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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. Stevenson DD, Simon RA "Lack of cross-reactivity between rofecoxib and aspirin in aspirin-sensitive patients with asthma." J Allerg Clin Immunol 108 (2001): 47-51
  2. "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn, Kalamazoo, MI.
  3. "Product Information. Naprosyn (naproxen)." Syntex Laboratories Inc, Palo Alto, CA.
  4. 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
  5. "Product Information. Voltaren (diclofenac)." Novartis Pharmaceuticals, East Hanover, NJ.
  6. Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, eds. "Harrison's Principles of Internal Medicine. 14th ed." New York, NY: McGraw-Hill Health Professionals Division (1998):
  7. "Product Information. Clinoril (sulindac)." Merck & Co, Inc, West Point, PA.
  8. "Product Information. Feldene (piroxicam)." Pfizer US Pharmaceuticals, New York, NY.
  9. Lewis RV "Severe asthma after naproxen." Lancet 05/30/87 (1987): 1270
  10. Carmona MJ, Blanca M, Garcia A, Fernandez S, Burgos F, Miranda A, Vega JM, Garcia J "Intolerance to piroxicam in patients with adverse reactions to nonsteroidal antiinflammatory drugs." J Allergy Clin Immunol 90 (1992): 873-9
  11. Israel E, Fischer AR, Rosenberg MA, Lilly CM, Callery JC, Shapiro J, Cohn J, Rubin P, Drazen JM "The pivotal role of 5-lipoxygenase products in the reaction of aspirin-sensitive asthmatics to aspirin." Am Rev Respir Dis 148 (1993): 1447-51
  12. Haddow GR, Riley E, Isaacs R, McSharry R "Ketorolac, nasal polyposis, and bronchial asthma: a cause for concern." Anesth Analg 76 (1993): 420-2
  13. Settipane RA, Stevenson DD "Cross sensitivity with acetaminophen in aspirin-sensitive subjects with asthma." J Allergy Clin Immunol 84 (1989): 26-33
  14. "Product Information. Mobic (meloxicam)" Boehringer-Ingelheim, Ridgefield, CT.
  15. Cohen RD, Bateman ED, Potgieter PD "Near-fatal bronchospasm in an asthmatic patient following ingestion of flurbiprofen. A case report." S Afr Med J 61 (1982): 803
  16. "Product Information. Bextra (valdecoxib)." Pharmacia Corporation, Peapack, NJ.
  17. Schreuder G "Ketoprofen: possible idiosyncratic acute bronchospasm." Med J Aust 152 (1990): 332-3
  18. "Product Information. Ansaid (flurbiprofen)." Pharmacia and Upjohn, Kalamazoo, MI.
  19. Dahlen B, Szczeklik A, Murray HH "Celecoxib in patients with asthma and aspirin intolerance." N Engl J Med 344 (2000): 142
  20. "Product Information. Indocin (indomethacin)." Merck & Co, Inc, West Point, PA.
  21. Ayres JG, Fleming DM, Whittington RM "Asthma death due to ibuprofen." Lancet 05/09/87 (1987): 1082
  22. "Product Information. Daypro (oxaprozin)." Searle, Skokie, IL.
  23. "Product Information. Vioxx (rofecoxib)." Merck & Co, Inc, West Point, PA.
  24. Shapiro N "Acute angioedema after ketorolac ingestion - report of case." J Oral Maxillofac Surg 52 (1994): 626-7
  25. Lee TH "Mechanism of aspirin sensitivity." Am Rev Respir Dis 145 (1992): s34-6
  26. "Product Information. Celebrex (celecoxib)." Searle, Chicago, IL.
  27. Szczeklik A, Stevenson DD "Aspirin-induced asthma: Advances in pathogenesis and management." J Allerg Clin Immunol 104 (1999): 5-13
  28. Salberg DJ, Simon MR "Severe asthma induced by naproxen: a case report and review of the literature." Ann Allergy 45 (1980): 372-5
  29. "Product Information. Tolectin (tolmetin)." McNeil Pharmaceutical, Raritan, NJ.
  30. "Product Information. Relafen (nabumetone)." SmithKline Beecham, Philadelphia, PA.
  31. Nasser SMS, Lee TH "Aspirin-induced early and late asthmatic responses." Clin Exp Allergy 25 (1995): 1-3
  32. Chan TY "Severe asthma attacks precipitated by NSAIDs." Ann Pharmacother 29 (1995): 199
  33. Zikowski D, Hord AH, Haddox JD, Glascock J "Ketorolac-induced bronchospasm." Anesth Analg 76 (1993): 417-9
  34. "Product Information. Orudis (ketoprofen)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  35. Lee TH "Mechanism of bronchospasm in aspirin-sensitive asthma." Am Rev Respir Dis 148 (1993): 1442-3
  36. "Product Information. Nalfon (fenoprofen)." Xspire Pharma, Ridgeland, MS.
  37. Woessner KM, Simon RA, Stevenson DD "The safety of celecoxib in patients with aspirin-sensitive asthma." Arthritis Rheum 46 (2002): 2201-6
  38. "Product Information. Lodine (etodolac)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
View all 38 references
Major

