Can you take Apresazide with Ipilimumab?
2 drug interactions and 45 additional warnings found for the following 2 drugs:
- Apresazide (hydralazine/hydrochlorothiazide)
- ipilimumab
Drug interactions
Moderate drug interactions
Moderate:
hydrALAZINE hydroCHLOROthiazide
Applies to: Apresazide (hydralazine / hydrochlorothiazide) and Apresazide (hydralazine / hydrochlorothiazide)
HydroCHLOROthiazide may add to the blood pressure lowering effects of hydrALAZINE. You may need a dose adjustment or more frequent monitoring of your blood pressure to safely use both medications.
Contact your doctor if you experience:
- dizziness
- weakness
- fatigue
- lightheadedness
- headache
- flushing
- fainting
- a rapid pulse or heart rate
Avoid driving or operating hazardous machinery until you know how these medications affect you, and use caution when getting up from a sitting or lying position.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Moderate:
hydrALAZINE ipilimumab
Applies to: Apresazide (hydralazine / hydrochlorothiazide) and ipilimumab
Using hydrALAZINE together with ipilimumab may increase the risk of nerve damage, which is a potential side effect of both medications.
Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications.
Let your doctor know if you develop weakness, numbness, pain, burning, or tingling in your hands, feet, or limbs.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
hydrALAZINE Alcohol (Ethanol)
Applies to: Apresazide (hydralazine / hydrochlorothiazide)
Ethanol and hydrALAZINE may have additive effects in lowering your blood pressure.
You may experience headache, dizziness, lightheadedness, fainting, or changes in pulse or heart rate, especially when treatment is started, the dose is changed, or treatment is restarted.
Tell your doctor promptly if these symptoms occur and seek urgent medical help if you faint or have severe dizziness.
Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Moderate:
hydroCHLOROthiazide Alcohol (Ethanol)
Applies to: Apresazide (hydralazine / hydrochlorothiazide)
Ethanol and hydroCHLOROthiazide may have additive effects in lowering your blood pressure.
You may experience headache, dizziness, lightheadedness, fainting, or changes in pulse or heart rate, especially when treatment is started, the dose is changed, or treatment is restarted.
Tell your doctor promptly if these symptoms occur and seek urgent medical help if you faint or have severe dizziness.
Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Disease interactions
43 potential interactions Applies to: 39 conditions, including High Cholesterol, Allergies, Underactive Thyroid, Asthma, and Gout.
Abnormal Glucose Tolerance
Moderate:
Apresazide
The hydroCHLOROthiazide in Apresazide has a moderate potential interaction with Abnormal Glucose Tolerance.
Thiazide diuretics may cause hyperglycemia and glycosuria in patients with diabetes. They may also precipitate diabetes in prediabetic patients. These effects are usually reversible following discontinuation of the drugs. Therapy with thiazide diuretics should be administered cautiously in patients with diabetes mellitus, glucose intolerance, or a predisposition to hyperglycemia. Patients with diabetes mellitus should be monitored more closely during thiazide therapy, and their antidiabetic regimen adjusted accordingly.
Adrenal Insufficiency
Major:
ipilimumab
Ipilimumab has a major potential interaction with Adrenal Insufficiency.
Immune-mediated endocrinopathies, including severe to life-threatening cases, have occurred with ipilimumab therapy. It is recommended to monitor for signs/symptoms that may be clinical manifestations of underlying immune-mediated adverse reactions. Clinical chemistries (including adrenocorticotropic hormone [ACTH] level and thyroid function) should be evaluated at baseline and before each dose. Medical management should be started promptly, including specialty consultation as appropriate. Ipilimumab should be withheld or permanently discontinued depending on severity of endocrinopathies.
Allergies
Major:
ipilimumab
Ipilimumab has a major potential interaction with Allergies.
Ipilimumab can cause immune-mediated rash or dermatitis (including bullous and exfoliative dermatitis, Stevens-Johnson syndrome [SJS], toxic epidermal necrolysis [TEN], and drug rash with eosinophilia and systemic symptoms [DRESS]). Topical emollients and/or topical corticosteroids may be adequate to treat mild to moderate non-bullous/exfoliative rashes. Ipilimumab should be withheld for suspected SJS, TEN, or DRESS and permanently discontinued for confirmed SJS, TEN, or DRESS.
