Drug Interactions between anhydrous calcium iodide / isoproterenol and Byvalson
This report displays the potential drug interactions for the following 2 drugs:
- anhydrous calcium iodide/isoproterenol
- Byvalson (nebivolol/valsartan)
Interactions between your drugs
isoproterenol nebivolol
Applies to: anhydrous calcium iodide / isoproterenol and Byvalson (nebivolol / valsartan)
GENERALLY AVOID: Some beta-blockers may antagonize the bronchodilatory, hypotensive, and tachycardic effects of isoproterenol. The mechanism is blockade of beta-adrenergic receptors, which leads to bronchoconstriction, vasodilation, and increased heart rate. Beta-blockers have been used successfully to treat catecholamine or isoproterenol-induced tachyarrhythmias.
MANAGEMENT: This combination should generally be avoided. Patients who are receiving isoproterenol for cardiac conditions should be closely monitored for adequate therapeutic effect if a beta blocker is added. If no alternative exists, small doses of a B-1 selective beta-blocker (e.g., acebutolol, atenolol, betaxolol, bisoprolol, or metoprolol) may be preferable; however, respiratory status should be closely monitored in patients with obstructive pulmonary disease.
References
- 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
- Vlay SC "Isoproterenol-induced bradyarrhythmias." Am Heart J 122 (1991): 1169
- Vlay SC "Catecholamine-sensitive ventricular tachycardia." Am Heart J 114 (1987): 455-61
- Pickles H, Perucca E, Fish A, Richens A "Propranolol and sotalol as antagonists of isoproterenol-enhanced physiologic tremor." Clin Pharmacol Ther 30 (1981): 303-10
- Mann DE, Marmont P, Shultz J, Reiter MJ "Atrioventricular nodal reentrant tachycardia initiated by catecholamine-induced ventricular tachycardia. A case report." J Electrocardiol 24 (1991): 191-5
- Ziegler MG, Chernow B, Woodson LC, Coyle J, Cruess D, Lake CR "The effect of propranolol on catecholamine clearance." Clin Pharmacol Ther 40 (1986): 116-9
- Johnsson G, Svedmyr N, Thiringer G "Effects of intravenous propranolol and metoprolol and their interaction with isoprenaline on pulmonary function, heart rate and blood pressure in asthmatics." Eur J Clin Pharmacol 8 (1975): 175-80
- Messerli FH, Kuchel O, Tolis G, Hamet P, Fraysse J, Genest J "Effects of beta-adrenergic blockade on plasma cyclic AMP and blood sugar responses to glucagon and isoproterenol in man." Int J Clin Pharmacol Biopharm 14 (1976): 189-94
- Thiringer G, Svedmyr N "Interaction of orally administered metoprolol, practolol and propranolol with isoprenaline in asthmatics." Eur J Clin Pharmacol 10 (1976): 163-70
anhydrous calcium iodide nebivolol
Applies to: anhydrous calcium iodide / isoproterenol and Byvalson (nebivolol / valsartan)
ADJUST DOSING INTERVAL: Concurrent administration with calcium salts may decrease the oral bioavailability of atenolol and possibly other beta-blockers. The exact mechanism of interaction is unknown. In six healthy subjects, calcium 500 mg (as lactate, carbonate, and gluconate) reduced the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of atenolol (100 mg) by 51% and 32%, respectively. The elimination half-life increased by 44%. Twelve hours after the combination, beta-blocking activity (as indicated by inhibition of exercise tachycardia) was reduced compared to that with atenolol alone. However, during a 4-week treatment in six hypertensive patients, there was no difference in blood pressure values between treatments. The investigators suggest that prolongation of the elimination half-life induced by calcium coadministration may have led to atenolol cumulation during long-term dosing, which compensated for the reduced bioavailability.
MANAGEMENT: It may help to separate the administration times of beta-blockers and calcium products by at least 2 hours. Patients should be monitored for potentially diminished beta-blocking effects following the addition of calcium therapy.
References
- Kirch W, Schafer-Korting M, Axthelm T, Kohler H, Mutschler E "Interaction of atenolol with furosemide and calcium and aluminum salts." Clin Pharmacol Ther 30 (1981): 429-35
valsartan nebivolol
Applies to: Byvalson (nebivolol / valsartan) and Byvalson (nebivolol / valsartan)
GENERALLY AVOID: In the Valsartan Heart Failure Trial, the combination of valsartan with a beta-blocker and an ACE inhibitor was associated with unfavorable outcomes on morbidity and mortality in heart failure patients. The mechanism is unknown.
MANAGEMENT: The manufacturer recommends that the triple combination of valsartan with a beta-blocker and an ACE inhibitor be avoided in heart failure patients.
References
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
Drug and food interactions
valsartan food
Applies to: Byvalson (nebivolol / valsartan)
GENERALLY AVOID: Moderate-to-high dietary intake of potassium, especially salt substitutes, may increase the risk of hyperkalemia in some patients who are using angiotensin II receptor blockers (ARBs). ARBs can promote hyperkalemia through inhibition of angiotensin II-induced aldosterone secretion. Patients with diabetes, heart failure, dehydration, or renal insufficiency have a greater risk of developing hyperkalemia.
MANAGEMENT: Patients should receive dietary counseling and be advised to not use potassium-containing salt substitutes or over-the-counter potassium supplements without consulting their physician. If salt substitutes are used concurrently, regular monitoring of serum potassium levels is recommended. Patients should also be advised to seek medical attention if they experience symptoms of hyperkalemia such as weakness, irregular heartbeat, confusion, tingling of the extremities, or feelings of heaviness in the legs.
References
- "Product Information. Cozaar (losartan)." Merck & Co., Inc PROD (2001):
- "Product Information. Diovan (valsartan)." Novartis Pharmaceuticals PROD (2001):
isoproterenol food
Applies to: anhydrous calcium iodide / isoproterenol
MONITOR: Coadministration of two or more sympathomimetic agents may increase the risk of adverse effects such as nervousness, irritability, and increased heart rate. Central nervous system (CNS) stimulants, particularly amphetamines, can potentiate the adrenergic response to vasopressors and other sympathomimetic agents. Additive increases in blood pressure and heart rate may occur due to enhanced peripheral sympathetic activity.
MANAGEMENT: Caution is advised if two or more sympathomimetic agents are coadministered. Pulse and blood pressure should be closely monitored.
References
- Rosenblatt JE, Lake CR, van Kammen DP, Ziegler MG, Bunney WE Jr "Interactions of amphetamine, pimozide, and lithium on plasma norepineophrine and dopamine-beta-hydroxylase in schizophrenic patients." Psychiatry Res 1 (1979): 45-52
- Cavanaugh JH, Griffith JD, Oates JA "Effect of amphetamine on the pressor response to tyramine: formation of p-hydroxynorephedrine from amphetamine in man." Clin Pharmacol Ther 11 (1970): 656
- "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc PROD (2001):
- "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals PROD (2001):
- "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals PROD (2001):
- "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):
- "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company (2002):
Therapeutic duplication warnings
No warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
See also
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
No interaction information available. |
Further information
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