Can you take Atapryl with Lamotrigine?

lamoTRIgine has a moderate potential interaction with Autoimmune Disorders.

Therapy with lamotrigine increases the risk of aseptic meningitis. Symptoms upon presentation included headache, fever, nausea, vomiting, and nuchal rigidity and usually occurred after treatment initiation. In most cases, symptoms resolved after discontinuation of treatment but returned quickly and more severely with reexposure. Some of the patients who developed aseptic meningitis had underlying diagnoses of systemic lupus erythematosus and other autoimmune diseases.

lamoTRIgine has a moderate potential interaction with Bone Marrow Depression/Low Blood Counts.

Reports of blood dyscrasias that may or may not be associated with multi-organ hypersensitivity (also known as DRESS) have been reported in patients treated with lamotrigine. These have included neutropenia, leukopenia, anemia, thrombocytopenia, pancytopenia, and, rarely, aplastic anemia and pure red cell aplasia.

The selegiline in Atapryl has a moderate potential interaction with Cardiovascular Conditions and Disorders.

The use of selegiline has been associated with cardiovascular events such as tachycardia, bradycardia, syncope, hypertension, hypotension, arrhythmias, and aggravation of angina pectoris. Therapy with selegiline should be administered cautiously in patients with cardiac disease.

lamoTRIgine has a major potential interaction with Depression.

Antiepileptic drugs can increase depression and suicidal thoughts or behaviors in patients receiving these drugs for any indication. Patients should be monitored for the emergence or worsening of depression, suicidal thoughts and unusual changes in mood or behavior. Caregivers and family should be alert for the emergence or worsening of symptoms. Behaviors of concern should be reported immediately to the healthcare providers.

lamoTRIgine has a moderate potential interaction with Depression.

Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. AEDs should be administered cautiously in patients with depression or other psychiatric disorders; phentermine-topiramate should be avoided in patients with history of suicidal attempts or active suicidal ideation. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. If patients have symptoms of suicidal ideation or behavior, a dosage reduction or treatment discontinuation should be considered.

lamoTRIgine has a major potential interaction with Dermatitis, Drug-Induced.

Severe, potentially fatal reactions such as Stevens-Johnson syndrome and toxic epidermal necrolysis have been associated with the use of lamotrigine. The incidence has been reported at approximately 1 in 1000 for adults and up to 1 in 50 for pediatric patients treated with the drug. Life-threatening rashes have usually, but not always, occurred within 2 to 8 weeks of initiating treatment. Therapy with lamotrigine should be administered cautiously in patients with preexisting drug-induced dermatitis, since it may delay the recognition of a potential reaction to lamotrigine. Lamotrigine therapy should be withdrawn promptly at the first sign of a rash. However, discontinuation of treatment may not prevent a rash from becoming life-threatening or permanently disabling or disfiguring. There have been suggestions that the risk of rash may be increased by 1) coadministration with valproic acid, 2) exceeding the recommended initial dosage, or 3) exceeding the recommended rate of dosage escalation of lamotrigine.

The selegiline in Atapryl has a moderate potential interaction with Glaucoma/Intraocular Hypertension.

The use of selegiline may exacerbate glaucoma. Therapy with selegiline should be administered cautiously in patients with glaucoma.

lamoTRIgine has a moderate potential interaction with Heart Disease.

Lamotrigine may slow ventricular conduction (widen QRS) and induce proarrhythmia in patients with structural heart disease or myocardial ischemia. In vitro studies have shown Class IB antiarrhythmic activity at therapeutically relevant concentrations. Clinical studies have not shown antiarrhythmic activity in healthy individuals, but because of the risk of proarrhythmia, including sudden death, lamotrigine should not be used in patients who have cardiac conduction disorders (e.g., second- or third-degree heart block), ventricular arrhythmias, or cardiac disease or abnormality (e.g., myocardial ischemia, heart failure, structural heart disease, Brugada syndrome or other sodium channelopathies).

The selegiline in Atapryl has a moderate potential interaction with High Blood Pressure.

Selegiline can cause hypertensive reactions and it should be used with caution in patients with hypertension. Patients should report any symptoms such as occipital headache, palpitations, neck stiffness or soreness, nausea, sweating, dilated pupils and photophobia. Patients receiving therapy need to have monitored their blood pressure frequently to detect any evidence of pressor response. Additionally, patients should be advised to avoid foods and drinks with high tyramine content such as cheese, sour cream, beer, liver, bananas and others, as these might trigger a hypertensive crisis.

