Interactions between Alkets and Riociguat

The calcium carbonate in Alkets has a major potential interaction with Achlorhydria.

Calcium is absorbed from the intestinal tract by active transport and passive diffusion. Malabsorption syndromes (celiac disease, GI resection), deficiency of vitamin D, parathyroid hormone, or calcitonin, or an alkaline gastric pH (achlorhydria, carbonate or phosphate salts) can decrease the absorption of oral formulations of calcium. Calcium is available in oral and parenteral formulations.

The calcium carbonate in Alkets has a major potential interaction with Arrhythmia.

Calcium is involved in cardiac muscle contraction and electrical impulse conduction. Therapy with calcium salt formulations (particularly IV) should be administered cautiously to patients with cardiac disease. Patients receiving cardiac glycosides and concomitant IV calcium may experience arrhythmias. Therapy with IV calcium should be administered slowly and at reduced dosages in patients with cardiac disease.

Riociguat has a moderate potential interaction with High Blood Pressure.

Riociguat reduces blood pressure. There is a potential for symptomatic hypotension or ischemia in patients with hypovolemia, severe left ventricular outflow obstruction, resting hypotension, autonomic dysfunction, or concomitant treatment with antihypertensive agents. Consider a dose reduction if the patient develops signs or symptoms of hypotension.

Riociguat has a moderate potential interaction with Hypotension.

Riociguat reduces blood pressure. There is a potential for symptomatic hypotension or ischemia in patients with hypovolemia, severe left ventricular outflow obstruction, resting hypotension, autonomic dysfunction, or concomitant treatment with antihypertensive agents. Consider a dose reduction if the patient develops signs or symptoms of hypotension.

Riociguat has a major potential interaction with Interstitial Lung Disease.

Use of riociguat is contraindicated in patients with pulmonary hypertension associated with idiopathic interstitial pneumonias (PH-IIP).

Riociguat has a moderate potential interaction with Liver Disease.

Use of riociguat is not recommended in patients with severe hepatic impairment (Child-Pugh C); safety and efficacy of riociguat have not been demonstrated in this population.

The calcium carbonate in Alkets has a major potential interaction with Malabsorption Syndrome.

Calcium is absorbed from the intestinal tract by active transport and passive diffusion. Malabsorption syndromes (celiac disease, GI resection), deficiency of vitamin D, parathyroid hormone, or calcitonin, or an alkaline gastric pH (achlorhydria, carbonate or phosphate salts) can decrease the absorption of oral formulations of calcium. Calcium is available in oral and parenteral formulations.

The calcium carbonate in Alkets has a major potential interaction with Phosphate Imbalance.

Elevated serum concentrations of calcium and phosphate can exceed the solubility level and result in calcium- phosphate precipitates that deposit in vascular and renal systems as well as other soft tissues of the body. Therapy with calcium should be administered with extreme caution in patients with hyperphosphatemia (hypoparathyroidism or severe renal impairment). Administration of oral calcium acetate or calcium carbonate, in addition to providing calcium, complexes phosphates within the GI tract. These complexes are eliminated in the feces. Clinical monitoring of serum calcium and phosphate concentrations is necessary.

Riociguat has a moderate potential interaction with Pulmonary Edema.

Use of riociguat, a pulmonary vasodilator, is not recommended in patients with pulmonary veno-occlusive disease (PVOD) as it may significantly worsen cardiovascular status. If signs of pulmonary edema occur, the possibility of associated PVOD should be considered and, if confirmed, treatment should be discontinued.

The calcium carbonate in Alkets has a major potential interaction with Renal Dysfunction.

Absorption of oral calcium formulations may be altered and elimination of calcium by the kidney decreased with renal impairment. Hyperphosphatemia occurs during renal failure. Calcium acetate or calcium carbonate, in addition to providing calcium, complexes phosphates within the GI tract. Calcium carbonate can partially correct metabolic acidosis associated with chronic renal failure. Clinical monitoring of renal function and serum calcium and phosphate concentrations is necessary.

Riociguat has a moderate potential interaction with Renal Dysfunction.

Use of riociguat is not recommended in patients with CrCl less than 15 mL/min; safety and efficacy of riociguat have not been demonstrated in this population.

The calcium carbonate in Alkets has a major potential interaction with Sarcoidosis.

Hypercalciuria, with or without hypercalcemia, may occasionally occur in patients with sarcoidosis. Elevated calcium levels may result from increased intestinal absorption of calcium, which is related to the extrarenal production of vitamin D by mononuclear phagocytes present within the sarcoid granuloma. Therapy with calcium salts should be administered cautiously and only if necessary in patients with sarcoidosis.