Can you take Alfenta with Lorcaserin?

The ALfentanil in Alfenta has a major potential interaction with Acute Alcohol Intoxication.

The use of opiate agonists is contraindicated in patients with acute alcohol intoxication exhibiting depressed vital signs. The central nervous system depressant effects of opiate agonists may be additive with those of alcohol. Severe respiratory depression and death may occur. Therapy with opiate agonists should be administered cautiously in patients who might be prone to acute alcohol intake.

The ALfentanil in Alfenta has a moderate potential interaction with Adrenal Insufficiency.

Patients with Addison's disease may have increased risk of respiratory depression and prolonged CNS depression associated with the use of narcotic (opioid) analgesic agents. Conversely, these agents may cause or potentiate adrenal insufficiency. Therapy with opioids should be administered cautiously and initiated at reduced dosages in patients with adrenocortical insufficiency. Subsequent doses should be titrated based on individual response rather than a fixed dosing schedule.

The ALfentanil in Alfenta has a major potential interaction with Altered Consciousness.

Opiate agonists may produce significant central nervous system and respiratory depression of varying duration, particularly when given in high dosages and/or by rapid intravenous administration. Apnea may result from decreased respiratory drive as well as increased airway resistance, and rigidity of respiratory muscles may occur during rapid IV administration or when these agents are used in the induction of anesthesia. At therapeutic analgesic dosages, the respiratory effects are usually not clinically important except in patients with preexisting pulmonary impairment. Therapy with opiate agonists should be avoided or administered with extreme caution and initiated at reduced dosages in patients with severe CNS depression; sleep apnea; hypoxia, anoxia, or hypercapnia; upper airway obstruction; chronic pulmonary insufficiency; a limited ventilatory reserve; or other respiratory disorders. In the presence of excessive respiratory secretions, the use of opiate agonists may also be problematic because they decrease ciliary activity and reduce the cough reflex. Caution is also advised in patients who may be at increased risk for respiratory depression, such as comatose patients or those with head injury, intracranial lesions, or intracranial hypertension. Clinical monitoring of pulmonary function is recommended, and equipment for resuscitation should be immediately available if parenteral or neuraxial routes are used. Naloxone may be administered to reverse clinically significant respiratory depression, which may be prolonged depending on the opioid agent, cumulative dose, and route of administration.

The ALfentanil in Alfenta has a moderate potential interaction with Arrhythmia.

Opiate agonists have cholinergic activity. Large doses and/or rapid intravenous administration may produce bradycardia and arrhythmias via stimulation of medullary vagal nuclei. Therapy with opiate agonists should be administered cautiously in patients with a history of arrhythmias. Clinical monitoring of cardiovascular status is recommended during therapy.

The ALfentanil in Alfenta has a major potential interaction with Asphyxia.

Opiate agonists may produce significant central nervous system and respiratory depression of varying duration, particularly when given in high dosages and/or by rapid intravenous administration. Apnea may result from decreased respiratory drive as well as increased airway resistance, and rigidity of respiratory muscles may occur during rapid IV administration or when these agents are used in the induction of anesthesia. At therapeutic analgesic dosages, the respiratory effects are usually not clinically important except in patients with preexisting pulmonary impairment. Therapy with opiate agonists should be avoided or administered with extreme caution and initiated at reduced dosages in patients with severe CNS depression; sleep apnea; hypoxia, anoxia, or hypercapnia; upper airway obstruction; chronic pulmonary insufficiency; a limited ventilatory reserve; or other respiratory disorders. In the presence of excessive respiratory secretions, the use of opiate agonists may also be problematic because they decrease ciliary activity and reduce the cough reflex. Caution is also advised in patients who may be at increased risk for respiratory depression, such as comatose patients or those with head injury, intracranial lesions, or intracranial hypertension. Clinical monitoring of pulmonary function is recommended, and equipment for resuscitation should be immediately available if parenteral or neuraxial routes are used. Naloxone may be administered to reverse clinically significant respiratory depression, which may be prolonged depending on the opioid agent, cumulative dose, and route of administration.

