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Omidria (ketorolac / phenylephrine ophthalmic) Disease Interactions

There are 6 disease interactions with Omidria (ketorolac / phenylephrine ophthalmic):

Major

Nsaids (Includes Omidria) ↔ Asthma

Severe Potential Hazard, High plausibility

Applies to: Asthma

Approximately 10% of patients with asthma may have aspirin-sensitive asthma, characterized by nasal polyposis, pansinusitis, eosinophilia, and precipitation of asthma and rhinitis attacks after ingestion of aspirin. The use of aspirin in these patients has been associated with severe bronchospasm and fatal anaphylactoid reactions. Since cross-sensitivity has been noted between aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), therapy with any NSAID should be avoided in asthmatic patients with a history of aspirin or other NSAID sensitivity, and administered cautiously in all patients with preexisting asthma. Prior to initiating therapy with NSAIDs, patients should be questioned about previous allergic-type reactions to these agents. Salicylate salts, salsalate, salicylamide, and acetaminophen may be appropriate alternatives in patients with a history of NSAID-induced bronchospasm, since cross-sensitivity to these agents appears to be low. However, cross-sensitivity has been demonstrated occasionally with high dosages of these agents (e.g., acetaminophen >= 1000 mg), thus it may be appropriate to initiate therapy with low dosages and increase gradually. There is some evidence suggesting that COX-2 inhibitors may be safely used in patients with aspirin-sensitive asthma, although the labeling for these products contraindicate such use. If necessary, aspirin desensitization may also be attempted in some patients under medical surveillance.

References

  1. "Product Information. Voltaren (diclofenac)." Novartis Pharmaceuticals, East Hanover, NJ.
  2. "Product Information. Naprosyn (naproxen)." Syntex Laboratories Inc, Palo Alto, CA.
  3. Stevenson DD, Hougham AJ, Schrank PJ, Goldlust MB, Wilson RR "Salsalate cross-sensitivity in aspirin-sensitive patients with asthma." J Allergy Clin Immunol 86 (1990): 749-58
View all 38 references
Major

Ophthalmic Sympathomimetics (Includes Omidria) ↔ Narrow Angles

Severe Potential Hazard, High plausibility

Applies to: Glaucoma (Narrow Angle), Glaucoma/Intraocular Hypertension

The use of nonspecific ophthalmic sympathomimetic agents is contraindicated in patients with narrow-angle glaucoma or anatomically narrow angles. These agents stimulate both alpha-1 and alpha-2 adrenergic receptors, thus topical administration can induce transient mydriasis. In patients with narrow angles, pupillary dilation can provoke an acute attack of angle-closure glaucoma. If possible, these agents (except for phenylephrine 2.5% or 10%) should also be avoided in patients with other forms of glaucoma, since mydriasis may occasionally increase intraocular pressure.

References

  1. "Product Information. Collyrium Fresh (tetrahydrozoline)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  2. "Product Information. Neo-Synephrine (phenylephrine ophthalmic)" Sanofi Winthrop Pharmaceuticals, New York, NY.
  3. "Product Information. Naphcon (naphazoline ophthalmic)" Alcon Laboratories Inc, Fort Worth, TX.
View all 4 references
Moderate

Ophthalmic Nsaids (Includes Omidria) ↔ Platelet Inhibition

Moderate Potential Hazard, Low plausibility

Applies to: Coagulation Defect, Thrombocytopathy, Thrombocytopenia, Bleeding, Vitamin K Deficiency

Topically applied nonsteroidal anti-inflammatory drugs (NSAIDs) are systemically absorbed, with the potential for producing rare but clinically significant systemic effects. NSAIDs have been shown to reversibly inhibit platelet adhesion and aggregation and may slightly prolong bleeding time in healthy individuals. These effects may be more pronounced in patients with underlying hemostatic abnormalities. Thrombocytopenia has also been reported rarely during NSAID use. Therapy with ocular NSAIDs should be administered cautiously in patients with significant active bleeding or a hemorrhagic diathesis, including hemostatic and/or coagulation defects associated with hemophilia, vitamin K deficiency, hypoprothrombinemia, thrombocytopenia, thrombocytopathy, or severe hepatic impairment.