Anuria
Major:
Apresazide
The hydroCHLOROthiazide in Apresazide has a major potential interaction with Anuria.
The use of thiazide diuretics is contraindicated in patients with anuria.
Asthma
Moderate:
Apresazide
The hydroCHLOROthiazide in Apresazide has a moderate potential interaction with Asthma.
Thiazide diuretics should be used with caution in patients with history of bronchial asthma as sensitivity reactions may occur.
Autoimmune Disorders
Major:
ipilimumab
Ipilimumab has a major potential interaction with Autoimmune Disorders.
Ipilimumab can cause immune-mediated adverse reactions, which may be severe or fatal. Immune-mediated adverse reactions can occur in any organ system or tissue. Care should be exercised when using ipilimumab in patients with preexisting immune system disorders (e.g., ulcerative colitis, Crohn's disease, lupus). It is recommended to monitor for signs/symptoms that may be clinical manifestations of underlying immune-mediated adverse reactions. Clinical chemistries (including liver enzymes, creatinine, adrenocorticotropic hormone [ACTH] level, and thyroid function) should be evaluated at baseline and before each dose. Medical management should be started promptly, including specialty consultation as appropriate. Ipilimumab should be withheld or permanently discontinued depending on severity.
Autonomic Neuropathy
Major:
ipilimumab
Ipilimumab has a major potential interaction with Autonomic Neuropathy.
Ipilimumab can cause immune-mediated adverse reactions, which may be severe or fatal. Immune-mediated adverse reactions can occur in any organ system or tissue. Care should be exercised when using ipilimumab in patients with preexisting immune system disorders (e.g., ulcerative colitis, Crohn's disease, lupus). It is recommended to monitor for signs/symptoms that may be clinical manifestations of underlying immune-mediated adverse reactions. Clinical chemistries (including liver enzymes, creatinine, adrenocorticotropic hormone [ACTH] level, and thyroid function) should be evaluated at baseline and before each dose. Medical management should be started promptly, including specialty consultation as appropriate. Ipilimumab should be withheld or permanently discontinued depending on severity.
Bone Marrow Depression/Low Blood Counts
Major:
Apresazide
The hydrALAZINE in Apresazide has a major potential interaction with Bone Marrow Depression/Low Blood Counts.
Hydralazine may rarely cause blood dyscrasias at recommended dosages. Reduction in hemoglobin, red cell count, agranulocytosis, leukopenia, and purpura have been reported. Therapy with hydralazine should be administered cautiously in patients with these preexisting conditions and if such abnormalities develop during the course of therapy, treatment should be discontinued. Monitoring blood counts should be considered for those patients at higher risk.
Bone Marrow Transplantation
Major:
ipilimumab
Ipilimumab has a major potential interaction with Bone Marrow Transplantation.
Fatal or serious graft-versus-host disease (GVHD) can occur in patients who receive ipilimumab either before or after allogeneic hematopoietic stem cell transplantation (HSCT). These complications may occur despite intervening therapy between cytotoxic T-lymphocyte antigen 4 (CTLA-4) receptor blocking antibody and allogeneic HSCT. It is recommended to monitor patients closely for evidence of GVHD and intervene promptly. The benefit versus risks of treatment with ipilimumab after allogeneic HSCT should be considered.
Cerebral Vascular Disorder
Moderate:
Apresazide
The hydrALAZINE in Apresazide has a moderate potential interaction with Cerebral Vascular Disorder.
The vasodilatory effects of hydralazine may aggravate cerebral vasculopathy. Therapy with hydralazine should be administered cautiously in patients with cerebral vasculopathy.
Dehydration
Major:
Apresazide
The hydroCHLOROthiazide in Apresazide has a major potential interaction with Dehydration.