Lorcaserin has a moderate potential interaction with Bone Marrow Depression/Low Blood Counts.

Hematological changes, including decreases in hemoglobin and hematocrit counts, have been reported with the use of lorcaserin. Caution should be exercised when treating patients who have ongoing or a history of significant hematologic abnormalities. It is recommended to consider periodic monitoring of complete blood count during treatment.

The ALfentanil in Alfenta has a major potential interaction with Brain Tumor.

Opiate agonists may produce significant central nervous system and respiratory depression of varying duration, particularly when given in high dosages and/or by rapid intravenous administration. Apnea may result from decreased respiratory drive as well as increased airway resistance, and rigidity of respiratory muscles may occur during rapid IV administration or when these agents are used in the induction of anesthesia. At therapeutic analgesic dosages, the respiratory effects are usually not clinically important except in patients with preexisting pulmonary impairment. Therapy with opiate agonists should be avoided or administered with extreme caution and initiated at reduced dosages in patients with severe CNS depression; sleep apnea; hypoxia, anoxia, or hypercapnia; upper airway obstruction; chronic pulmonary insufficiency; a limited ventilatory reserve; or other respiratory disorders. In the presence of excessive respiratory secretions, the use of opiate agonists may also be problematic because they decrease ciliary activity and reduce the cough reflex. Caution is also advised in patients who may be at increased risk for respiratory depression, such as comatose patients or those with head injury, intracranial lesions, or intracranial hypertension. Clinical monitoring of pulmonary function is recommended, and equipment for resuscitation should be immediately available if parenteral or neuraxial routes are used. Naloxone may be administered to reverse clinically significant respiratory depression, which may be prolonged depending on the opioid agent, cumulative dose, and route of administration.

The ALfentanil in Alfenta has a major potential interaction with Brain Tumor.

The hypoventilation associated with administration of opiate agonists, particularly by the intravenous route, can induce cerebral hypoxia and vasodilatation with resultant increase in intracranial pressure. Opiate agonists should not be used in patients with suspected or known head injury or increased intracranial pressure. Also, clinicians treating such patients should be aware that opiate agonists may interfere with the evaluation of CNS function, especially with respect to consciousness levels, respiratory status, and pupillary changes.

Lorcaserin has a moderate potential interaction with Breast Cancer.

Lorcaserin can cause elevations in prolactin. In clinical trials of at least one year duration, elevations of prolactin greater than the upper limit of normal, two times the upper limit of normal, and five times the upper limit of normal occurred in 6.7%, 1.7%, and 0.1% of lorcaserin-treated patients, compared to 4.8%, 0.8%, and 0.0% of placebo-treated patients, respectively. One patient treated with lorcaserin developed a prolactinoma. Based on in vitro data, approximately one-third of human breast cancers are thought to be prolactin-dependent. The clinical significance of this observation with respect to long-term lorcaserin therapy is unknown. Chronic administration of other prolactin-stimulating drugs (e.g., neuroleptics, phenothiazines) has been associated with mammary tumorigenesis in rodent studies but not in human clinical or epidemiologic studies. Until further data are available, therapy with lorcaserin should be administered cautiously in patients with a previously detected breast cancer.

The ALfentanil in Alfenta has a major potential interaction with Cerebral Vascular Disorder.

The hypoventilation associated with administration of opiate agonists, particularly by the intravenous route, can induce cerebral hypoxia and vasodilatation with resultant increase in intracranial pressure. Opiate agonists should not be used in patients with suspected or known head injury or increased intracranial pressure. Also, clinicians treating such patients should be aware that opiate agonists may interfere with the evaluation of CNS function, especially with respect to consciousness levels, respiratory status, and pupillary changes.

The ALfentanil in Alfenta has a major potential interaction with Cerebral Vascular Disorder.