References

  1. Thwaites BK, Nigus DB, Bouska GW, Mongan PD, Ayala EF, Merrill GA "Intravenous ketorolac tromethamine worsens platelet function during knee arthroscopy under spinal anesthesia." Anesth Analg 82 (1996): 1176-81
  2. "Product Information. Voltaren (diclofenac)." Ciba Vision Ophthalmics, Duluth, GA.
  3. Camba L, Joyner MV "Acute thrombocytopenia following ingestion of indomethacin." Acta Haematol 71 (1984): 350-2
View all 28 references
Moderate

Topical Sympathomimetics (Includes Omidria) ↔ Bph

Moderate Potential Hazard, Moderate plausibility

Applies to: Benign Prostatic Hyperplasia, Prostate Tumor

Topically applied sympathomimetic agents are systemically absorbed, with the potential for producing clinically significant systemic effects, particularly during prolonged or indiscriminate use. In patients with prostate enlargement, urinary difficulty may develop or worsen due to smooth muscle contraction in the bladder neck via stimulation of alpha-1 adrenergic receptors. Therapy with topical sympathomimetic agents should be administered cautiously in patients with hypertrophy or neoplasm of the prostate. It is important that the recommended dosages of the individual products not be exceeded.

References

  1. "Product Information. Neo-Synephrine (phenylephrine ophthalmic)" Sanofi Winthrop Pharmaceuticals, New York, NY.
  2. "Product Information. Benzedrex (propylhexedrine nasal)" Menley and James Laboratories Inc, Horsham, PA.
  3. "Product Information. Privine (naphazoline nasal)" Novartis Consumer Health, Summit, NJ.
View all 14 references
Moderate

Topical Sympathomimetics (Includes Omidria) ↔ Cardiovascular

Moderate Potential Hazard, Moderate plausibility

Applies to: Cardiovascular Disease, Cerebrovascular Insufficiency, Hyperthyroidism, Corneal Abrasion

Topically applied sympathomimetic agents are systemically absorbed, with the potential for producing clinically significant systemic effects, particularly during prolonged or indiscriminate use. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta-1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, and coronary occlusion have been reported rarely during the use of ophthalmic and nasal sympathomimetic agents, but may be more likely if the corneal epithelium is damaged or if an excessive amount of drug is swallowed during nasal administration. Therapy with topical sympathomimetic agents should be administered cautiously in patients with corneal abrasion, sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders, especially coronary insufficiency, cardiac arrhythmia, or hypertension. The potent ophthalmic formulations (e.g., phenylephrine 2.5% or 10%) that are used for diagnostic and pre-surgical purposes should not be used in such patients. For other preparations, it is important that the recommended dosages of the individual products not be exceeded.

References

  1. "Product Information. Tyzine (tetrahydrozoline)." Kenwood Laboratories, Fairfield, NJ.
  2. Lansche RK "Systemic reactions to topical epinephrine and phenylephrine." Am J Ophthalmol 61 (1966): 95-8
  3. Ellis PP "Systemic reactions to topical therapy." Int Ophthalmol Clin 11 (1971): 1-11
View all 14 references
Moderate

Topical Sympathomimetics (Includes Omidria) ↔ Diabetes

Moderate Potential Hazard, Moderate plausibility

Applies to: Diabetes Mellitus

Topically applied sympathomimetic agents are systemically absorbed, particularly during prolonged or indiscriminate use. Slight increases in blood glucose concentrations may occur with the use of these drugs. Therapy with topical sympathomimetic agents should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate. It is important that the recommended dosages of the individual products not be exceeded.

References

  1. "Product Information. Ocuclear (oxymetazoline ophthalmic)" Schering-Plough, Liberty Corner, NJ.
  2. "Product Information. Vicks Vapor Inhaler (desoxyephedrine nasal)" Procter and Gamble Pharmaceuticals, Cincinnati, OH.
  3. "Product Information. Otriviv (xylometazoline nasal)" Novartis Pharmaceuticals, East Hanover, NJ.
View all 14 references

Omidria (ketorolac / phenylephrine ophthalmic) drug Interactions

There are 270 drug interactions with Omidria (ketorolac / phenylephrine ophthalmic)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

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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