. "Product Information. Sulfacet-R (sulfacetamide sodium topical)." Dermik Laboratories/Aventis (2001):
  51. "Product Information. AVC Cream (sulfanilamide topical)" Aventis Pharmaceuticals, Swiftwater, PA.
View all 51 references
Major

Topical sulfonamides (applies to Cosopt) porphyria

Major Potential Hazard, Moderate plausibility.

Sulfonamides may be systemically absorbed when applied to the skin, eye, or mucosal membranes. Therapy with topical sulfonamides should be administered cautiously in patients with porphyria, since these drugs can precipitate an acute attack. The use of oral sulfonamides is considered contraindicated in patients with porphyria.

References

  1. "Product Information. Gantrisin (sulfisoxazole ophthalmic)." Roche Laboratories, Nutley, NJ.
  2. "Product Information. Azopt (brinzolamide ophthalmic)." Alcon Laboratories Inc (2001):
  3. "Product Information. Trusopt (dorzolamide ophthalmic)." Merck & Company Inc (2001):
  4. "Product Information. Klaron (sulfacetamide sodium topical)." Dermik Laboratories/Aventis (2001):
  5. "Product Information. Sulamyd Ophthalmic Solution (sodium sulfacetamide ophthalmic)." Schering Corporation, Kenilworth, NJ.
  6. "Product Information. Sultrin (triple sulfa topical)" Janssen Pharmaceuticals, Titusville, NJ.
  7. "Product Information. Sulfacet-R (sulfacetamide sodium topical)." Dermik Laboratories/Aventis (2001):
  8. "Product Information. AVC Cream (sulfanilamide topical)" Aventis Pharmaceuticals, Swiftwater, PA.
View all 8 references
Moderate

Ophthalmic beta-blockers (applies to Cosopt) myasthenia gravis

Moderate Potential Hazard, Low plausibility. Applicable conditions: Myoneural Disorder

Topically applied beta-adrenergic receptor blocking agents (aka beta-blockers) are systemically absorbed, with the potential for producing clinically significant systemic effects even at low or undetectable plasma levels. In the nervous and musculoskeletal systems, beta blockade may potentiate muscle weakness consistent with certain myasthenic symptoms such as diplopia, ptosis, and generalized weakness. Several beta-blockers have been associated rarely with aggravation of muscle weakness in patients with preexisting myasthenia gravis or myasthenic symptoms.

References

  1. Aimard G, Confavreux C, Charles N "Fulminant myasthenia gravis soon after initiation of acebutolol therapy." Eur Neurol 30 (1990): 279-81
  2. Berstein LP, Henkind P "Additional information on adverse reactions to timolol." Am J Ophthalmol 92 (1981): 295-6
  3. Coppeto JR "Timolol-associated myasthenia gravis." Am J Ophthalmol 98 (1984): 244-5
  4. Verkijk A "Worsening of myasthenia gravis with timolol maleate eyedrops." Ann Neurol 17 (1985): 211-2
  5. Herishanu Y, Rosenberg P "Beta-blockers and myasthenia gravis." Ann Intern Med 83 (1975): 834-5
  6. "Product Information. OptiPranolol (metipranolol)." Bausch and Lomb, Tampa, FL.
  7. Benjamin KW "Toxicity of ocular medications." Int Ophthalmol Clin 19 (1979): 199-255
  8. "Product Information. Betagan Liquifilm (levobunolol)." Allergan Inc, Irvine, CA.
  9. Lam KSL, Choi KL, Kung AWC, Wat MS, Ip TP "Phaeochromocytoma associated with myasthenia gravis precipitated by propranolol treatment." Aust N Z J Med 25 (1995): 257
  10. "Product Information. Betoptic (betaxolol ophthalmic)." Alcon Laboratories Inc (2001):
  11. "Product Information. Timoptic (timolol ophthalmic)." Merck & Company Inc (2001):
  12. "Product Information. Betaxon (levobetaxolol ophthalmic)." Alza (2001):
  13. "Product Information. Ocupress (carteolol ophthalmic)." Ciba Vision Ophthalmics (2001):
View all 13 references
Moderate