Opiate agonists may produce significant central nervous system and respiratory depression of varying duration, particularly when given in high dosages and/or by rapid intravenous administration. Apnea may result from decreased respiratory drive as well as increased airway resistance, and rigidity of respiratory muscles may occur during rapid IV administration or when these agents are used in the induction of anesthesia. At therapeutic analgesic dosages, the respiratory effects are usually not clinically important except in patients with preexisting pulmonary impairment. Therapy with opiate agonists should be avoided or administered with extreme caution and initiated at reduced dosages in patients with severe CNS depression; sleep apnea; hypoxia, anoxia, or hypercapnia; upper airway obstruction; chronic pulmonary insufficiency; a limited ventilatory reserve; or other respiratory disorders. In the presence of excessive respiratory secretions, the use of opiate agonists may also be problematic because they decrease ciliary activity and reduce the cough reflex. Caution is also advised in patients who may be at increased risk for respiratory depression, such as comatose patients or those with head injury, intracranial lesions, or intracranial hypertension. Clinical monitoring of pulmonary function is recommended, and equipment for resuscitation should be immediately available if parenteral or neuraxial routes are used. Naloxone may be administered to reverse clinically significant respiratory depression, which may be prolonged depending on the opioid agent, cumulative dose, and route of administration.

The ALfentanil in Alfenta has a major potential interaction with Dehydration.

Opiate agonists can induce vasodilation and significant hypotension, particularly when given in high dosages and/or by rapid intravenous administration. Opiate analgesics cause vasodilatation that may exacerbate hypotension and hypoperfusion and, therefore, are contraindicated in circulatory shock. At therapeutic analgesic dosages, ambulatory patients are more likely to experience dizziness and hypotension than patients who are confined to bed. However, orthostatic hypotension may occur in supine patients upon rising. Therapy with opiate agonists should be administered cautiously and initiated at reduced dosages in patients with hypovolemia, or a predisposition to hypotension. When given by intramuscular or subcutaneous administration, clinicians should also be aware that impaired perfusion in these patients may prevent complete absorption of the drug. With repeated injections, an excessive amount may be absorbed suddenly if normal circulation is reestablished.

Lorcaserin has a moderate potential interaction with Depression.

Drugs like lorcaserin that target the central nervous system have been associated with depression and suicidal ideation. Psychiatric events of euphoria, hallucination, and dissociation were observed with lorcaserin at supratherapeutic dosages in short-term studies. In clinical trials of at least one year duration, 0.2% of patients treated with lorcaserin developed euphoria, compared to <0.1% treated with placebo. Therapy with lorcaserin should be administered cautiously in patients with preexisting depression or psychiatric illnesses. Lorcaserin dosage should not exceed 10 mg twice a day, and patients should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior. Lorcaserin should be discontinued in patients who experience suicidal thoughts or behavior.

The ALfentanil in Alfenta has a major potential interaction with Gastrointestinal Obstruction.

Opioid analgesics are contraindicated in patients with known or suspected gastrointestinal obstruction, including paralytic ileus.

The ALfentanil in Alfenta has a major potential interaction with Head Injury.

Opiate agonists may produce significant central nervous system and respiratory depression of varying duration, particularly when given in high dosages and/or by rapid intravenous administration. Apnea may result from decreased respiratory drive as well as increased airway resistance, and rigidity of respiratory muscles may occur during rapid IV administration or when these agents are used in the induction of anesthesia. At therapeutic analgesic dosages, the respiratory effects are usually not clinically important except in patients with preexisting pulmonary impairment. Therapy with opiate agonists should be avoided or administered with extreme caution and initiated at reduced dosages in patients with severe CNS depression; sleep apnea; hypoxia, anoxia, or hypercapnia; upper airway obstruction; chronic pulmonary insufficiency; a limited ventilatory reserve; or other respiratory disorders. In the presence of excessive respiratory secretions, the use of opiate agonists may also be problematic because they decrease ciliary activity and reduce the cough reflex. Caution is also advised in patients who may be at increased risk for respiratory depression, such as comatose patients or those with head injury, intracranial lesions, or intracranial hypertension. Clinical monitoring of pulmonary function is recommended, and equipment for resuscitation should be immediately available if parenteral or neuraxial routes are used. Naloxone may be administered to reverse clinically significant respiratory depression, which may be prolonged depending on the opioid agent, cumulative dose, and route of administration.

