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Istalol (timolol ophthalmic) Disease Interactions

There are 9 disease interactions with Istalol (timolol ophthalmic):

Major

Ophthalmic Beta-Blockers (Includes Istalol) ↔ Asthma/Copd

Severe Potential Hazard, High plausibility

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

Ophthalmic Beta-Blockers (Includes Istalol) ↔ Bradycardia/Av Block

Severe Potential Hazard, High plausibility

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

Ophthalmic Beta-Blockers (Includes Istalol) ↔ Cardiogenic Shock

Severe Potential Hazard, High plausibility

Applies to: Cardiogenic Shock

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

Ophthalmic Beta-Blockers (Includes Istalol) ↔ Chf

Severe Potential Hazard, High plausibility

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

Ophthalmic Beta-Blockers (Includes Istalol) ↔ Diabetes

Severe Potential Hazard, High plausibility

Applies to: 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. "Product Information. Betoptic (betaxolol ophthalmic)." Alcon Laboratories Inc, Fort Worth, TX.
  2. Benjamin KW "Toxicity of ocular medications." Int Ophthalmol Clin 19 (1979): 199-255
  3. "Product Information. Betaxon (levobetaxolol ophthalmic)" Alza, Palo Alto, CA.
  4. "Product Information. Betagan Liquifilm (levobunolol)." Allergan Inc, Irvine, CA.
  5. "Product Information. Timoptic (timolol ophthalmic)." Merck & Co, Inc, West Point, PA.
  6. Darga LL, Hakim MJ, Lucas CP, Franklin BA "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
  7. "Product Information. OptiPranolol (metipranolol)." Bausch and Lomb, Tampa, FL.
  8. Giugliano D, Acampora R, Marfella R, DeRosa N, Ziccardi P, Ragone R, DeAngelis L, DOnofrio F "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
  9. Uusitupa M, Aro A, Pietikainen M "Severe hypoglycaemia caused by physical strain and pindolol therapy." Ann Clin Res 12 (1980): 25-7
  10. "Product Information. Ocupress (carteolol ophthalmic)" Ciba Vision Ophthalmics, Duluth, GA.
  11. Grimaldi A, Bennett P, Delas B, 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
  12. Velde TM, Kaiser FE "Ophthalmic timolol treatment causing altered hypoglycemic response in a diabetic patient." Arch Intern Med 143 (1983): 1627
View all 12 references
Major

Ophthalmic Beta-Blockers (Includes Istalol) ↔ Hypersensitivity

Severe Potential Hazard, High plausibility

Applies to: 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. Betaxon (levobetaxolol ophthalmic)" Alza, Palo Alto, CA.
  2. "Product Information. Ocupress (carteolol ophthalmic)" Ciba Vision Ophthalmics, Duluth, GA.
  3. "Product Information. Betoptic (betaxolol ophthalmic)." Alcon Laboratories Inc, Fort Worth, TX.
  4. "Product Information. OptiPranolol (metipranolol)." Bausch and Lomb, Tampa, FL.
  5. "Product Information. Timoptic (timolol ophthalmic)." Merck & Co, Inc, West Point, PA.
  6. "Product Information. Betagan Liquifilm (levobunolol)." Allergan Inc, Irvine, CA.
View all 6 references
Major

Ophthalmic Beta-Blockers (Includes Istalol) ↔ Hyperthyroidism

Severe Potential Hazard, High plausibility

Applies to: Hyperthyroidism

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. Betoptic (betaxolol ophthalmic)." Alcon Laboratories Inc, Fort Worth, TX.
  2. "Product Information. Betaxon (levobetaxolol ophthalmic)" Alza, Palo Alto, CA.
  3. "Product Information. OptiPranolol (metipranolol)." Bausch and Lomb, Tampa, FL.
  4. "Product Information. Betagan Liquifilm (levobunolol)." Allergan Inc, Irvine, CA.
  5. "Product Information. Ocupress (carteolol ophthalmic)" Ciba Vision Ophthalmics, Duluth, GA.
  6. "Product Information. Timoptic (timolol ophthalmic)." Merck & Co, Inc, West Point, PA.
View all 6 references
Major

Ophthalmic Beta-Blockers (Includes Istalol) ↔ Pvd

Severe Potential Hazard, Moderate plausibility

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

Ophthalmic Beta-Blockers (Includes Istalol) ↔ Myasthenia Gravis

Moderate Potential Hazard, Low plausibility

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

Istalol (timolol ophthalmic) drug Interactions

There are 560 drug interactions with Istalol (timolol 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.

Further information

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

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