Topical sulfonamides (applies to Cosopt) crystalluria

Moderate Potential Hazard, Low plausibility. Applicable conditions: Dehydration, Diarrhea, Vomiting

Sulfonamides may be systemically absorbed when applied to the skin, eye, or mucosal membranes. The use of sulfonamides has been associated with crystalluria due to precipitation of the sulfonamide and/or its N4-acetyl metabolite in the urinary tract. Renal toxicity such as uro- and nephrolithiasis, nephritis, toxic nephrosis, hematuria, proteinuria, and elevated BUN and creatinine has been reported. Hydration and adequate urinary output (> 1.5 L/day) should be maintained during sulfonamide administration. Patients who are dehydrated (e.g., due to severe diarrhea or vomiting) may be at increased risk for the development of crystalluria and lithiasis and should be encouraged to consume additional amounts of liquid. Renal function tests and urinalysis should be performed regularly during prolonged therapy (> 2 weeks).

References

  1. Levi J, Robson M, Rosenfeld J, Dolberg L "Acute tubulo-interstitial nephritis following sulfadiazine therapy." Isr J Med Sci 6 (1970): 561-6
  2. Collins K, Kaplowitz L, Heimberger R, Sahai J, Polk R "Sulfadiazine-induced crystalluria in a patient with the acquired immunodeficiency syndrome: a reminder." Am J Med 84 (1988): 791-2
  3. Rothstein D, Brosius F, Simon D "Sulfadiazine crystalluria revisited." Arch Intern Med 150 (1990): 2379-84
  4. Belenfant X, Doco-Lecompte T, Molina J, et al. "Sulfadiazine-induced crystalluria in AIDS patients with toxoplasma encephalitis." AIDS 5 (1991): 587-9
  5. Dratch PL, Sasson JP, Shortsleeve MJ "Renal US findings in sulfadiazine-induced crystalluria." Radiology 185 (1992): 739-40
  6. Brunkhorst R, Hein R, Schedel I, Thon WF, Schmidt RE "Symptomatic sulfadiazine crystalluria in AIDS patients: a report of two cases." Clin Nephrol 39 (1993): 254-6
  7. Guertin KR, Casemento JB, Erturk E, Kende AS "Bilateral acetylsulfapyridine nephrolithiasis associated with chronic sulfasalazine therapy." J Urol 151 (1994): 1605-6
  8. "Product Information. Gantrisin (sulfisoxazole ophthalmic)." Roche Laboratories, Nutley, NJ.
  9. "Product Information. Azopt (brinzolamide ophthalmic)." Alcon Laboratories Inc (2001):
  10. "Product Information. Trusopt (dorzolamide ophthalmic)." Merck & Company Inc (2001):
  11. "Product Information. Klaron (sulfacetamide sodium topical)." Dermik Laboratories/Aventis (2001):
  12. "Product Information. Sulamyd Ophthalmic Solution (sodium sulfacetamide ophthalmic)." Schering Corporation, Kenilworth, NJ.
  13. "Product Information. Sultrin (triple sulfa topical)" Janssen Pharmaceuticals, Titusville, NJ.
  14. "Product Information. Sulfacet-R (sulfacetamide sodium topical)." Dermik Laboratories/Aventis (2001):
  15. "Product Information. AVC Cream (sulfanilamide topical)" Aventis Pharmaceuticals, Swiftwater, PA.
View all 15 references
Moderate

Topical sulfonamides (applies to Cosopt) liver disease

Moderate Potential Hazard, Low plausibility.

Sulfonamides may be systemically absorbed when applied to the skin, eye, or mucosal membranes. Hepatotoxicity, including jaundice, diffuse hepatocellular necrosis, hypersensitivity hepatitis and hepatic failure, has rarely been reported in patients receiving sulfonamides. In addition, sulfonamides are partially metabolized by the liver and may accumulate in patients with hepatic impairment. Therapy with topical sulfonamides should be administered cautiously in patients with liver disease.