The use of thiazide diuretics is commonly associated with loss of electrolytes, most significantly potassium but also sodium, chloride, bicarbonate, and magnesium. The loss of other electrolytes such as phosphate, bromide and iodide is usually slight. Potassium and magnesium depletion may lead to cardiac arrhythmias and cardiac arrest. Other electrolyte-related complications include metabolic alkalosis and hyponatremia, which are rarely life-threatening. Therapy with thiazide diuretics should be administered cautiously in patients with or predisposed to fluid and electrolyte depletion, including patients with primary or secondary aldosteronism (may have low potassium levels); those with severe or prolonged diarrhea or vomiting; and those with poor nutritional status. Fluid and electrolyte abnormalities should be corrected prior to initiating therapy, and blood pressure as well as serum electrolyte concentrations monitored periodically and maintained at normal ranges during therapy. Patients should be advised to immediately report signs and symptoms of fluid or electrolyte imbalance, including dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, arrhythmia, or gastrointestinal disturbances such as nausea and vomiting. Digitalized patients and patients with a history of ventricular arrhythmias should be monitored carefully, since development of hypokalemia may be particularly dangerous in these patients. The risk of hypokalemia may be minimized by slow diuresis, a lower thiazide dosage, potassium supplementation, or combined use with a potassium-sparing diuretic.
Dermatitis Herpetiformis
Major:
ipilimumab
Ipilimumab has a major potential interaction with Dermatitis Herpetiformis.
Ipilimumab can cause immune-mediated rash or dermatitis (including bullous and exfoliative dermatitis, Stevens-Johnson syndrome [SJS], toxic epidermal necrolysis [TEN], and drug rash with eosinophilia and systemic symptoms [DRESS]). Topical emollients and/or topical corticosteroids may be adequate to treat mild to moderate non-bullous/exfoliative rashes. Ipilimumab should be withheld for suspected SJS, TEN, or DRESS and permanently discontinued for confirmed SJS, TEN, or DRESS.
Diabetes Mellitus
Moderate:
Apresazide
The hydroCHLOROthiazide in Apresazide has a moderate potential interaction with Diabetes Mellitus.
Thiazide diuretics may cause hyperglycemia and glycosuria in patients with diabetes. They may also precipitate diabetes in prediabetic patients. These effects are usually reversible following discontinuation of the drugs. Therapy with thiazide diuretics should be administered cautiously in patients with diabetes mellitus, glucose intolerance, or a predisposition to hyperglycemia. Patients with diabetes mellitus should be monitored more closely during thiazide therapy, and their antidiabetic regimen adjusted accordingly.
Diarrhea
Major:
Apresazide
The hydroCHLOROthiazide in Apresazide has a major potential interaction with Diarrhea.
The use of thiazide diuretics is commonly associated with loss of electrolytes, most significantly potassium but also sodium, chloride, bicarbonate, and magnesium. The loss of other electrolytes such as phosphate, bromide and iodide is usually slight. Potassium and magnesium depletion may lead to cardiac arrhythmias and cardiac arrest. Other electrolyte-related complications include metabolic alkalosis and hyponatremia, which are rarely life-threatening. Therapy with thiazide diuretics should be administered cautiously in patients with or predisposed to fluid and electrolyte depletion, including patients with primary or secondary aldosteronism (may have low potassium levels); those with severe or prolonged diarrhea or vomiting; and those with poor nutritional status. Fluid and electrolyte abnormalities should be corrected prior to initiating therapy, and blood pressure as well as serum electrolyte concentrations monitored periodically and maintained at normal ranges during therapy. Patients should be advised to immediately report signs and symptoms of fluid or electrolyte imbalance, including dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, arrhythmia, or gastrointestinal disturbances such as nausea and vomiting. Digitalized patients and patients with a history of ventricular arrhythmias should be monitored carefully, since development of hypokalemia may be particularly dangerous in these patients. The risk of hypokalemia may be minimized by slow diuresis, a lower thiazide dosage, potassium supplementation, or combined use with a potassium-sparing diuretic.
Electrolyte Abnormalities
Major:
Apresazide
The hydroCHLOROthiazide in Apresazide has a major potential interaction with Electrolyte Abnormalities.
