Can you take Bitolterol with Pasireotide?
1 drug interaction and 16 additional warnings found for the following 2 drugs:
- bitolterol
- pasireotide
Drug interactions
Moderate drug interactions
Moderate:
bitolterol pasireotide
Applies to: bitolterol and pasireotide
Using bitolterol together with pasireotide can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a rare side effect.
You may 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)
The risk may exist even when bitolterol or similar medications are given by oral inhalation directly into the lungs, and more so if these products are overused. Do not exceed the dose and frequency of use recommended on the product label or prescribed by your doctor.
Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications.
You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications.
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:
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
15 potential interactions Applies to: 12 conditions, including High Blood Pressure, Underactive Thyroid, Seizures, Arrhythmia, and Hypokalemia.
Adrenal Insufficiency
Moderate:
pasireotide
Pasireotide has a moderate potential interaction with Adrenal Insufficiency.
Treatment with somatostatin analogs may suppress the pituitary hormones other than GH/IGF-1. It is recommended to monitor pituitary function prior to initiation of therapy and periodically during treatment, as clinically appropriate. Patients should be monitored for and instructed on the signs and symptoms of adrenal insufficiency during therapy. If adrenal insufficiency is suspected it should be confirmed and treated per standard of care with exogenous glucocorticoids at replacement doses.
Arrhythmia
Moderate:
pasireotide
Pasireotide has a moderate potential interaction with Arrhythmia.
The use of pasireotide is associated with QT prolongation. Pasireotide should be used with caution in patients who are at significant risk of developing QT prolongation. It is recommended to correct levels of hypokalemia and hypomagnesemia prior to starting therapy with this agent. Assess ECG at the beginning of therapy and monitor during therapy. Care should be taken in predisposed patients.
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.
Moderate:
pasireotide
Pasireotide has a moderate potential interaction with Diabetes Mellitus.
Elevations in blood glucose levels have been reported with the use of somatostatin analogs. Cushing's disease patients with poor glycemic control may be at a higher risk of developing severe hyperglycemia and associated complications, e.g., ketoacidosis. It is recommended to assess the glycemic status of hemoglobin A1C prior to starting treatment with these agents. Self-monitoring of blood glucose and/or FPG assessments should be done every week for the first two to three months and periodically thereafter, as clinically appropriate, as well as over the first two to four weeks after any dose increase. If uncontrolled hyperglycemia persists, despite appropriate medical management, the dose of these agents should be reduced or discontinued.
Electrolyte Abnormalities
Moderate:
pasireotide
Pasireotide has a moderate potential interaction with Electrolyte Abnormalities.
The use of pasireotide is associated with QT prolongation. Pasireotide should be used with caution in patients who are at significant risk of developing QT prolongation. It is recommended to correct levels of hypokalemia and hypomagnesemia prior to starting therapy with this agent. Assess ECG at the beginning of therapy and monitor during therapy. Care should be taken in predisposed patients.
Gallbladder Disease
Moderate:
pasireotide
Pasireotide has a moderate potential interaction with Gallbladder Disease.
Somatostatin analogs may reduce gallbladder motility and lead to gallstones formation. It is recommended to assess the gallbladder prior to starting therapy and periodically thereafter.
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.
Moderate:
pasireotide
Pasireotide has a moderate potential interaction with Heart Disease.
Bradycardia has been reported with the use of somatostatin analogs. It is recommended to carefully monitor patients with cardiac disorders for the development of bradycardia. Dose adjustments of beta-blockers, calcium channel blockers, or correction of electrolyte disturbances may be necessary. Care should be taken when initiating treatment with these agents in patients with bradycardia.
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.
Moderate:
pasireotide
Pasireotide has a moderate potential interaction with Hypokalemia.
The use of pasireotide is associated with QT prolongation. Pasireotide should be used with caution in patients who are at significant risk of developing QT prolongation. It is recommended to correct levels of hypokalemia and hypomagnesemia prior to starting therapy with this agent. Assess ECG at the beginning of therapy and monitor during therapy. Care should be taken in predisposed patients.
Liver Disease
Major:
pasireotide
Pasireotide has a major potential interaction with Liver Disease.
The use of pasireotide causes elevations in ALT or AST. No dose adjustment is required in patients with mild hepatic impairment, but is required for patients with moderate hepatic impairment. The use of pasireotide should be avoided in patients with severe hepatic impairment. Regular monitoring of liver function test is recommended and interruption of treatment should be considered if abnormal values exceeding 5 times ULN or rising values are obtained during the course of therapy.
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.
Underactive Thyroid
Moderate:
pasireotide
Pasireotide has a moderate potential interaction with Underactive Thyroid.
Bradycardia has been reported with the use of somatostatin analogs. It is recommended to carefully monitor patients with cardiac disorders for the development of bradycardia. Dose adjustments of beta-blockers, calcium channel blockers, or correction of electrolyte disturbances may be necessary. Care should be taken when initiating treatment with these agents in patients with bradycardia.
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:
pasireotide
A total of 429 drugs are known to interact with pasireotide.
- Pasireotide is in the drug class somatostatin and somatostatin analogs.
- Pasireotide 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.