Can you take Apomorphine with Flavalta?

The EPINEPHrine in Flavalta has a moderate potential interaction with Acidosis.

Acidosis, hypoxia, and hypercapnia may reduce the effectiveness of sympathomimetic amines in raising blood pressure. These conditions should be corrected before initiating therapy with sympathomimetic amines, if possible. Monitoring the patients acid-base balance, carbon dioxide levels, and oxygen saturation is recommended.

Apomorphine has a moderate potential interaction with Alcoholism.

In a study of healthy subjects, the hypotensive effect of apomorphine on systolic and diastolic blood pressure was exacerbated by the concomitant use of alcohol. Patients should avoid alcohol when using apomorphine.

Apomorphine has a moderate potential interaction with Asthma.

Apomorphine products contain sodium metabisulfite, a sulfite that may cause allergic-type reactions (including anaphylactic symptoms and life-threatening or less severe asthmatic episodes) in certain susceptible patients. While the overall prevalence in the general population is unknown and probably low, sulfite sensitivity is seen more often in patients with asthma than in those without asthma.

The EPINEPHrine in Flavalta has a major potential interaction with Cardiovascular Conditions and Disorders.

Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.

Apomorphine has a moderate potential interaction with Cardiovascular Conditions and Disorders.

Apomorphine has been shown to reduce resting systolic and diastolic blood pressure and may have the potential to exacerbate cardiac and cerebral ischemia in patients with known cardiovascular and cerebrovascular disease. If patients develop signs/symptoms of cardiac or cerebral ischemia, prescribers should reevaluate the continued use of apomorphine.

Apomorphine has a moderate potential interaction with Cerebral Vascular Disorder.

Apomorphine has been shown to reduce resting systolic and diastolic blood pressure and may have the potential to exacerbate cardiac and cerebral ischemia in patients with known cardiovascular and cerebrovascular disease. If patients develop signs/symptoms of cardiac or cerebral ischemia, prescribers should reevaluate the continued use of apomorphine.

The EPINEPHrine in Flavalta has a major potential interaction with Dehydration.

The use of sympathomimetic amines has been infrequently associated with significant hypotension especially in dehydrated patients secondary to the drug's beta-2 mediated vasodilation. Hypovolemia should be corrected, if possible, before administering sympathomimetic amines. Blood pressure and ECG should be monitored at regular intervals. Monitoring of cardiac output and pulmonary wedge pressure may also be desired.

The EPINEPHrine in Flavalta has a moderate potential interaction with Diabetes Mellitus.

Sympathomimetic agents may cause increases in blood glucose concentrations. These effects are usually transient and slight but may be significant with dosages higher than those normally recommended. Therapy with sympathomimetic agents should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate.

Apomorphine has a moderate potential interaction with Electrolyte Abnormalities.

The risks/benefits of apomorphine treatment should be considered before starting this drug in patients with risk factors for prolonged QTc. There is a dose-related prolongation of QTc interval after apomorphine exposure similar to that achieved with therapeutic doses of this drug. For the intermittent injection formulation, doses greater than 6 mg do not provide additional clinical benefit and are not recommended. Drugs that prolong QTc interval have been associated with torsades de pointes and sudden death. The link between QTc prolongation and torsades de pointes is most apparent with larger increases (20 msec and greater), but smaller QTc prolongations may also increase risk, particularly in susceptible patients (e.g., those with hypokalemia, hypomagnesemia, bradycardia, genetic predisposition [such as congenital QT interval prolongation], or concomitant use of other drugs that prolong QTc interval). Although no occurrence of torsades de pointes was reported in association with apomorphine at recommended doses in clinical trials, an increased risk cannot be ruled out due to limited experience.

The lidocaine in Flavalta has a major potential interaction with Heart Block.

The use of lidocaine is contraindicated in patients with Stokes-Adam syndrome, Wolff-Parkinson White syndrome, or second- or third-degree AV block in the absence of a functional artificial pacemaker, or congenital QT prolongation.

The lidocaine in Flavalta has a major potential interaction with Heart Failure.

Antiarrhythmic agents can induce severe hypotension (particularly with IV administration) or induce or worsen congestive heart failure (CHF). Patients with primary cardiomyopathy or inadequately compensated CHF are at increased risk. Antiarrhythmic agents should be administered cautiously and dosage and/or frequency of administration modified in patients with hypotension or adequately compensated CHF. Alternative therapy should be considered unless these conditions are secondary to cardiac arrhythmia.

The lidocaine in Flavalta has a moderate potential interaction with Hyperkalemia.