The use of thiazide diuretics is commonly associated with loss of electrolytes, most significantly potassium but also sodium, chloride, bicarbonate, and magnesium. The loss of other electrolytes such as phosphate, bromide and iodide is usually slight. Potassium and magnesium depletion may lead to cardiac arrhythmias and cardiac arrest. Other electrolyte-related complications include metabolic alkalosis and hyponatremia, which are rarely life-threatening. Therapy with thiazide diuretics should be administered cautiously in patients with or predisposed to fluid and electrolyte depletion, including patients with primary or secondary aldosteronism (may have low potassium levels); those with severe or prolonged diarrhea or vomiting; and those with poor nutritional status. Fluid and electrolyte abnormalities should be corrected prior to initiating therapy, and blood pressure as well as serum electrolyte concentrations monitored periodically and maintained at normal ranges during therapy. Patients should be advised to immediately report signs and symptoms of fluid or electrolyte imbalance, including dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, arrhythmia, or gastrointestinal disturbances such as nausea and vomiting. Digitalized patients and patients with a history of ventricular arrhythmias should be monitored carefully, since development of hypokalemia may be particularly dangerous in these patients. The risk of hypokalemia may be minimized by slow diuresis, a lower thiazide dosage, potassium supplementation, or combined use with a potassium-sparing diuretic.
Glomerulonephritis
Moderate:
Apresazide
The hydrALAZINE in Apresazide has a moderate potential interaction with Glomerulonephritis.
The use of hydralazine has been associated with the development of glomerulonephritis. Hydralazine should be used with caution in patients with advanced renal damage and these patients may require a lower dose. Renal function should be monitored and supported as required.
Gout
Moderate:
Apresazide
The hydroCHLOROthiazide in Apresazide has a moderate potential interaction with Gout.
Thiazide diuretics decrease the rate of uric acid excretion. Hyperuricemia occurs frequently but is usually asymptomatic and rarely leads to clinical gout except in patients with a history of gout or chronic renal failure. Therapy with thiazide diuretics should be administered cautiously in such patients.
High Cholesterol
Moderate:
Apresazide
The hydroCHLOROthiazide in Apresazide has a moderate potential interaction with High Cholesterol.
Thiazide diuretics may increase serum triglyceride and cholesterol levels, primarily LDL and VLDL. Whether these effects are dose-related and sustained during chronic therapy are unknown. Patients with preexisting hyperlipidemia may require closer monitoring during thiazide therapy, and adjustments made accordingly in their lipid-lowering regimen
Hyperaldosteronism
Major:
Apresazide
The hydroCHLOROthiazide in Apresazide has a major potential interaction with Hyperaldosteronism.
The use of thiazide diuretics is commonly associated with loss of electrolytes, most significantly potassium but also sodium, chloride, bicarbonate, and magnesium. The loss of other electrolytes such as phosphate, bromide and iodide is usually slight. Potassium and magnesium depletion may lead to cardiac arrhythmias and cardiac arrest. Other electrolyte-related complications include metabolic alkalosis and hyponatremia, which are rarely life-threatening. Therapy with thiazide diuretics should be administered cautiously in patients with or predisposed to fluid and electrolyte depletion, including patients with primary or secondary aldosteronism (may have low potassium levels); those with severe or prolonged diarrhea or vomiting; and those with poor nutritional status. Fluid and electrolyte abnormalities should be corrected prior to initiating therapy, and blood pressure as well as serum electrolyte concentrations monitored periodically and maintained at normal ranges during therapy. Patients should be advised to immediately report signs and symptoms of fluid or electrolyte imbalance, including dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, arrhythmia, or gastrointestinal disturbances such as nausea and vomiting. Digitalized patients and patients with a history of ventricular arrhythmias should be monitored carefully, since development of hypokalemia may be particularly dangerous in these patients. The risk of hypokalemia may be minimized by slow diuresis, a lower thiazide dosage, potassium supplementation, or combined use with a potassium-sparing diuretic.
Hyperparathyroidism
Moderate:
Apresazide
The hydroCHLOROthiazide in Apresazide has a moderate potential interaction with Hyperparathyroidism.
Urinary calcium excretion is decreased by thiazide diuretics during chronic administration. Pathologic changes in the parathyroid gland with hypercalcemia and hypophosphatemia have been reported during prolonged therapy. However, the common complications of hyperparathyroidism such as renal lithiasis, bone resorption, and peptic ulceration have not been seen. Clinicians should be cognizant of these effects when prescribing or administering thiazide therapy to patients with hyperparathyroidism. These drugs should be discontinued before carrying out tests for parathyroid function.
Hyperthyroidism
Major:
ipilimumab
Ipilimumab has a major potential interaction with Hyperthyroidism.