References

  1. Fawaz K, Keeffe E, Kowdley K "Prolonged cholestasis due to trimethoprim-sulfamethoxazole." Gastroenterology 102 (1992): 2148-50
  2. Weigand K, Becker EW, Berg PA, Hofer T "Demonstration of sensititzed lymphocytes to trimethoprim/sulfamethoxazole and ofloxacin in a patient with cholestatic hepatitis." J Hepatol 15 (1992): 262-3
  3. Christie D, Haas J, Stevenson D "Hepatic injury in a child caused by trimethoprim-sulfamethoxazole." Pediatrics 61 (1978): 864-6
  4. Mertl L, Horak J, Hrabal P "Severe liver injuries due to sulfamethoxazole-trimethoprim and sulfamethoxydiazine." Hepatogastroenterology 31 (1984): 199-200
  5. Steinbrecher U, Mishkin S "Sulfamethoxazole-induced hepatic injury." Dig Dis Sci 26 (1981): 756-9
  6. Alberti-Flor JJ, Ferrer JP, Hernandez ME, Jeffers L, Howell S "Fulminant liver failure and pancreatitis associated with the use of sulfamethoxazole-trimethoprim." Am J Gastroenterol 84 (1989): 1577-9
  7. Ransohoff D, Jacobs G "Terminal hepatic failure following a small dose of sulfamethoxazole-trimethoprim." Gastroenterology 80 (1981): 816-9
  8. Hekster C, Vree T "Clinical pharmacokinetics of sulphonamides and their N4-acetyl derivatives." Antibiot Chemother 31 (1982): 22-118
  9. Madsen S "A comparative study of the excretion of sulfonamide-metabolites in cases of renal failure and hepatitis." Chemotherapy 11 (1966): 1-9
  10. Andreasen F, Elsborg L, Husted S, Thomsen O "Pharmacokinetics of sulfadiazine and trimethoprim in man." Eur J Clin Pharmacol 14 (1978): 57-67
  11. Bergan T, Fellner H, Ortengren B "Development of sulphonamide-trimethoprim combinations for urinary tract infections. Part 2: Comparative pharmacokinetics of five sulphonamides." Infection 7 Suppl 4 (1979): s367-70
  12. Senczuk W, Stachowska B "Studies on kinetics of sulfadiazine and trimethoprim excretion in man." Int J Clin Pharmacol Ther Toxicol 25 (1987): 81-5
  13. Bergan T, Magni L, Ortengren B "Development of sulphonamide-trimethoprim combinations for urinary tract infections. part 3: pharmacokinetic characterization of sulphadiazine and sulphamethoxazole." Infection 7 (1979): s371-81
  14. Bergan T, Brodwall EK "Human pharmacokinetics of a sulfamethoxazole-trimethoprim combination." Acta Med Scand 192 (1972): 483-92
  15. Heusghem C, Kremers P, Duvivier J "Pharmacokinetic studies of co-trimoxazole in man after single and repeated doses." J Clin Pharmacol 14 (1974): 112-7
  16. Patel RB, Welling PG "Clinical pharmacokinetics of co-trimoxazole (trimethoprim-sulphamethoxazole)." Clin Pharmacokinet 5 (1980): 405-23
  17. Aronson JK, Truelove SC, Khan AK "The disposition and metabolism of sulphasalazine (salicylazosulphapyridine) in man." Br J Clin Pharmacol 13 (1982): 523-8
  18. Klotz U "Clinical pharmacokinetics of sulphasalazine, its metabolites and other prodrugs of 5-aminosalicylic acid." Clin Pharmacokinet 10 (1985): 285-302