Electrolyte imbalance can alter the therapeutic effectiveness of antiarrhythmic agents. Hypokalemia and hypomagnesemia can reduce the effectiveness of antiarrhythmic agents. In some cases, these disorders can exaggerate the degree of QTc prolongation and increase the potential for torsade de pointes. Hyperkalemia can potentiate the toxic effects of antiarrhythmic agents. Electrolyte imbalance should be corrected prior to initiating antiarrhythmic therapy. Clinical monitoring of cardiac function and electrolyte concentrations is recommended.

The EPINEPHrine in Flavalta has a major potential interaction with Hyperthyroidism.

Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.

Apomorphine has a moderate potential interaction with Hypokalemia.

The risks/benefits of apomorphine treatment should be considered before starting this drug in patients with risk factors for prolonged QTc. There is a dose-related prolongation of QTc interval after apomorphine exposure similar to that achieved with therapeutic doses of this drug. For the intermittent injection formulation, doses greater than 6 mg do not provide additional clinical benefit and are not recommended. Drugs that prolong QTc interval have been associated with torsades de pointes and sudden death. The link between QTc prolongation and torsades de pointes is most apparent with larger increases (20 msec and greater), but smaller QTc prolongations may also increase risk, particularly in susceptible patients (e.g., those with hypokalemia, hypomagnesemia, bradycardia, genetic predisposition [such as congenital QT interval prolongation], or concomitant use of other drugs that prolong QTc interval). Although no occurrence of torsades de pointes was reported in association with apomorphine at recommended doses in clinical trials, an increased risk cannot be ruled out due to limited experience.

The lidocaine in Flavalta has a moderate potential interaction with Hypokalemia.

Electrolyte imbalance can alter the therapeutic effectiveness of antiarrhythmic agents. Hypokalemia and hypomagnesemia can reduce the effectiveness of antiarrhythmic agents. In some cases, these disorders can exaggerate the degree of QTc prolongation and increase the potential for torsade de pointes. Hyperkalemia can potentiate the toxic effects of antiarrhythmic agents. Electrolyte imbalance should be corrected prior to initiating antiarrhythmic therapy. Clinical monitoring of cardiac function and electrolyte concentrations is recommended.

The lidocaine in Flavalta has a major potential interaction with Hypotension.

Antiarrhythmic agents can induce severe hypotension (particularly with IV administration) or induce or worsen congestive heart failure (CHF). Patients with primary cardiomyopathy or inadequately compensated CHF are at increased risk. Antiarrhythmic agents should be administered cautiously and dosage and/or frequency of administration modified in patients with hypotension or adequately compensated CHF. Alternative therapy should be considered unless these conditions are secondary to cardiac arrhythmia.

Apomorphine has a moderate potential interaction with Hypotension.

Dopamine agonists may impair the systemic regulation of blood pressure, with resultant orthostatic hypotension at any time, but especially during dose escalation. Additionally, patients with Parkinson's disease may have an impaired capacity to respond to an orthostatic challenge. For these reasons, patients with Parkinson's disease (or restless legs syndrome) who are being treated with dopaminergic agonists typically require careful monitoring for signs/symptoms of orthostatic hypotension, especially during dose escalation, and should be advised of this risk.

The lidocaine in Flavalta has a major potential interaction with Liver Disease.

Lidocaine is rapidly and extensively metabolized by the liver. Less than 10% is eliminated unchanged in the urine. Several inactive and two active forms (MEGX and GX) have been identified. MEGX and GX exhibit antiarrhythmic and convulsant properties. GX accumulates during prolonged intravenous lidocaine infusion. The pharmacokinetic disposition of lidocaine is altered by changes in hepatic function, including hepatic blood flow. Therapy with lidocaine should be administered cautiously and dosing modifications for repeated or loading and maintenance doses may be necessary. Clinical monitoring of cardiac (continuous ECG) is required and serum metabolite concentrations and monitoring hepatic function are recommended.

Apomorphine has a moderate potential interaction with Liver Disease.

Apomorphine has not been studied in patients with severe liver dysfunction. Because apomorphine concentration and exposure (AUC and Cmax) is increased, caution should be exercised if apomorphine is administered to patients with mild or moderate liver dysfunction; these patients should be closely monitored.

Apomorphine has a moderate potential interaction with Long QT Syndrome.