The ALfentanil in Alfenta has a major potential interaction with Head Injury.

The hypoventilation associated with administration of opiate agonists, particularly by the intravenous route, can induce cerebral hypoxia and vasodilatation with resultant increase in intracranial pressure. Opiate agonists should not be used in patients with suspected or known head injury or increased intracranial pressure. Also, clinicians treating such patients should be aware that opiate agonists may interfere with the evaluation of CNS function, especially with respect to consciousness levels, respiratory status, and pupillary changes.

Lorcaserin has a moderate potential interaction with Heart Block.

Lorcaserin may decrease heart rate. In clinical trials of at least one year duration, the mean decrease in heart rate was 1.2 beats per minute (bpm) in lorcaserin-treated and 0.4 bpm in placebo-treated patients without diabetes, and 2.0 bpm in lorcaserin-treated and 0.4 bpm in placebo-treated patients with type 2 diabetes. The incidence of heart rate less than 50 bpm was 5.3% in lorcaserin-treated and 3.2% in placebo-treated patients without diabetes, and 3.6% in lorcaserin-treated and 2.0% in placebo-treated patients with type 2 diabetes. In the combined population, adverse reactions of bradycardia occurred in 0.3% of lorcaserin-treated and 0.1% of placebo-treated patients. Therapy with lorcaserin should be administered cautiously in patients with bradycardia or a history of heart block greater than first degree.

Lorcaserin has a major potential interaction with Heart Failure.

Regurgitant cardiac valvular disease, primarily affecting the mitral and/or aortic valves, has been reported in patients who took serotonergic drugs with 5-HT2B receptor agonist activity. The etiology is thought to involve activation of 5-HT2B receptors on cardiac interstitial cells. At therapeutic concentrations, lorcaserin is selective for 5-HT2C receptors relative to 5-HT2B receptors, thus it is not known if lorcaserin can cause valvulopathy. In clinical trials of one year duration, 2.4% of patients receiving lorcaserin and 2.0% of patients receiving placebo developed echocardiographic criteria for valvular regurgitation at one year (mild or greater aortic regurgitation and/or moderate or greater mitral regurgitation). None of these patients was symptomatic. Lorcaserin has not been studied in patients with congestive heart failure or hemodynamically-significant valvular heart disease. Preliminary data suggest that 5-HT2B receptors may be overexpressed in congestive heart failure. Therapy with lorcaserin should be administered cautiously in patients with congestive heart failure or preexisting valvulopathy. Patients who develop signs and symptoms of valvular heart disease such as dizziness, fatigue, weakness, dyspnea, edema, or arrhythmia during treatment with lorcaserin should seek prompt medical attention. Discontinuation of lorcaserin should be considered.

The ALfentanil in Alfenta has a major potential interaction with Hypotension.

Opiate agonists can induce vasodilation and significant hypotension, particularly when given in high dosages and/or by rapid intravenous administration. Opiate analgesics cause vasodilatation that may exacerbate hypotension and hypoperfusion and, therefore, are contraindicated in circulatory shock. At therapeutic analgesic dosages, ambulatory patients are more likely to experience dizziness and hypotension than patients who are confined to bed. However, orthostatic hypotension may occur in supine patients upon rising. Therapy with opiate agonists should be administered cautiously and initiated at reduced dosages in patients with hypovolemia, or a predisposition to hypotension. When given by intramuscular or subcutaneous administration, clinicians should also be aware that impaired perfusion in these patients may prevent complete absorption of the drug. With repeated injections, an excessive amount may be absorbed suddenly if normal circulation is reestablished.

The ALfentanil in Alfenta has a moderate potential interaction with Liver Disease.

Narcotic (opioid) analgesic agents are extensively metabolized by the liver, and several of them (e.g., codeine, hydrocodone, meperidine, methadone, morphine, propoxyphene) have active metabolites that are further converted to inactive substances. The serum concentrations of these agents and their metabolites may be increased and the half-lives prolonged in patients with impaired hepatic function. Therapy with opioids should be administered cautiously and initiated at reduced dosages in patients with liver disease. Subsequent doses should be titrated based on individual response rather than a fixed dosing schedule.

