Can you take Botox Cosmetic with Ser-Ap-Es?
3 drug interactions and 43 additional warnings found for the following 2 drugs:
- Botox Cosmetic (onabotulinumtoxinA)
- Ser-Ap-Es (hydralazine/hydrochlorothiazide/reserpine)
Drug interactions
Moderate drug interactions
Moderate:
hydrALAZINE hydroCHLOROthiazide
Applies to: Ser-Ap-Es (hydralazine / hydrochlorothiazide / reserpine) and Ser-Ap-Es (hydralazine / hydrochlorothiazide / reserpine)
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, or 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 reserpine
Applies to: Ser-Ap-Es (hydralazine / hydrochlorothiazide / reserpine) and Ser-Ap-Es (hydralazine / hydrochlorothiazide / reserpine)
Reserpine 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, or 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:
hydroCHLOROthiazide reserpine
Applies to: Ser-Ap-Es (hydralazine / hydrochlorothiazide / reserpine) and Ser-Ap-Es (hydralazine / hydrochlorothiazide / reserpine)
Before taking hydroCHLOROthiazide, tell your doctor if you also use reserpine. You may need dose adjustments or special tests in order to safely take both medications together. The blood pressure lowering effects of this combination may be additive. You should take reserpine at bedtime and to notify your doctor if have dizziness or feel faint. 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: Ser-Ap-Es (hydralazine / hydrochlorothiazide / reserpine)
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: Ser-Ap-Es (hydralazine / hydrochlorothiazide / reserpine)
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.
Moderate:
reserpine Alcohol (Ethanol)
Applies to: Ser-Ap-Es (hydralazine / hydrochlorothiazide / reserpine)
Ethanol and reserpine 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
40 potential interactions Applies to: 37 conditions, including High Cholesterol, Depression, Asthma, Urinary Tract Infection, and Gout.
Abnormal Glucose Tolerance
Moderate:
Ser-Ap-Es
The hydroCHLOROthiazide in Ser-Ap-Es 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.
Anuria
Major:
Ser-Ap-Es
The hydroCHLOROthiazide in Ser-Ap-Es has a major potential interaction with Anuria.
The use of thiazide diuretics is contraindicated in patients with anuria.
Asthma
Moderate:
Ser-Ap-Es
The hydroCHLOROthiazide in Ser-Ap-Es 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.
Bone Marrow Depression/Low Blood Counts
Major:
Ser-Ap-Es
The hydrALAZINE in Ser-Ap-Es 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.
Cerebral Vascular Disorder
Moderate:
Ser-Ap-Es
The hydrALAZINE in Ser-Ap-Es 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:
Ser-Ap-Es
The hydroCHLOROthiazide in Ser-Ap-Es 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.
Depression
Major:
Ser-Ap-Es
The reserpine in Ser-Ap-Es has a major potential interaction with Depression.
The use of rauwolfia alkaloids is contraindicated in patients with a history of mental depression, especially suicidal tendencies. Rauwolfia alkaloids depletes catecholamine and serotonin stores.
Diabetes Mellitus
Moderate:
Ser-Ap-Es
The hydroCHLOROthiazide in Ser-Ap-Es 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:
Ser-Ap-Es
The hydroCHLOROthiazide in Ser-Ap-Es 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.
Dysphagia
Major:
Botox Cosmetic
The onabotulinumtoxinA in Botox Cosmetic has a major potential interaction with Dysphagia.
Treatment with botulinum toxin products, including abobotulinumtoxinA, incobotulinumtoxinA, onabotulinumtoxinA, daxibotulinumtoxinA, letibotulinumtoxinA and others can result in swallowing and breathing difficulties and in general increased neuromuscular compromise. Deaths due to severe dysphagia or respiratory failure have been reported after treatment with botulinum toxin. Care should be exercised with using these products in patients with pre- existing swallowing or respiratory disorders or peripheral motor neuropathic diseases or neuromuscular disorders (e.g., myasthenia gravis, amyotrophic lateral sclerosis), as they may be at increased risk of clinically significant effects including generalized muscle weakness, diplopia, ptosis, dysphonia, dysarthria, severe dysphagia and respiratory compromise. Patients treated with botulinum toxin may require immediate medical attention should they develop these complications. Caution is advised.
