Drug Interactions between Apokyn and Ezide
This report displays the potential drug interactions for the following 2 drugs:
- Apokyn (apomorphine)
- Ezide (hydrochlorothiazide)
Interactions between your drugs
hydroCHLOROthiazide apomorphine
Applies to: Ezide (hydrochlorothiazide) and Apokyn (apomorphine)
MONITOR CLOSELY: Apomorphine may potentiate the hypotensive effect of vasodilators and antihypertensive agents. Apomorphine alone has been associated with orthostatic hypotension, hypotension, syncope, and dose-dependent decreases in systolic and diastolic blood pressure. In clinical studies of the subcutaneous formulation of apomorphine in patients with advanced Parkinson's disease, hypotension (10% vs 4%), myocardial infarction (3% vs. 1%), serious pneumonia (5% vs. 3%), serious falls (9% vs. 3%), and bone and joint injuries (6% vs. 2%) were experienced more commonly in patients receiving concomitant antihypertensive medications or vasodilators (n=94) compared to those not receiving these medications (n=456). Some of these events may be related to the increased incidence of hypotension.
MANAGEMENT: Caution and close monitoring for altered efficacy and safety are recommended if patients receive apomorphine with an antihypertensive agent or vasodilator. Some authorities consider the combination of subcutaneous apomorphine with antihypertensive medications or vasodilators to be contraindicated due to a lack of data from studies that systematically evaluated the potential interaction between apomorphine and these agents. Patients should be made aware of the possible side effects (e.g., dizziness, lightheadedness, orthostasis) and be cautioned about driving, operating machinery, or performing other hazardous tasks. They should also be advised to avoid rising abruptly from a sitting or recumbent position and to contact their physician if they experience symptoms of hypotension such as dizziness, lightheadedness, or fainting.
References
- (2004) "Product Information. Apokyn (apomorphine)." Mylan Pharmaceuticals Inc
- (2022) "Product Information. Apokyn (apomorphine)." US WorldMeds LLC
- (2022) "Product Information. Kynmobi (apomorphine)." Sunovion Pharmaceuticals Inc
- (2023) "Product Information. Movapo (apomorphine)." Paladin Labs Inc, 2.0
- (2022) "Product Information. Kynmobi (apomorphine)." Sunovion Pharmaceuticals Canada Inc
- (2024) "Product Information. Dacepton (apomorphine)." Ever Pharma UK Ltd
- (2024) "Product Information. aPomine Intermittent (apomorphine)." Pfizer Australia Pty Ltd, 1.1
- (2024) "Product Information. Movapo (apomorphine)." Stada Pharmaceuticals Australia Pty Ltd
Drug and food interactions
hydroCHLOROthiazide food
Applies to: Ezide (hydrochlorothiazide)
MONITOR: Many psychotherapeutic and CNS-active agents (e.g., anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics, opioids, alcohol, muscle relaxants) exhibit hypotensive effects, especially during initiation of therapy and dose escalation. Coadministration with antihypertensives and other hypotensive agents, in particular vasodilators and alpha-blockers, may result in additive effects on blood pressure and orthostasis.
MANAGEMENT: Caution and close monitoring for development of hypotension is advised during coadministration of these agents. Some authorities recommend avoiding alcohol in patients receiving vasodilating antihypertensive drugs. Patients should be advised to avoid rising abruptly from a sitting or recumbent position and to notify their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia.
References
- Sternbach H (1991) "Fluoxetine-associated potentiation of calcium-channel blockers." J Clin Psychopharmacol, 11, p. 390-1
- Shook TL, Kirshenbaum JM, Hundley RF, Shorey JM, Lamas GA (1984) "Ethanol intoxication complicating intravenous nitroglycerin therapy." Ann Intern Med, 101, p. 498-9
- Feder R (1991) "Bradycardia and syncope induced by fluoxetine." J Clin Psychiatry, 52, p. 139
- Ellison JM, Milofsky JE, Ely E (1990) "Fluoxetine-induced bradycardia and syncope in two patients." J Clin Psychiatry, 51, p. 385-6
- Rodriguez de la Torre B, Dreher J, Malevany I, et al. (2001) "Serum levels and cardiovascular effects of tricyclic antidepressants and selective serotonin reuptake inhibitors in depressed patients." Ther Drug Monit, 23, p. 435-40
- Cerner Multum, Inc. "Australian Product Information."
- Pacher P, Kecskemeti V (2004) "Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns?" Curr Pharm Des, 10, p. 2463-75
- Andrews C, Pinner G (1998) "Postural hypotension induced by paroxetine." BMJ, 316, p. 595
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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