Lorcaserin has a moderate potential interaction with Liver Disease.

Lorcaserin is extensively metabolized in the liver by multiple enzymatic pathways. In study subjects with varying degrees of hepatic function, lorcaserin peak plasma concentration (Cmax) was reduced by 7.8% and 14.3% in subjects with mild (Child-Pugh score 5 to 6) and moderate (Child-Pugh score 7 to 9) hepatic impairment, respectively, compared to subjects with normal hepatic function. Lorcaserin exposure (AUC) increased by approximately 22% and 30% in patients with mild and moderate hepatic impairment, respectively, and the half-life was prolonged by 59% to 19 hours in patients with moderate hepatic impairment. No dosage adjustment of lorcaserin is required in patients with mild to moderate hepatic impairment. The effect of severe hepatic impairment on the pharmacokinetics of lorcaserin was not evaluated. Therapy with lorcaserin should be administered cautiously in patients with severe hepatic impairment.

Lorcaserin has a moderate potential interaction with Myeloproliferative Disorders.

Lorcaserin may cause priapism due to 5-HT2C receptor agonism. The condition is characterized by prolonged, often painful erections lasting longer than 4 hours. If not treated promptly, priapism can cause irreversible damage to the erectile tissue. Therapy with lorcaserin should be administered cautiously in patients with a history of priapism, conditions that may predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, leukemia, thalassemia), or anatomical deformations of the penis (e.g., angulation, cavernosal fibrosis, Peyronie's disease). Patients who experience an erection lasting longer than 4 hours, whether painful or not, should immediately discontinue the drug and seek emergency medical attention.

Lorcaserin has a moderate potential interaction with Penis Disorders.

Lorcaserin may cause priapism due to 5-HT2C receptor agonism. The condition is characterized by prolonged, often painful erections lasting longer than 4 hours. If not treated promptly, priapism can cause irreversible damage to the erectile tissue. Therapy with lorcaserin should be administered cautiously in patients with a history of priapism, conditions that may predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, leukemia, thalassemia), or anatomical deformations of the penis (e.g., angulation, cavernosal fibrosis, Peyronie's disease). Patients who experience an erection lasting longer than 4 hours, whether painful or not, should immediately discontinue the drug and seek emergency medical attention.

Lorcaserin has a moderate potential interaction with Peyronie Disease.

Lorcaserin may cause priapism due to 5-HT2C receptor agonism. The condition is characterized by prolonged, often painful erections lasting longer than 4 hours. If not treated promptly, priapism can cause irreversible damage to the erectile tissue. Therapy with lorcaserin should be administered cautiously in patients with a history of priapism, conditions that may predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, leukemia, thalassemia), or anatomical deformations of the penis (e.g., angulation, cavernosal fibrosis, Peyronie's disease). Patients who experience an erection lasting longer than 4 hours, whether painful or not, should immediately discontinue the drug and seek emergency medical attention.

The ALfentanil in Alfenta has a major potential interaction with Prematurity/Underweight in Infancy.

The use of narcotic (opioid) analgesic agents is contraindicated in premature infants. These agents may cross the immature blood-brain barrier to a greater extent than in adults, resulting in disproportionate respiratory depression.

Lorcaserin has a moderate potential interaction with Priapism.

Lorcaserin may cause priapism due to 5-HT2C receptor agonism. The condition is characterized by prolonged, often painful erections lasting longer than 4 hours. If not treated promptly, priapism can cause irreversible damage to the erectile tissue. Therapy with lorcaserin should be administered cautiously in patients with a history of priapism, conditions that may predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, leukemia, thalassemia), or anatomical deformations of the penis (e.g., angulation, cavernosal fibrosis, Peyronie's disease). Patients who experience an erection lasting longer than 4 hours, whether painful or not, should immediately discontinue the drug and seek emergency medical attention.

Lorcaserin has a moderate potential interaction with Psychosis.