  19. Blotman F, Leroux JL, Chertok P, Ghezail M "Hypersensitivity reactions to sulfasalazine: skin rash, fever, hepatitis and activated lymphocytes." Clin Exp Rheumatol 10 (1992): 427
  20. Tedesco FJ, Kalser MH, Kanner RS "Azulfidine- (sulfasalazine-) induced hepatic injury." Am J Dig Dis 23 (1978): 956-8
  21. Losek JD, Werlin SL "Sulfasalazine hepatotoxicity." Am J Dis Child 135 (1981): 1070-2
  22. Braverman D, Rachmilewitz D, Schwartz J, Fich A, Zifroni A "Sulfasalazine hepatotoxicity." Am J Gastroenterol 79 (1984): 401-2
  23. LeLeiko NS, Ribe J, Benkov KJ, Shen SC, Thung SN "Fatal massive hepatic necrosis: a probable hypersensitivity reaction to sulfasalazine." Am J Gastroenterol 81 (1986): 205-8
  24. Love KR, Poland GA "Marked atypical lymphocytosis, hepatitis, and skin rash in sulfasalazine drug allergy." Am J Med 81 (1986): 707-8
  25. Sotolongo RP, Rudzki C, Ishak KG, Neefe LI "Hypersensitivity reaction to sulfasalazine with severe hepatotoxicity." Gastroenterology 75 (1978): 95-9
  26. Jr, Haines JD "Hepatotoxicity after treatment with sulfasalazine." Postgrad Med 79 (1986): 193-4,
  27. Painter DM, Marinos G, Riley J, McCaughan GW "Sulfasalazine-induced fulminant hepatic failure." J Clin Gastroenterol 14 (1992): 132-5
  28. Donowitz M, Namias A, Bhalotra R "Reversible sulfasalazine-induced granulomatous hepatitis." J Clin Gastroenterol 3 (1981): 193-8
  29. Bancroft J, Moyer MS, Gremse DA "Sulfasalazine hypersensitivity with hepatotoxicity, thrombocytopenia, and erythroid hypoplasia." J Pediatr Gastroenterol Nutr 9 (1989): 261-3
  30. Rubin R "Sulfasalazine-induced fulminant hepatic failure and necrotizing pancreatitis." Am J Gastroenterol 89 (1994): 789-91
  31. Campbell DE, Schroder H "Absorption, metabolism, and excretion of salicylazosulfapyridine in man." Clin Pharmacol Ther 13 (1972): 539-51
  32. Margreiter R, Fend F, Simma B, Vogel W, Deutsch J, Sperl W, Meister B, Ofner D "Fulminant hepatic failure in a child as a potential adverse effect of trimethoprim-sulphamethoxazole." Eur J Pediatr 154 (1995): 530-3
  33. "Product Information. Gantrisin (sulfisoxazole ophthalmic)." Roche Laboratories, Nutley, NJ.
  34. "Product Information. Azopt (brinzolamide ophthalmic)." Alcon Laboratories Inc (2001):
  35. "Product Information. Trusopt (dorzolamide ophthalmic)." Merck & Company Inc (2001):
  36. "Product Information. Klaron (sulfacetamide sodium topical)." Dermik Laboratories/Aventis (2001):
  37. "Product Information. Sulamyd Ophthalmic Solution (sodium sulfacetamide ophthalmic)." Schering Corporation, Kenilworth, NJ.
  38. "Product Information. Sultrin (triple sulfa topical)" Janssen Pharmaceuticals, Titusville, NJ.
  39. "Product Information. Sulfacet-R (sulfacetamide sodium topical)." Dermik Laboratories/Aventis (2001):
  40. "Product Information. AVC Cream (sulfanilamide topical)" Aventis Pharmaceuticals, Swiftwater, PA.
View all 40 references
Moderate

