Can you take Bitolterol with Loperamide?
1 drug interaction and 13 additional warnings found for the following 2 drugs:
- bitolterol
- loperamide
Drug interactions
Moderate drug interactions
Moderate:
bitolterol loperamide
Applies to: bitolterol and loperamide
Using excessive doses of loperamide can cause serious and potentially fatal complications such as irregular heart rhythm and cardiac arrest, and the risk may be increased when combined with other medications that can also cause cardiac problems such as bitolterol.
You may also be more susceptible if you have:
- a heart condition called congenital long QT syndrome
- other cardiac diseases
- conduction abnormalities
- electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting)
Do not exceed the dose and frequency or duration of use of loperamide recommended on the product label or prescribed by your doctor. Talk to your doctor if you have any questions or concerns.
You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone.
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:
loperamide Food/Lifestyle
Applies to: loperamide
Alcohol can increase the nervous system side effects of loperamide such as:
- dizziness
- drowsiness
- difficulty concentrating
Some people may also experience impairment in thinking and judgment.
You should avoid or limit the use of alcohol while being treated with loperamide.
Do not use more than the recommended dose of loperamide, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you.
Talk to your doctor or pharmacist if you have any questions or concerns.
Moderate:
bitolterol Caffeine
Applies to: bitolterol
Both bitolterol and caffeine can increase blood pressure and heart rate, and combining them may enhance these effects.
Talk to your doctor before using these medications, especially if you have a history of high blood pressure or heart disease. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications.
Contact your doctor if your condition changes or you experience increased side effects.
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
11 potential interactions Applies to: 11 conditions, including High Blood Pressure, Seizures, Hypokalemia, Hyperthyroidism, and Inflammatory Bowel Disease.
Dehydration
Moderate:
loperamide
Loperamide has a moderate potential interaction with Dehydration.
Diarrhea can cause severe dehydration and electrolyte imbalance. Fluid accumulation within the GI track due to antiperistaltic-associated decrease in peristalsis can further aggravate dehydration and electrolyte imbalance. Antiperistaltic agents should be administered cautiously in patients with electrolyte imbalance and rehydration and electrolyte replacement should be initiated prior to initiation of therapy.
Diabetes Mellitus
Moderate:
bitolterol
Bitolterol has a moderate potential interaction with Diabetes Mellitus.
Adrenergic bronchodilators 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. Large doses of IV albuterol (not commercially available in the U.S.) and terbutaline sulfate have been reported to cause exacerbation of preexisting diabetes mellitus and ketoacidosis. Therapy with adrenergic bronchodilators should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate. Systemic adverse effects are minimized, but not abolished, by administration of these agents via oral inhalation.
Heart Disease
Moderate:
bitolterol
Bitolterol has a moderate potential interaction with Heart Disease.
Adrenergic bronchodilators can stimulate cardiovascular beta- 1 and beta- 2 receptors, resulting in adverse effects such as tachycardia, palpitation, peripheral vasodilation, blood pressure changes, and ECG changes (e.g., flattening of the T wave; prolongation of the QT interval; ST segment depression). Direct stimulation of cardiac tissues is mediated by beta- 1 receptors and thus less likely to occur with beta-2-selective agents such as albuterol. However, beta-2-selectivity is not absolute and can be lost with larger doses. High dosages of these agents have been associated with precipitation or aggravation of angina, myocardial ischemia, and cardiac arrhythmias. Therapy with adrenergic bronchodilators should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, and/or underlying cardiovascular disorders such as coronary insufficiency, cardiac arrhythmias, or hypertension. The recommended dosages should not be exceeded.
High Blood Pressure
Moderate:
bitolterol
Bitolterol has a moderate potential interaction with High Blood Pressure.
Adrenergic bronchodilators can stimulate cardiovascular beta- 1 and beta- 2 receptors, resulting in adverse effects such as tachycardia, palpitation, peripheral vasodilation, blood pressure changes, and ECG changes (e.g., flattening of the T wave; prolongation of the QT interval; ST segment depression). Direct stimulation of cardiac tissues is mediated by beta- 1 receptors and thus less likely to occur with beta-2-selective agents such as albuterol. However, beta-2-selectivity is not absolute and can be lost with larger doses. High dosages of these agents have been associated with precipitation or aggravation of angina, myocardial ischemia, and cardiac arrhythmias. Therapy with adrenergic bronchodilators should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, and/or underlying cardiovascular disorders such as coronary insufficiency, cardiac arrhythmias, or hypertension. The recommended dosages should not be exceeded.