Drugs like lorcaserin that target the central nervous system have been associated with depression and suicidal ideation. Psychiatric events of euphoria, hallucination, and dissociation were observed with lorcaserin at supratherapeutic dosages in short-term studies. In clinical trials of at least one year duration, 0.2% of patients treated with lorcaserin developed euphoria, compared to <0.1% treated with placebo. Therapy with lorcaserin should be administered cautiously in patients with preexisting depression or psychiatric illnesses. Lorcaserin dosage should not exceed 10 mg twice a day, and patients should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior. Lorcaserin should be discontinued in patients who experience suicidal thoughts or behavior.

Lorcaserin has a moderate potential interaction with Pulmonary Heart or Vascular Disease.

Lorcaserin is believed to promote satiety by selectively activating serotonin 2C receptors on anorexigenic pro-opiomelanocortin neurons located in the hypothalamus. Certain centrally-acting weight loss agents that act on the serotonin system have been associated with pulmonary hypertension, a rare but lethal disease. Care should be taken when prescribing this drug to patients at risk or with pulmonary hypertension.

The ALfentanil in Alfenta has a major potential interaction with Pulmonary Impairment.

Opiate agonists may produce significant central nervous system and respiratory depression of varying duration, particularly when given in high dosages and/or by rapid intravenous administration. Apnea may result from decreased respiratory drive as well as increased airway resistance, and rigidity of respiratory muscles may occur during rapid IV administration or when these agents are used in the induction of anesthesia. At therapeutic analgesic dosages, the respiratory effects are usually not clinically important except in patients with preexisting pulmonary impairment. Therapy with opiate agonists should be avoided or administered with extreme caution and initiated at reduced dosages in patients with severe CNS depression; sleep apnea; hypoxia, anoxia, or hypercapnia; upper airway obstruction; chronic pulmonary insufficiency; a limited ventilatory reserve; or other respiratory disorders. In the presence of excessive respiratory secretions, the use of opiate agonists may also be problematic because they decrease ciliary activity and reduce the cough reflex. Caution is also advised in patients who may be at increased risk for respiratory depression, such as comatose patients or those with head injury, intracranial lesions, or intracranial hypertension. Clinical monitoring of pulmonary function is recommended, and equipment for resuscitation should be immediately available if parenteral or neuraxial routes are used. Naloxone may be administered to reverse clinically significant respiratory depression, which may be prolonged depending on the opioid agent, cumulative dose, and route of administration.

The ALfentanil in Alfenta has a moderate potential interaction with Renal Dysfunction.

Although narcotic (opioid) analgesic agents are generally metabolized by the liver, renal impairment can alter the elimination of these agents and their metabolites (some of which are pharmacologically active), resulting in drug accumulation and increased risk of toxicity. Therapy with opioids should be administered cautiously and initiated at reduced dosages in patients with significantly impaired renal function. Subsequent doses should be titrated based on individual response rather than a fixed dosing schedule.

Lorcaserin has a moderate potential interaction with Renal Dysfunction.

Lorcaserin is extensively metabolized in the liver by multiple enzymatic pathways, and the metabolites are primarily eliminated by the kidney. In patients with varying degrees of renal function, lorcaserin systemic exposure (AUC) was not significantly different, but AUC of the sulfamate metabolite (M1) was increased by approximately 1.7-fold in mild (CrCl 50 to 80 mL/min), 2.3-fold in moderate (CrCl 30 to 50 mL/min), and 10.5-fold in severe renal impairment (CrCl <30 mL/min) compared to normal renal function (CrCl >80 mL/min), while AUC of the N-carbamoyl-glucuronide metabolite (M5) was increased by approximately 1.5-, 2.5-, and 5.1-fold, respectively. No dosage adjustment of lorcaserin is required in patients with mild renal impairment, but caution is advised when used in patients with moderate renal impairment. Use in patients with severe renal impairment or end stage renal disease is not recommended.

The ALfentanil in Alfenta has a major potential interaction with Respiratory Arrest.