Topical sulfonamides (applies to Cosopt) renal dysfunction

Moderate Potential Hazard, Moderate plausibility.

Sulfonamides may be systemically absorbed when applied to the skin, eye, or mucosal membranes. Once absorbed, sulfonamides and their metabolites are eliminated by the kidney. Patients with renal impairment may be at greater risk for adverse effects from sulfonamides due to decreased drug clearance. Additionally, sulfonamides may cause renal toxicity secondary to crystalluria, including uro- and nephrolithiasis, nephritis, toxic nephrosis, hematuria, proteinuria, and elevated BUN and creatinine. Hydration and adequate urinary output (> 1.5 L/day) should be maintained during sulfonamide administration. Renal function tests and urinalysis should be performed regularly during prolonged therapy (> 2 weeks). Some manufacturers of topical sulfonamide products do not recommend their use in patients with impaired renal function.

References

  1. Filo R, Smith E, Light J, Yum M "Interstitial nephritis caused by trimethoprim-sulfamethoxazole in renal transplant recipients." JAMA 244 (1980): 360-1
  2. Evans A, Webb D, Rudra T "Acute tubular necrosis following co-trimoxazole therapy." Nephron 53 (1989): 85-6
  3. Cryst C, Hammar S "Acute granulomatous interstitial nephritis due to co-trimoxazole." Am J Nephrol 8 (1988): 483-8
  4. Levi J, Robson M, Rosenfeld J, Dolberg L "Acute tubulo-interstitial nephritis following sulfadiazine therapy." Isr J Med Sci 6 (1970): 561-6
  5. Donaghy A, Wakefield D, Goadsby P, Lloyd A "Acquired immunodeficiency syndrome (AIDS) and sulfadiazine-associated acute renal failure." Ann Intern Med 107 (1987): 783-4
  6. Collins K, Kaplowitz L, Heimberger R, Sahai J, Polk R "Sulfadiazine-induced crystalluria in a patient with the acquired immunodeficiency syndrome: a reminder." Am J Med 84 (1988): 791-2
  7. Bendixen B, Carbone L, Appel G "Sulfadiazine-associated obstructive nephropathy occurring in a patient with the acquired immunodeficiency syndrome." Am J Kidney Dis 12 (1988): 72-5
  8. Bahri S, Christin S, Baumelou A, Jacobs C, Ben Hmida M, Deray G "Acute renal failure due to sulfadiazine in patients with AIDS." Nephron 55 (1990): 233-4
  9. Rothstein D, Brosius F, Simon D "Sulfadiazine crystalluria revisited." Arch Intern Med 150 (1990): 2379-84
  10. Belenfant X, Doco-Lecompte T, Molina J, et al. "Sulfadiazine-induced crystalluria in AIDS patients with toxoplasma encephalitis." AIDS 5 (1991): 587-9
  11. Santos O, Madeira E, Marques L, Silva M "Obstructive renal failure due to therapy with sulfadiazine in an AIDS patient." Nephron 62 (1992): 361
  12. Hekster C, Vree T "Clinical pharmacokinetics of sulphonamides and their N4-acetyl derivatives." Antibiot Chemother 31 (1982): 22-118
  13. Adam W, Dawborn J "Urinary excretion and plasma levels of sulphonamides in patients with renal impairment." Australas Ann Med 19 (1970): 250-4
  14. Madsen S "A comparative study of the excretion of sulfonamide-metabolites in cases of renal failure and hepatitis." Chemotherapy 11 (1966): 1-9
  15. Andreasen F, Elsborg L, Husted S, Thomsen O "Pharmacokinetics of sulfadiazine and trimethoprim in man." Eur J Clin Pharmacol 14 (1978): 57-67
  16. Bergan T, Anstad U, Vik-Mo H, Brodwall E "Pharmacokinetics of sulphadiazine, sulphamethoxazole and trimethoprim in patients with varying renal function." Infection 7 (1979): s382-7
  17. Bergan T, Fellner H, Ortengren B "Development of sulphonamide-trimethoprim combinations for urinary tract infections. Part 2: Comparative pharmacokinetics of five sulphonamides." Infection 7 Suppl 4 (1979): s367-70
  18. Senczuk W, Stachowska B "Studies on kinetics of sulfadiazine and trimethoprim excretion in man." Int J Clin Pharmacol Ther Toxicol 25 (1987): 81-5