Immune-mediated endocrinopathies, including severe to life-threatening cases, have occurred with ipilimumab therapy. It is recommended to monitor for signs/symptoms that may be clinical manifestations of underlying immune-mediated adverse reactions. Clinical chemistries (including adrenocorticotropic hormone [ACTH] level and thyroid function) should be evaluated at baseline and before each dose. Medical management should be started promptly, including specialty consultation as appropriate. Ipilimumab should be withheld or permanently discontinued depending on severity of endocrinopathies.
Hypokalemia
Major:
Apresazide
The hydroCHLOROthiazide in Apresazide has a major potential interaction with Hypokalemia.
The use of thiazide diuretics is commonly associated with loss of electrolytes, most significantly potassium but also sodium, chloride, bicarbonate, and magnesium. The loss of other electrolytes such as phosphate, bromide and iodide is usually slight. Potassium and magnesium depletion may lead to cardiac arrhythmias and cardiac arrest. Other electrolyte-related complications include metabolic alkalosis and hyponatremia, which are rarely life-threatening. Therapy with thiazide diuretics should be administered cautiously in patients with or predisposed to fluid and electrolyte depletion, including patients with primary or secondary aldosteronism (may have low potassium levels); those with severe or prolonged diarrhea or vomiting; and those with poor nutritional status. Fluid and electrolyte abnormalities should be corrected prior to initiating therapy, and blood pressure as well as serum electrolyte concentrations monitored periodically and maintained at normal ranges during therapy. Patients should be advised to immediately report signs and symptoms of fluid or electrolyte imbalance, including dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, arrhythmia, or gastrointestinal disturbances such as nausea and vomiting. Digitalized patients and patients with a history of ventricular arrhythmias should be monitored carefully, since development of hypokalemia may be particularly dangerous in these patients. The risk of hypokalemia may be minimized by slow diuresis, a lower thiazide dosage, potassium supplementation, or combined use with a potassium-sparing diuretic.
Hyponatremia
Major:
Apresazide
The hydroCHLOROthiazide in Apresazide has a major potential interaction with Hyponatremia.
The use of thiazide diuretics is commonly associated with loss of electrolytes, most significantly potassium but also sodium, chloride, bicarbonate, and magnesium. The loss of other electrolytes such as phosphate, bromide and iodide is usually slight. Potassium and magnesium depletion may lead to cardiac arrhythmias and cardiac arrest. Other electrolyte-related complications include metabolic alkalosis and hyponatremia, which are rarely life-threatening. Therapy with thiazide diuretics should be administered cautiously in patients with or predisposed to fluid and electrolyte depletion, including patients with primary or secondary aldosteronism (may have low potassium levels); those with severe or prolonged diarrhea or vomiting; and those with poor nutritional status. Fluid and electrolyte abnormalities should be corrected prior to initiating therapy, and blood pressure as well as serum electrolyte concentrations monitored periodically and maintained at normal ranges during therapy. Patients should be advised to immediately report signs and symptoms of fluid or electrolyte imbalance, including dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, arrhythmia, or gastrointestinal disturbances such as nausea and vomiting. Digitalized patients and patients with a history of ventricular arrhythmias should be monitored carefully, since development of hypokalemia may be particularly dangerous in these patients. The risk of hypokalemia may be minimized by slow diuresis, a lower thiazide dosage, potassium supplementation, or combined use with a potassium-sparing diuretic.
Infectious Gastroenteritis
Major:
ipilimumab
Ipilimumab has a major potential interaction with Infectious Gastroenteritis.
Ipilimumab can cause immune-mediated colitis, which may be fatal. CMV infection/reactivation has been reported in patients with corticosteroid-refractory immune-mediated colitis; repeating infectious workup should be considered in these patients to exclude alternative etiologies. Ipilimumab should be withheld or permanently discontinued depending on severity of colitis.
Inflammatory Bowel Disease
Major:
ipilimumab
Ipilimumab has a major potential interaction with Inflammatory Bowel Disease.
Ipilimumab can cause immune-mediated colitis, which may be fatal. CMV infection/reactivation has been reported in patients with corticosteroid-refractory immune-mediated colitis; repeating infectious workup should be considered in these patients to exclude alternative etiologies. Ipilimumab should be withheld or permanently discontinued depending on severity of colitis.