Ophthalmic Sympathomimetics (Includes Omidria) ↔ Narrow Angles

Severe Potential Hazard, High plausibility

Applies to: Glaucoma (Narrow Angle)

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. Naphcon (naphazoline ophthalmic)" Alcon Laboratories Inc, Fort Worth, TX.
  3. "Product Information. Neo-Synephrine (phenylephrine ophthalmic)" Sanofi Winthrop Pharmaceuticals, New York, NY.
  4. "Product Information. Ocuclear (oxymetazoline ophthalmic)" Schering-Plough, Liberty Corner, NJ.
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. "Product Information. Voltaren (diclofenac)." Ciba Vision Ophthalmics, Duluth, GA.
  2. 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
  3. Katz ME, Wang P "Fenoprofen-associated thrombocytopenia." Ann Intern Med 92 (1980): 262
  4. Camba L, Joyner MV "Acute thrombocytopenia following ingestion of indomethacin." Acta Haematol 71 (1984): 350-2
  5. Price AJ, Obeid D "Spontaneous non-gastrointestinal bleeding associated with diclofenac ." Lancet 2 (1989): 1520
  6. "Product Information. Acular (ketorolac)." Allergan Inc, Irvine, CA.
  7. Shojania AM, Rusen SD "Thrombocytopenia secondary to sulindac therapy." Can Med Assoc J 125 (1981): 1313
  8. Sanz MA, Martinez JA, Gomis F, Garcia-Borras JJ "Sulindac-induced bone marrow toxicity." Lancet 2 (1980): 802-3
  9. Bondeson J, Berglund S "Diclofenac-induced thrombocytopenic purpura with renal and hepatic involvement." J Intern Med 230 (1991): 543-7
  10. Bobrove AM "Diflunisal-associated thrombocytopenia in a patient with rheumatoid arthritis ." Arthritis Rheum 31 (1988): 148-9
  11. Bjornstad H, Vik O "Thrombocytopenic purpura associated with piroxicam." Br J Clin Pract 40 (1986): 42
  12. Schafer AI "Effects of nonsteroidal antiinflammatory drugs on platelet function and systemic hemostasis." J Clin Pharmacol 35 (1995): 209-19
  13. Stambaugh JE Jr, Gordon RL, Geller R "Leukopenia and thrombocytopenia secondary to clinoril therapy." Lancet 2 (1980): 594
  14. Kramer MR, Levene C, Hershko C "Severe reversible autoimmune haemolytic anaemia and thrombocytopenia associated with diclofenac therapy." Scand J Haematol 36 (1986): 118-20
  15. "Product Information. Ocufen Liquifilm (flurbiprofen)." Allergan Inc, Irvine, CA.
  16. Fraunfelder FT, Fraunfelder FW; Randall JA "Drug-Induced Ocular Side Effects 5th" Boston, MA: Butterworth-Heinemann (2001):
  17. Poldre PA "Naproxen thrombocytopenia." Am J Hematol 31 (1989): 74
  18. Khazan U, Toth M, Mutgi A "Diclofenac sodium and bruising ." Ann Intern Med 112 (1990): 472-3
  19. "Product Information. Profenal (suprofen topical)." Alcon Laboratories Inc, Fort Worth, TX.
  20. Rosenbaum JT, O'Connor M "Thrombocytopenia associated with sulindac." Arthritis Rheum 24 (1981): 753-4
  21. Concannon MJ, Meng L, Welsh CF, Puckett CL "Inhibition of perioperative platelet aggregation using toradol (ketorolac)." Ann Plast Surg 30 (1993): 264-6
  22. Hirsh J, Dalen JE, Fuster V, Harker LB, Patrono C, Roth G "Aspirin and other platelet-active drugs: the relationship among dose, effectiveness, and side effects." Chest 108 Suppl (1995): s247-57
  23. Kim HL, Kovacs MJ "Diclofenac-associated thrombocytopenia and neutropenia." Ann Pharmacother 29 (1995): 713-5
  24. Gandini R, Cunietti E, Pappalepore V, et al "Effects of intravenous high doses of ketoprofen on blood clotting, bleeding time and platelet aggregation in man." J Int Med Res 11 (1983): 243
  25. Green D, Davies RO, Holmes GI et al "Effects of diflunisal on platelet function and fecal blood loss." Pharmacotherapy 3 (1983): s65-9
  26. Buchanan GR, Martin V, Levine PH, et al "The effects of "anti-platelet" drugs on bleeding time and platelet aggregation in normal human subjects." Am J Clin Pathol 68 (1977): 355-9
  27. Karachalios GN, Parigorakis JG "Thrombocytopenia and sulindac." Ann Intern Med 104 (1986): 128
  28. Epstein M, Vickars L, Stein H "Diclofenac induced immune thrombocytopenia." J Rheumatol 17 (1990): 1403-4
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. Benzedrex (propylhexedrine nasal)" Menley and James Laboratories Inc, Horsham, PA.
  2. "Product Information. Neo-Synephrine (phenylephrine ophthalmic)" Sanofi Winthrop Pharmaceuticals, New York, NY.