  19. Ohnhaus EE, Spring P "Elimination kinetics of sulfadiazine in patients with normal and impaired renal function." J Pharmacokinet Biopharm 3 (1975): 171-9
  20. Bergan T, Magni L, Ortengren B "Development of sulphonamide-trimethoprim combinations for urinary tract infections. part 3: pharmacokinetic characterization of sulphadiazine and sulphamethoxazole." Infection 7 (1979): s371-81
  21. Bergan T, Brodwall EK "Human pharmacokinetics of a sulfamethoxazole-trimethoprim combination." Acta Med Scand 192 (1972): 483-92
  22. Adam WR, Dawborn JK, Henning M "Excretion of trimethoprim and sulphamethoxazole in patients with renal failure." Aust N Z J Med 3 (1973): 383-7
  23. Heusghem C, Kremers P, Duvivier J "Pharmacokinetic studies of co-trimoxazole in man after single and repeated doses." J Clin Pharmacol 14 (1974): 112-7
  24. Fernex M, Rieder J, Schwartz DE, et al. "Pharmacokinetics of the antibacterial combination sulfamethoxazole plus trimethoprim in patients with normal or impaired kidney function." Antibiot Chemother 18 (1974): 148-98
  25. Bergan T, Anstad U, Vik-Mo H, Brodwall EK "Pharmacokinetics of sulphadiazine, sulphamethoxazole and trimethoprim in patients with varying renal function." Infection 7 (1979): s382-7
  26. Patel RB, Welling PG "Clinical pharmacokinetics of co-trimoxazole (trimethoprim-sulphamethoxazole)." Clin Pharmacokinet 5 (1980): 405-23
  27. Ferber H, Neurath GB, Vergin H, Zimmermann I "Single and multiple dose kinetics of co-tetroxazine and co-trimoxazole in patients." Int J Clin Pharmacol Ther Toxicol 19 (1981): 350-7
  28. Pocelinko R, Cohen M "Renal transport mechanisms for the excretion of sulfisoxazole." J Pharmacol Exp Ther 185 (1973): 703-12
  29. Amend W, Oie S, Vincenti F, Gambertoglio J, Shermantine M "Pharmacokinetics of sulfisoxazole in renal transplant patients." Antimicrob Agents Chemother 28 (1985): 535-9
  30. Allan RN, Dwarakanath AD, Michael J "Sulphasalazine-induced renal failure." Gut 33 (1992): 1006-7
  31. Madeira EP, Marques LP, Santos OR, Silva MT "Obstructive renal failure due to therapy with sulfadiazine in an AIDS patient." Nephron 62 (1992): 361
  32. Dratch PL, Sasson JP, Shortsleeve MJ "Renal US findings in sulfadiazine-induced crystalluria." Radiology 185 (1992): 739-40
  33. Farinas MC, Gonzalez A, Gonzalez-Macias J, Sampedro I, Echevarria S, Perez del Molino A "Renal failure due to sulphadiazine in AIDS patients with cerebral toxoplasmosis." J Intern Med 233 (1993): 365-7
  34. Brunkhorst R, Hein R, Schedel I, Thon WF, Schmidt RE "Symptomatic sulfadiazine crystalluria in AIDS patients: a report of two cases." Clin Nephrol 39 (1993): 254-6
  35. Guertin KR, Casemento JB, Erturk E, Kende AS "Bilateral acetylsulfapyridine nephrolithiasis associated with chronic sulfasalazine therapy." J Urol 151 (1994): 1605-6
  36. Becker K, Jablonowski H, Haussinger D "Sulfadiazine-associated nephrotoxicity in patients with the acquired immunodeficiency syndrome." Medicine 75 (1996): 185-94
  37. "Product Information. Gantrisin (sulfisoxazole ophthalmic)." Roche Laboratories, Nutley, NJ.
  38. "Product Information. Azopt (brinzolamide ophthalmic)." Alcon Laboratories Inc (2001):
  39. "Product Information. Trusopt (dorzolamide ophthalmic)." Merck & Company Inc (2001):
  40. "Product Information. Klaron (sulfacetamide sodium topical)." Dermik Laboratories/Aventis (2001):
  41. "Product Information. Sulamyd Ophthalmic Solution (sodium sulfacetamide ophthalmic)." Schering Corporation, Kenilworth, NJ.
  42. "Product Information. Sultrin (triple sulfa topical)" Janssen Pharmaceuticals, Titusville, NJ.
  43. "Product Information. Sulfacet-R (sulfacetamide sodium topical)." Dermik Laboratories/Aventis (2001):
  44. "Product Information. AVC Cream (sulfanilamide topical)" Aventis Pharmaceuticals, Swiftwater, PA.
View all 44 references
Moderate