Ischemic Heart Disease
Major:
Apresazide
The hydrALAZINE in Apresazide has a major potential interaction with Ischemic Heart Disease.
The use of hydralazine is contraindicated in patients with coronary artery disease. Reflex tachycardia may commonly occur. Palpitations and chest pain have also been reported. Myocardial infarction has been associated with the use of hydralazine.
Liver Disease
Major:
Apresazide
The hydroCHLOROthiazide in Apresazide has a major potential interaction with Liver Disease.
Patients with severe liver disease or cirrhosis are very susceptible to thiazide-induced hypokalemic hypochloremic alkalosis. Blood ammonia concentrations may be further increased in patients with previously elevated concentrations. Hepatic encephalopathy and death have occurred secondary to the electrolyte alterations accompanying diuretic use. Therapy with thiazide diuretics should be administered cautiously in patients with impaired hepatic function or progressive liver disease, and discontinued promptly if signs of impending hepatic coma appear (e.g., tremors, confusion, and increased jaundice).
Major:
ipilimumab
Ipilimumab has a major potential interaction with Liver Disease.
Ipilimumab can cause immune-mediated adverse reactions, which may be severe or fatal. Immune-mediated hepatitis has occurred with ipilimumab therapy. It is recommended to monitor for signs/symptoms that may be clinical manifestations of underlying immune-mediated adverse reactions. Clinical chemistries (including liver enzymes) should be evaluated at baseline and before each dose. Ipilimumab should be withheld or permanently discontinued depending on severity of hepatitis.
Moderate:
ipilimumab
Ipilimumab has a moderate potential interaction with Liver Disease.
Care should be exercised when using ipilimumab in patients with moderate (total bilirubin greater than 1.5 to 3 times the upper limit of normal [1.5 to 3 x ULN] and any AST) or severe (total bilirubin greater than 3 x ULN and any AST) liver dysfunction as ipilimumab has not been studied in these patients. Mild liver dysfunction (total bilirubin greater than 1 to 1.5 x ULN or AST greater than ULN) had no clinically significant effect on the clearance of ipilimumab.
Lupus Erythematosus
Major:
Apresazide
The hydroCHLOROthiazide in Apresazide has a major potential interaction with Lupus Erythematosus.
The use of thiazide diuretics has been reported to possibly exacerbate or activate systemic lupus erythematosus. Reported cases have generally been associated with chlorothiazide and hydrochlorothiazide. Therapy with thiazide diuretics should be administered cautiously in patients with a history or risk of SLE.
Major:
Apresazide
The hydrALAZINE in Apresazide has a major potential interaction with Lupus Erythematosus.
The use of hydralazine has been associated with the development of lupus erythematosus and lupus-like syndromes, as well as exacerbation of the disease. Hydralazine therapy should be withdrawn in patients experiencing worsening of preexisting lupus. Monitoring complete blood counts, and antinuclear antibody titers before and during prolonged therapy is recommended.
Magnesium Imbalance
Major:
Apresazide
The hydroCHLOROthiazide in Apresazide has a major potential interaction with Magnesium Imbalance.
The use of thiazide diuretics is commonly associated with loss of electrolytes, most significantly potassium but also sodium, chloride, bicarbonate, and magnesium. The loss of other electrolytes such as phosphate, bromide and iodide is usually slight. Potassium and magnesium depletion may lead to cardiac arrhythmias and cardiac arrest. Other electrolyte-related complications include metabolic alkalosis and hyponatremia, which are rarely life-threatening. Therapy with thiazide diuretics should be administered cautiously in patients with or predisposed to fluid and electrolyte depletion, including patients with primary or secondary aldosteronism (may have low potassium levels); those with severe or prolonged diarrhea or vomiting; and those with poor nutritional status. Fluid and electrolyte abnormalities should be corrected prior to initiating therapy, and blood pressure as well as serum electrolyte concentrations monitored periodically and maintained at normal ranges during therapy. Patients should be advised to immediately report signs and symptoms of fluid or electrolyte imbalance, including dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, arrhythmia, or gastrointestinal disturbances such as nausea and vomiting. Digitalized patients and patients with a history of ventricular arrhythmias should be monitored carefully, since development of hypokalemia may be particularly dangerous in these patients. The risk of hypokalemia may be minimized by slow diuresis, a lower thiazide dosage, potassium supplementation, or combined use with a potassium-sparing diuretic.