The risks/benefits of apomorphine treatment should be considered before starting this drug in patients with risk factors for prolonged QTc. There is a dose-related prolongation of QTc interval after apomorphine exposure similar to that achieved with therapeutic doses of this drug. For the intermittent injection formulation, doses greater than 6 mg do not provide additional clinical benefit and are not recommended. Drugs that prolong QTc interval have been associated with torsades de pointes and sudden death. The link between QTc prolongation and torsades de pointes is most apparent with larger increases (20 msec and greater), but smaller QTc prolongations may also increase risk, particularly in susceptible patients (e.g., those with hypokalemia, hypomagnesemia, bradycardia, genetic predisposition [such as congenital QT interval prolongation], or concomitant use of other drugs that prolong QTc interval). Although no occurrence of torsades de pointes was reported in association with apomorphine at recommended doses in clinical trials, an increased risk cannot be ruled out due to limited experience.

The lidocaine in Flavalta has a moderate potential interaction with Magnesium Imbalance.

Electrolyte imbalance can alter the therapeutic effectiveness of antiarrhythmic agents. Hypokalemia and hypomagnesemia can reduce the effectiveness of antiarrhythmic agents. In some cases, these disorders can exaggerate the degree of QTc prolongation and increase the potential for torsade de pointes. Hyperkalemia can potentiate the toxic effects of antiarrhythmic agents. Electrolyte imbalance should be corrected prior to initiating antiarrhythmic therapy. Clinical monitoring of cardiac function and electrolyte concentrations is recommended.

The EPINEPHrine in Flavalta has a moderate potential interaction with Neurological Disorders.

Epinephrine should be administered with caution to patients with Parkinson's disease as these patients may experience psychomotor agitation or notice a temporary worsening of symptoms.

The EPINEPHrine in Flavalta has a moderate potential interaction with Parkinsonism.

Epinephrine should be administered with caution to patients with Parkinson's disease as these patients may experience psychomotor agitation or notice a temporary worsening of symptoms.

The EPINEPHrine in Flavalta has a major potential interaction with Pheochromocytoma.

Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.

Apomorphine has a moderate potential interaction with Psychosis.

Ordinarily, patients with major psychotic disorder should not be treated with dopaminergic antiparkinsonian agents, because of the risk of exacerbating psychosis. Hallucinations and psychotic-like behavior have been reported with dopaminergic medications. In addition, certain medications used to treat psychosis may exacerbate the symptoms of Parkinson's disease and may decrease the effectiveness of these drugs. The use of bromocriptine in patients with severe psychotic disorders is not recommended.

The lidocaine in Flavalta has a major potential interaction with Renal Dysfunction.

Lidocaine is primarily eliminated by the kidney. Less than 10% is eliminated unchanged in the urine. Two active metabolites (MEGX and GX) have been identified that exhibit antiarrhythmic and convulsant properties. GX accumulates during prolonged intravenous lidocaine infusion. Serum concentrations of lidocaine and the active metabolites are increased and the half-life prolonged in patients with renal impairment. Therapy with lidocaine should be administered cautiously and dosing modified for repeated or maintenance doses in patients with compromised renal function. Clinical monitoring of cardiac function (continual ECG) is required and serum metabolite concentrations and monitoring renal function are recommended.

Apomorphine has a moderate potential interaction with Renal Dysfunction.

Apomorphine has not been studied in patients with severe renal dysfunction. For patients with mild or moderate renal dysfunction using the intermittent injection formulation, the test dose and starting dose of apomorphine should be reduced to 1 mg. For patients with mild or moderate renal dysfunction using the continuous infusion formulation, the initial extra dose of apomorphine is 0.5 to 1 mg and should not exceed 1 mg; no adjustment is needed for the continuous dose, maximum recommended daily dose, or subsequent extra doses after the initial extra dose.

The lidocaine in Flavalta has a major potential interaction with Seizures.

Seizures have occurred during lidocaine therapy and have been associated with the rapid administration of a large intravenous doses or accumulation of active metabolites with maintenance therapy. Therapy with lidocaine should be administered cautiously to patients with or predisposed to seizure disorders. Clinical monitoring of cardiac (continuous ECG) is required, and serum metabolite concentrations are recommended.

Apomorphine has a moderate potential interaction with Sleep Disorders.

Somnolence is commonly associated with apomorphine. Patients treated with apomorphine have also reported falling asleep while engaged in activities of daily living, including the operation of motor vehicles, which sometimes resulted in accidents. Falling asleep while engaged in activities of daily living usually occurs in patients with preexisting somnolence, although patients may not give such a history. Before starting treatment with apomorphine, patients should be informed of the risk of drowsiness and asked about factors that could increase the risk with apomorphine, such as the presence of sleep disorders.

Apomorphine has a moderate potential interaction with Tardive Dyskinesia.

Apomorphine may cause dyskinesia or exacerbate preexisting dyskinesia. Patients should be informed that new or worsening dyskinesia may occur.