Topical sulfonamides (applies to Cosopt) urinary obstruction

Moderate Potential Hazard, Low plausibility. Applicable conditions: Urinary Retention

Sulfonamides may be systemically absorbed when applied to the skin, eye, or mucosal membranes. Once absorbed, sulfonamides are excreted and concentrated in the urine. Therapy with topical sulfonamides should be administered cautiously in patients with urinary obstruction or retention, since excessive drug accumulation may occur. These patients may also be at increased risk for sulfonamide crystalluria, which may be associated with renal toxicity such as uro- and nephrolithiasis, nephritis, toxic nephrosis, hematuria, proteinuria, and elevated BUN and creatinine. A urinary output of at least 1.5 L/day should be maintained during sulfonamide administration. Renal function tests and urinalysis should be performed regularly during prolonged therapy (> 2 weeks).

References

  1. Collins K, Kaplowitz L, Heimberger R, Sahai J, Polk R "Sulfadiazine-induced crystalluria in a patient with the acquired immunodeficiency syndrome: a reminder." Am J Med 84 (1988): 791-2
  2. Bendixen B, Carbone L, Appel G "Sulfadiazine-associated obstructive nephropathy occurring in a patient with the acquired immunodeficiency syndrome." Am J Kidney Dis 12 (1988): 72-5
  3. Rothstein D, Brosius F, Simon D "Sulfadiazine crystalluria revisited." Arch Intern Med 150 (1990): 2379-84
  4. Belenfant X, Doco-Lecompte T, Molina J, et al. "Sulfadiazine-induced crystalluria in AIDS patients with toxoplasma encephalitis." AIDS 5 (1991): 587-9
  5. Santos O, Madeira E, Marques L, Silva M "Obstructive renal failure due to therapy with sulfadiazine in an AIDS patient." Nephron 62 (1992): 361
  6. Madeira EP, Marques LP, Santos OR, Silva MT "Obstructive renal failure due to therapy with sulfadiazine in an AIDS patient." Nephron 62 (1992): 361
  7. Dratch PL, Sasson JP, Shortsleeve MJ "Renal US findings in sulfadiazine-induced crystalluria." Radiology 185 (1992): 739-40
  8. Brunkhorst R, Hein R, Schedel I, Thon WF, Schmidt RE "Symptomatic sulfadiazine crystalluria in AIDS patients: a report of two cases." Clin Nephrol 39 (1993): 254-6
  9. Guertin KR, Casemento JB, Erturk E, Kende AS "Bilateral acetylsulfapyridine nephrolithiasis associated with chronic sulfasalazine therapy." J Urol 151 (1994): 1605-6
  10. "Product Information. Gantrisin (sulfisoxazole ophthalmic)." Roche Laboratories, Nutley, NJ.
  11. "Product Information. Azopt (brinzolamide ophthalmic)." Alcon Laboratories Inc (2001):
  12. "Product Information. Trusopt (dorzolamide ophthalmic)." Merck & Company Inc (2001):
  13. "Product Information. Klaron (sulfacetamide sodium topical)." Dermik Laboratories/Aventis (2001):
  14. "Product Information. Sulamyd Ophthalmic Solution (sodium sulfacetamide ophthalmic)." Schering Corporation, Kenilworth, NJ.
  15. "Product Information. Sultrin (triple sulfa topical)" Janssen Pharmaceuticals, Titusville, NJ.
  16. "Product Information. Sulfacet-R (sulfacetamide sodium topical)." Dermik Laboratories/Aventis (2001):
  17. "Product Information. AVC Cream (sulfanilamide topical)" Aventis Pharmaceuticals, Swiftwater, PA.
View all 17 references

Cosopt drug interactions

There are 276 drug interactions with Cosopt (dorzolamide / timolol ophthalmic).


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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.