Malnourishment
Major:
Apresazide
The hydroCHLOROthiazide in Apresazide has a major potential interaction with Malnourishment.
The use of thiazide diuretics is commonly associated with loss of electrolytes, most significantly potassium but also sodium, chloride, bicarbonate, and magnesium. The loss of other electrolytes such as phosphate, bromide and iodide is usually slight. Potassium and magnesium depletion may lead to cardiac arrhythmias and cardiac arrest. Other electrolyte-related complications include metabolic alkalosis and hyponatremia, which are rarely life-threatening. Therapy with thiazide diuretics should be administered cautiously in patients with or predisposed to fluid and electrolyte depletion, including patients with primary or secondary aldosteronism (may have low potassium levels); those with severe or prolonged diarrhea or vomiting; and those with poor nutritional status. Fluid and electrolyte abnormalities should be corrected prior to initiating therapy, and blood pressure as well as serum electrolyte concentrations monitored periodically and maintained at normal ranges during therapy. Patients should be advised to immediately report signs and symptoms of fluid or electrolyte imbalance, including dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, arrhythmia, or gastrointestinal disturbances such as nausea and vomiting. Digitalized patients and patients with a history of ventricular arrhythmias should be monitored carefully, since development of hypokalemia may be particularly dangerous in these patients. The risk of hypokalemia may be minimized by slow diuresis, a lower thiazide dosage, potassium supplementation, or combined use with a potassium-sparing diuretic.
Organ Transplant
Moderate:
ipilimumab
Ipilimumab has a moderate potential interaction with Organ Transplant.
Solid organ transplant rejection has been reported during postmarketing experience with ipilimumab. Care should be exercised when using ipilimumab in patients who have received a solid organ transplant.
Pulmonary Impairment
Moderate:
ipilimumab
Ipilimumab has a moderate potential interaction with Pulmonary Impairment.
Ipilimumab can cause immune-mediated pneumonitis. Care should be exercised when using ipilimumab in patients with preexisting pulmonary impairment. Ipilimumab should be withheld or permanently discontinued depending on severity of pneumonitis.
Renal Dysfunction
Major:
Apresazide
The hydroCHLOROthiazide in Apresazide has a major potential interaction with Renal Dysfunction.
Thiazide diuretics may be ineffective when the glomerular filtration rate is low (GFR < 25 mL/min) because they are not expected to be filtered into the renal tubule, their site of action. In addition, thiazide diuretics decrease the GFR and may precipitate azotemia in renal disease. Cumulative effects may also develop because most of these drugs are excreted unchanged in the urine by glomerular filtration and active tubular secretion. Therapy with thiazide diuretics should be administered cautiously at reduced dosages in patients with renal impairment. If renal function becomes progressively worse, as indicated by rising BUN or serum creatinine levels, an interruption or discontinuation of thiazide therapy should be considered.
Moderate:
Apresazide
The hydrALAZINE in Apresazide has a moderate potential interaction with Renal Dysfunction.
The use of hydralazine has been associated with the development of glomerulonephritis. Hydralazine should be used with caution in patients with advanced renal damage and these patients may require a lower dose. Renal function should be monitored and supported as required.
Thyroid Disease
Moderate:
Apresazide
The hydroCHLOROthiazide in Apresazide has a moderate potential interaction with Thyroid Disease.
Thiazide diuretics may decrease serum PBI (protein-bound iodine) levels without associated thyroid disturbance. Clinicians should be cognizant of this effect when prescribing or administering thiazide therapy to patients with thyroid disorders.
Underactive Thyroid
Major:
ipilimumab
Ipilimumab has a major potential interaction with Underactive Thyroid.
Immune-mediated endocrinopathies, including severe to life-threatening cases, have occurred with ipilimumab therapy. It is recommended to monitor for signs/symptoms that may be clinical manifestations of underlying immune-mediated adverse reactions. Clinical chemistries (including adrenocorticotropic hormone [ACTH] level and thyroid function) should be evaluated at baseline and before each dose. Medical management should be started promptly, including specialty consultation as appropriate. Ipilimumab should be withheld or permanently discontinued depending on severity of endocrinopathies.