Opiate agonists may produce significant central nervous system and respiratory depression of varying duration, particularly when given in high dosages and/or by rapid intravenous administration. Apnea may result from decreased respiratory drive as well as increased airway resistance, and rigidity of respiratory muscles may occur during rapid IV administration or when these agents are used in the induction of anesthesia. At therapeutic analgesic dosages, the respiratory effects are usually not clinically important except in patients with preexisting pulmonary impairment. Therapy with opiate agonists should be avoided or administered with extreme caution and initiated at reduced dosages in patients with severe CNS depression; sleep apnea; hypoxia, anoxia, or hypercapnia; upper airway obstruction; chronic pulmonary insufficiency; a limited ventilatory reserve; or other respiratory disorders. In the presence of excessive respiratory secretions, the use of opiate agonists may also be problematic because they decrease ciliary activity and reduce the cough reflex. Caution is also advised in patients who may be at increased risk for respiratory depression, such as comatose patients or those with head injury, intracranial lesions, or intracranial hypertension. Clinical monitoring of pulmonary function is recommended, and equipment for resuscitation should be immediately available if parenteral or neuraxial routes are used. Naloxone may be administered to reverse clinically significant respiratory depression, which may be prolonged depending on the opioid agent, cumulative dose, and route of administration.

The ALfentanil in Alfenta has a moderate potential interaction with Seizures.

Narcotic (opioid) analgesic agents may increase the frequency of seizures in patients with seizure disorders, may increase the risk of seizures occurring in other clinical settings associated with seizures, and, at higher dosages, have been reported to induce seizures in patients without history of seizures. Patients with history of seizure disorders should be regularly evaluated for worsened seizure control during therapy. Prolonged meperidine use may increase the risk of toxicity (e.g., seizures) from the accumulation of the active metabolite (normeperidine).

The ALfentanil in Alfenta has a major potential interaction with Shock.

Opiate agonists can induce vasodilation and significant hypotension, particularly when given in high dosages and/or by rapid intravenous administration. Opiate analgesics cause vasodilatation that may exacerbate hypotension and hypoperfusion and, therefore, are contraindicated in circulatory shock. At therapeutic analgesic dosages, ambulatory patients are more likely to experience dizziness and hypotension than patients who are confined to bed. However, orthostatic hypotension may occur in supine patients upon rising. Therapy with opiate agonists should be administered cautiously and initiated at reduced dosages in patients with hypovolemia, or a predisposition to hypotension. When given by intramuscular or subcutaneous administration, clinicians should also be aware that impaired perfusion in these patients may prevent complete absorption of the drug. With repeated injections, an excessive amount may be absorbed suddenly if normal circulation is reestablished.

Lorcaserin has a moderate potential interaction with Sickle Cell Anemia.

Lorcaserin may cause priapism due to 5-HT2C receptor agonism. The condition is characterized by prolonged, often painful erections lasting longer than 4 hours. If not treated promptly, priapism can cause irreversible damage to the erectile tissue. Therapy with lorcaserin should be administered cautiously in patients with a history of priapism, conditions that may predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, leukemia, thalassemia), or anatomical deformations of the penis (e.g., angulation, cavernosal fibrosis, Peyronie's disease). Patients who experience an erection lasting longer than 4 hours, whether painful or not, should immediately discontinue the drug and seek emergency medical attention.

Lorcaserin has a moderate potential interaction with Sinus Node Dysfunction.

Lorcaserin may decrease heart rate. In clinical trials of at least one year duration, the mean decrease in heart rate was 1.2 beats per minute (bpm) in lorcaserin-treated and 0.4 bpm in placebo-treated patients without diabetes, and 2.0 bpm in lorcaserin-treated and 0.4 bpm in placebo-treated patients with type 2 diabetes. The incidence of heart rate less than 50 bpm was 5.3% in lorcaserin-treated and 3.2% in placebo-treated patients without diabetes, and 3.6% in lorcaserin-treated and 2.0% in placebo-treated patients with type 2 diabetes. In the combined population, adverse reactions of bradycardia occurred in 0.3% of lorcaserin-treated and 0.1% of placebo-treated patients. Therapy with lorcaserin should be administered cautiously in patients with bradycardia or a history of heart block greater than first degree.