The selegiline in Atapryl has a moderate potential interaction with Hypotension.

Hypotension has been observed during therapy with monoamine oxidase inhibitors. These drugs should be used with caution, especially in patients with tendency towards hypotension or taking other drugs known to cause hypotension.

The selegiline in Atapryl 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 selegiline in Atapryl has a moderate potential interaction with Liver Disease.

Patients with mild to moderate hepatic impairment (Child-Pugh 5 to 9), may require a dose reduction of selegiline depending on their clinical response. Selegiline is not recommended in patients with severe hepatic impairment (Child-Pugh >9).

lamoTRIgine has a moderate potential interaction with Liver Disease.

Lamotrigine is primarily converted by the liver to inactive glucuronide metabolites and subsequently eliminated by the kidney. Approximately 10% of a dose is excreted in the urine as unchanged drug. The plasma clearance of lamotrigine may be decreased and the half-life prolonged in patients with impaired renal and/or hepatic function. However, clinical data are limited. In a comparison of 12 healthy subjects and 24 with various degrees of liver disease, lamotrigine pharmacokinetics were significantly altered only in patients with severe cirrhosis. Therapy with lamotrigine should be administered cautiously and at reduced dosages in such patients.

lamoTRIgine has a moderate potential interaction with Lupus Erythematosus.

Therapy with lamotrigine increases the risk of aseptic meningitis. Symptoms upon presentation included headache, fever, nausea, vomiting, and nuchal rigidity and usually occurred after treatment initiation. In most cases, symptoms resolved after discontinuation of treatment but returned quickly and more severely with reexposure. Some of the patients who developed aseptic meningitis had underlying diagnoses of systemic lupus erythematosus and other autoimmune diseases.

lamoTRIgine has a moderate potential interaction with Phenylketonuria.

Lamotrigine tablets for oral suspension (chewable dispersible tablets) contain phenylalanine. The phenylalanine content should be considered when these products are used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics).

The selegiline in Atapryl has a major potential interaction with Psychosis.

Patients with major psychotic disorders should ordinarily not be treated with selegiline because of the risk of exacerbating psychosis.

lamoTRIgine has a moderate potential interaction with Psychosis.

Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. AEDs should be administered cautiously in patients with depression or other psychiatric disorders; phentermine-topiramate should be avoided in patients with history of suicidal attempts or active suicidal ideation. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. If patients have symptoms of suicidal ideation or behavior, a dosage reduction or treatment discontinuation should be considered.

The selegiline in Atapryl has a major potential interaction with Renal Dysfunction.

Small increments in serum BUN and creatinine have been observed in patients treated with high dose of selegiline. Treatment with selegiline is not recommended in patients with severe renal impairment and end-stage renal disease (CrCl <30 mL/min).

lamoTRIgine has a moderate potential interaction with Renal Dysfunction.

Lamotrigine is primarily converted by the liver to inactive glucuronide metabolites and subsequently eliminated by the kidney. Approximately 10% of a dose is excreted in the urine as unchanged drug. The plasma clearance of lamotrigine may be decreased and the half-life prolonged in patients with impaired renal and/or hepatic function. However, clinical data are limited. In a comparison of 12 healthy subjects and 24 with various degrees of liver disease, lamotrigine pharmacokinetics were significantly altered only in patients with severe cirrhosis. Therapy with lamotrigine should be administered cautiously and at reduced dosages in such patients.

The selegiline in Atapryl has a moderate potential interaction with Skin Cancer.

Patients with Parkinson's disease have a higher risk of developing melanoma than the general population. Patients and providers should be advised to monitor for melanoma frequently and regularly when using selegiline. Skin examinations should be performed by qualified individuals (e.g., dermatologists).

The selegiline in Atapryl has a moderate potential interaction with Sleep Disorders.

Selegiline should be used with caution in patients with sleep disorders as it can cause somnolence. Patients should exercise caution when driving, operating machines, or working at heights during treatment. Treatment should be discontinued if patients develop daytime sleepiness with episodes of falling asleep during activities such as conversation, eating, etc. If not discontinued, patients should be very cautious about the activities that they engage in that could be potentially dangerous. Prescribers should question the patients specifically about somnolence, as it is rarely reported by patients, and ask about sleep disorders and the use of concomitant sedating medications.

The selegiline in Atapryl has a moderate potential interaction with Urinary Retention.

The use of selegiline may exacerbate urinary retention. Therapy with selegiline should be administered cautiously in patients with urinary retention or obstruction.