Hyperthyroidism
Moderate:
bitolterol
Bitolterol has a moderate potential interaction with Hyperthyroidism.
Adrenergic bronchodilators can stimulate cardiovascular beta- 1 and beta- 2 receptors, resulting in adverse effects such as tachycardia, palpitation, peripheral vasodilation, blood pressure changes, and ECG changes (e.g., flattening of the T wave; prolongation of the QT interval; ST segment depression). Direct stimulation of cardiac tissues is mediated by beta- 1 receptors and thus less likely to occur with beta-2-selective agents such as albuterol. However, beta-2-selectivity is not absolute and can be lost with larger doses. High dosages of these agents have been associated with precipitation or aggravation of angina, myocardial ischemia, and cardiac arrhythmias. Therapy with adrenergic bronchodilators should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, and/or underlying cardiovascular disorders such as coronary insufficiency, cardiac arrhythmias, or hypertension. The recommended dosages should not be exceeded.
Hypokalemia
Moderate:
bitolterol
Bitolterol has a moderate potential interaction with Hypokalemia.
Adrenergic bronchodilators may cause decreases in serum potassium concentrations, primarily when given by nebulization or intravenous administration. Although this effect is usually transient and does not require supplementation, clinically significant hypokalemia may occur in some patients, with the potential to induce cardiovascular adverse effects. The relevance of these observations to oral or oral aerosol/powder for inhalation therapy is unknown. Therapy with adrenergic bronchodilators should be administered cautiously in patients with or predisposed to hypokalemia.
Infectious Gastroenteritis
Major:
loperamide
Loperamide has a major potential interaction with Infectious Gastroenteritis.
The use of drugs with antiperistaltic activity (primarily antidiarrheal and antimuscarinic agents, but also antispasmodic agents such as dicyclomine or oxybutynin at high dosages) is contraindicated in patients with diarrhea due to pseudomembranous enterocolitis or enterotoxin-producing bacteria. These drugs may prolong and/or worsen diarrhea associated with organisms that invade the intestinal mucosa, such as toxigenic E. coli, Salmonella and Shigella, and pseudomembranous colitis due to broad-spectrum antibiotics. Other symptoms and complications such as fever, shedding of organisms and extraintestinal illness may also be increased or prolonged. In general, because antiperistaltic agents decrease gastrointestinal motility, they may delay the excretion of infective gastroenteric organisms or toxins and should be used cautiously in patients with any infectious diarrhea, particularly if accompanied by high fever or pus or blood in the stool. Some cough and cold and other combination products may occasionally include antimuscarinic agents for their drying effects and may, therefore, require careful selection when necessary.
Inflammatory Bowel Disease
Moderate:
loperamide
Loperamide has a moderate potential interaction with Inflammatory Bowel Disease.
Decreased intestinal motility and prolonged transit time have resulted in toxic megacolon in patients with acute ulcerative colitis. Paralytic ileus has also occurred. Antiperistaltic agent GI motility and prolongs transit time and therapy should be administered cautiously in these patients.
Liver Disease
Moderate:
loperamide
Loperamide has a moderate potential interaction with Liver Disease.
Therapy with antiperistaltic agents should be administered with extreme caution in patients with hepatorenal disease or abnormal liver enzymes. Antiperistaltic agents are metabolized by the liver (diphenoxylate to an active form) and primarily excreted in the feces. Hepatic coma can be precipitated.
Renal Dysfunction
Moderate:
loperamide
Loperamide has a moderate potential interaction with Renal Dysfunction.
Therapy with antiperistaltic agents should be administered with extreme caution in patients with hepatorenal disease or abnormal liver enzymes. Antiperistaltic agents are metabolized by the liver (diphenoxylate to an active form) and primarily excreted in the feces. Hepatic coma can be precipitated.
Seizures
Moderate:
bitolterol
Bitolterol has a moderate potential interaction with Seizures.
Adrenergic bronchodilators may cause CNS stimulation. Therapy with adrenergic bronchodilators should be administered cautiously in patients with seizure disorders. Systemic adverse effects are minimized, but not abolished, by administration of these agents via oral inhalation.
More resources
bitolterol
A total of 396 drugs are known to interact with bitolterol.
- Bitolterol is in the drug class adrenergic bronchodilators.
- Bitolterol is used to treat the following conditions:
loperamide
A total of 383 drugs are known to interact with loperamide.
- Loperamide is in the drug class antidiarrheals.
- Loperamide 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
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.