Lorcaserin has a moderate potential interaction with Thalassemia.

Lorcaserin may cause priapism due to 5-HT2C receptor agonism. The condition is characterized by prolonged, often painful erections lasting longer than 4 hours. If not treated promptly, priapism can cause irreversible damage to the erectile tissue. Therapy with lorcaserin should be administered cautiously in patients with a history of priapism, conditions that may predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, leukemia, thalassemia), or anatomical deformations of the penis (e.g., angulation, cavernosal fibrosis, Peyronie's disease). Patients who experience an erection lasting longer than 4 hours, whether painful or not, should immediately discontinue the drug and seek emergency medical attention.

Lorcaserin has a moderate potential interaction with Type 2 Diabetes.

Obese, type 2 diabetic patients who achieve weight loss may demonstrate improved metabolic control of their disease as a result of their reduced weight. Therefore, patients with type 2 diabetes mellitus should be monitored during weight-reduction therapy (or therapy that may be expected to induce significant weight loss as a secondary effect) for hypoglycemia and reduced need for oral hypoglycemic medication or insulin, and the dosages of these agents adjusted accordingly. Patients should be apprised of the risk of hypoglycemia and be alert to potential signs and symptoms such as headache, dizziness, drowsiness, nervousness, confusion, tremor, hunger, weakness, perspiration, and palpitation.

The ALfentanil in Alfenta has a moderate potential interaction with Urinary Retention.

Narcotic (opioid) analgesic agents may inhibit the urinary voiding reflex and increase the tone of the vesical sphincter in the bladder. Acute urinary retention requiring catheterization may occur, particularly in patients with prostatic hypertrophy or urethral stricture and in older adult patients. These agents may also decrease urine production via direct effects on the kidney and central stimulation of the release of vasopressin. Therapy with opioids should be administered cautiously in patients with or predisposed to urinary retention and/or oliguria. The effects on smooth muscle tone appear to be the most pronounced with morphine.

Lorcaserin has a major potential interaction with Valvular Heart Disease.

Regurgitant cardiac valvular disease, primarily affecting the mitral and/or aortic valves, has been reported in patients who took serotonergic drugs with 5-HT2B receptor agonist activity. The etiology is thought to involve activation of 5-HT2B receptors on cardiac interstitial cells. At therapeutic concentrations, lorcaserin is selective for 5-HT2C receptors relative to 5-HT2B receptors, thus it is not known if lorcaserin can cause valvulopathy. In clinical trials of one year duration, 2.4% of patients receiving lorcaserin and 2.0% of patients receiving placebo developed echocardiographic criteria for valvular regurgitation at one year (mild or greater aortic regurgitation and/or moderate or greater mitral regurgitation). None of these patients was symptomatic. Lorcaserin has not been studied in patients with congestive heart failure or hemodynamically-significant valvular heart disease. Preliminary data suggest that 5-HT2B receptors may be overexpressed in congestive heart failure. Therapy with lorcaserin should be administered cautiously in patients with congestive heart failure or preexisting valvulopathy. Patients who develop signs and symptoms of valvular heart disease such as dizziness, fatigue, weakness, dyspnea, edema, or arrhythmia during treatment with lorcaserin should seek prompt medical attention. Discontinuation of lorcaserin should be considered.

Lorcaserin has a moderate potential interaction with Vascular Disorders of Penis.

Lorcaserin may cause priapism due to 5-HT2C receptor agonism. The condition is characterized by prolonged, often painful erections lasting longer than 4 hours. If not treated promptly, priapism can cause irreversible damage to the erectile tissue. Therapy with lorcaserin should be administered cautiously in patients with a history of priapism, conditions that may predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, leukemia, thalassemia), or anatomical deformations of the penis (e.g., angulation, cavernosal fibrosis, Peyronie's disease). Patients who experience an erection lasting longer than 4 hours, whether painful or not, should immediately discontinue the drug and seek emergency medical attention.