Valvular Heart Disease
Major:
Apresazide
The hydrALAZINE in Apresazide has a major potential interaction with Valvular Heart Disease.
The use of hydralazine is contraindicated in patients with mitral valvular rheumatic heart disease.
Ventricular Arrhythmia
Major:
Apresazide
The hydroCHLOROthiazide in Apresazide has a major potential interaction with Ventricular Arrhythmia.
The use of thiazide diuretics is commonly associated with loss of electrolytes, most significantly potassium but also sodium, chloride, bicarbonate, and magnesium. The loss of other electrolytes such as phosphate, bromide and iodide is usually slight. Potassium and magnesium depletion may lead to cardiac arrhythmias and cardiac arrest. Other electrolyte-related complications include metabolic alkalosis and hyponatremia, which are rarely life-threatening. Therapy with thiazide diuretics should be administered cautiously in patients with or predisposed to fluid and electrolyte depletion, including patients with primary or secondary aldosteronism (may have low potassium levels); those with severe or prolonged diarrhea or vomiting; and those with poor nutritional status. Fluid and electrolyte abnormalities should be corrected prior to initiating therapy, and blood pressure as well as serum electrolyte concentrations monitored periodically and maintained at normal ranges during therapy. Patients should be advised to immediately report signs and symptoms of fluid or electrolyte imbalance, including dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, arrhythmia, or gastrointestinal disturbances such as nausea and vomiting. Digitalized patients and patients with a history of ventricular arrhythmias should be monitored carefully, since development of hypokalemia may be particularly dangerous in these patients. The risk of hypokalemia may be minimized by slow diuresis, a lower thiazide dosage, potassium supplementation, or combined use with a potassium-sparing diuretic.
Visual Defect/Disturbance
Major:
ipilimumab
Ipilimumab has a major potential interaction with Visual Defect/Disturbance.
Ipilimumab can cause immune-mediated adverse reactions, which may be severe or fatal. It is recommended to monitor for signs/symptoms that may be clinical manifestations of underlying immune-mediated adverse reactions. Ipilimumab should be permanently discontinued for a Grade 2, 3, or 4 ophthalmologic adverse reaction that does not improve to Grade 1 within 2 weeks while receiving topical therapy or if systemic therapy is required.
Vomiting
Major:
Apresazide
The hydroCHLOROthiazide in Apresazide has a major potential interaction with Vomiting.
The use of thiazide diuretics is commonly associated with loss of electrolytes, most significantly potassium but also sodium, chloride, bicarbonate, and magnesium. The loss of other electrolytes such as phosphate, bromide and iodide is usually slight. Potassium and magnesium depletion may lead to cardiac arrhythmias and cardiac arrest. Other electrolyte-related complications include metabolic alkalosis and hyponatremia, which are rarely life-threatening. Therapy with thiazide diuretics should be administered cautiously in patients with or predisposed to fluid and electrolyte depletion, including patients with primary or secondary aldosteronism (may have low potassium levels); those with severe or prolonged diarrhea or vomiting; and those with poor nutritional status. Fluid and electrolyte abnormalities should be corrected prior to initiating therapy, and blood pressure as well as serum electrolyte concentrations monitored periodically and maintained at normal ranges during therapy. Patients should be advised to immediately report signs and symptoms of fluid or electrolyte imbalance, including dry mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, arrhythmia, or gastrointestinal disturbances such as nausea and vomiting. Digitalized patients and patients with a history of ventricular arrhythmias should be monitored carefully, since development of hypokalemia may be particularly dangerous in these patients. The risk of hypokalemia may be minimized by slow diuresis, a lower thiazide dosage, potassium supplementation, or combined use with a potassium-sparing diuretic.
More resources
Apresazide
A total of 675 drugs are known to interact with Apresazide.
- Apresazide is in the drug class miscellaneous antihypertensive combinations.
- Apresazide is used to treat the following conditions:
ipilimumab
A total of 680 drugs are known to interact with ipilimumab.
- Ipilimumab is in the drug class anti-CTLA-4 monoclonal antibodies.
- Ipilimumab is used to treat the following conditions:
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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