  3. "Product Information. Collyrium Fresh (tetrahydrozoline)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  4. "Product Information. Naphcon (naphazoline ophthalmic)" Alcon Laboratories Inc, Fort Worth, TX.
  5. "Product Information. Privine (naphazoline nasal)" Novartis Consumer Health, Summit, NJ.
  6. "Product Information. Afrin (oxymetazoline nasal)" Schering-Plough, Liberty Corner, NJ.
  7. "Product Information. Otriviv (xylometazoline nasal)" Novartis Pharmaceuticals, East Hanover, NJ.
  8. "Product Information. Neo-Synephrine Nasal (phenylephrine nasal)" Southwood Pharmaceuticals Inc, Irvine, CA.
  9. "Product Information. Ocuclear (oxymetazoline ophthalmic)" Schering-Plough, Liberty Corner, NJ.
  10. "Product Information. Tyzine (tetrahydrozoline)." Kenwood Laboratories, Fairfield, NJ.
  11. "Product Information. Vicks Vapor Inhaler (desoxyephedrine nasal)" Procter and Gamble Pharmaceuticals, Cincinnati, OH.
  12. "Product Information. Pretz-D (ephedrine nasal)" Parnell Pharmaceuticals Inc, San Rafael, CA.
  13. Ellis PP "Systemic reactions to topical therapy." Int Ophthalmol Clin 11 (1971): 1-11
  14. Lansche RK "Systemic reactions to topical epinephrine and phenylephrine." Am J Ophthalmol 61 (1966): 95-8
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. Ellis PP "Systemic reactions to topical therapy." Int Ophthalmol Clin 11 (1971): 1-11
  3. Lansche RK "Systemic reactions to topical epinephrine and phenylephrine." Am J Ophthalmol 61 (1966): 95-8
  4. "Product Information. Benzedrex (propylhexedrine nasal)" Menley and James Laboratories Inc, Horsham, PA.
  5. "Product Information. Collyrium Fresh (tetrahydrozoline)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  6. "Product Information. Neo-Synephrine (phenylephrine ophthalmic)" Sanofi Winthrop Pharmaceuticals, New York, NY.
  7. "Product Information. Privine (naphazoline nasal)" Novartis Consumer Health, Summit, NJ.
  8. "Product Information. Ocuclear (oxymetazoline ophthalmic)" Schering-Plough, Liberty Corner, NJ.
  9. "Product Information. Vicks Vapor Inhaler (desoxyephedrine nasal)" Procter and Gamble Pharmaceuticals, Cincinnati, OH.
  10. "Product Information. Afrin (oxymetazoline nasal)" Schering-Plough, Liberty Corner, NJ.
  11. "Product Information. Otriviv (xylometazoline nasal)" Novartis Pharmaceuticals, East Hanover, NJ.
  12. "Product Information. Naphcon (naphazoline ophthalmic)" Alcon Laboratories Inc, Fort Worth, TX.
  13. "Product Information. Pretz-D (ephedrine nasal)" Parnell Pharmaceuticals Inc, San Rafael, CA.
  14. "Product Information. Neo-Synephrine Nasal (phenylephrine nasal)" Southwood Pharmaceuticals Inc, Irvine, CA.
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. Otriviv (xylometazoline nasal)" Novartis Pharmaceuticals, East Hanover, NJ.
  3. "Product Information. Vicks Vapor Inhaler (desoxyephedrine nasal)" Procter and Gamble Pharmaceuticals, Cincinnati, OH.
  4. "Product Information. Privine (naphazoline nasal)" Novartis Consumer Health, Summit, NJ.
  5. "Product Information. Neo-Synephrine (phenylephrine ophthalmic)" Sanofi Winthrop Pharmaceuticals, New York, NY.
  6. "Product Information. Collyrium Fresh (tetrahydrozoline)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  7. "Product Information. Benzedrex (propylhexedrine nasal)" Menley and James Laboratories Inc, Horsham, PA.
  8. Ellis PP "Systemic reactions to topical therapy." Int Ophthalmol Clin 11 (1971): 1-11
  9. Lansche RK "Systemic reactions to topical epinephrine and phenylephrine." Am J Ophthalmol 61 (1966): 95-8
  10. "Product Information. Tyzine (tetrahydrozoline)." Kenwood Laboratories, Fairfield, NJ.
  11. "Product Information. Naphcon (naphazoline ophthalmic)" Alcon Laboratories Inc, Fort Worth, TX.
  12. "Product Information. Afrin (oxymetazoline nasal)" Schering-Plough, Liberty Corner, NJ.
  13. "Product Information. Neo-Synephrine Nasal (phenylephrine nasal)" Southwood Pharmaceuticals Inc, Irvine, CA.
  14. "Product Information. Pretz-D (ephedrine nasal)" Parnell Pharmaceuticals Inc, San Rafael, CA.
View all 14 references

Omidria (ketorolac / phenylephrine ophthalmic) drug Interactions

There are 276 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.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

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