Electrolyte Abnormalities
Major:
Ser-Ap-Es
The hydroCHLOROthiazide in Ser-Ap-Es 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.
Fluid Retention
Moderate:
Ser-Ap-Es
The reserpine in Ser-Ap-Es has a moderate potential interaction with Fluid Retention.
Peripheral- acting antiadrenergic agents can cause peripheral edema. Therapy with peripheral- acting antiadrenergic agents should be administered cautiously in patients adversely affected by sodium and water retention.
Gallstones
Moderate:
Ser-Ap-Es
The reserpine in Ser-Ap-Es has a moderate potential interaction with Gallstones.
Rauwolfia alkaloids increase gastrointestinal motility and secretion and can precipitate biliary colic in patients with gallstones. Therapy with rauwolfia alkaloids should be administered cautiously in patients with a history of gallstones.
Glomerulonephritis
Moderate:
Ser-Ap-Es
The hydrALAZINE in Ser-Ap-Es 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:
Ser-Ap-Es
The hydroCHLOROthiazide in Ser-Ap-Es 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:
Ser-Ap-Es
The hydroCHLOROthiazide in Ser-Ap-Es 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:
Ser-Ap-Es
The hydroCHLOROthiazide in Ser-Ap-Es 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:
Ser-Ap-Es
The hydroCHLOROthiazide in Ser-Ap-Es 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.
Hypokalemia
Major:
Ser-Ap-Es
The hydroCHLOROthiazide in Ser-Ap-Es 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:
Ser-Ap-Es
The hydroCHLOROthiazide in Ser-Ap-Es 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.
Infection
Major:
Botox Cosmetic
The onabotulinumtoxinA in Botox Cosmetic has a major potential interaction with Infection.
Botulinum toxin products, including abobotulinumtoxinA, incobotulinumtoxinA, onabotulinumtoxinA, letibotulinumtoxinA, and others should not be used in the presence of infection at the proposed injection site(s) as it could lead to severe local or disseminated infection(s).
Inflammatory Bowel Disease
Major:
Ser-Ap-Es
The reserpine in Ser-Ap-Es has a major potential interaction with Inflammatory Bowel Disease.
The use of rauwolfia alkaloids is contraindicated in patients with active peptic ulcer or ulcerative colitis. Since rauwolfia alkaloids increase gastrointestinal motility and secretion, these conditions may be aggravated. Therapy with rauwolfia alkaloids should be administered cautiously in patients with a history of peptic ulcer or ulcerative colitis because of the risk of reactivation.
Ischemic Heart Disease
Major:
Ser-Ap-Es
The hydrALAZINE in Ser-Ap-Es 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:
Ser-Ap-Es
The hydroCHLOROthiazide in Ser-Ap-Es 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).
Lupus Erythematosus
Major:
Ser-Ap-Es
The hydroCHLOROthiazide in Ser-Ap-Es 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:
Ser-Ap-Es
The hydrALAZINE in Ser-Ap-Es 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:
Ser-Ap-Es
The hydroCHLOROthiazide in Ser-Ap-Es 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:
Ser-Ap-Es
The hydroCHLOROthiazide in Ser-Ap-Es 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.
Myasthenia Gravis
Major:
Botox Cosmetic
The onabotulinumtoxinA in Botox Cosmetic has a major potential interaction with Myasthenia Gravis.
Treatment with botulinum toxin products, including abobotulinumtoxinA, incobotulinumtoxinA, onabotulinumtoxinA, daxibotulinumtoxinA, letibotulinumtoxinA and others can result in swallowing and breathing difficulties and in general increased neuromuscular compromise. Deaths due to severe dysphagia or respiratory failure have been reported after treatment with botulinum toxin. Care should be exercised with using these products in patients with pre- existing swallowing or respiratory disorders or peripheral motor neuropathic diseases or neuromuscular disorders (e.g., myasthenia gravis, amyotrophic lateral sclerosis), as they may be at increased risk of clinically significant effects including generalized muscle weakness, diplopia, ptosis, dysphonia, dysarthria, severe dysphagia and respiratory compromise. Patients treated with botulinum toxin may require immediate medical attention should they develop these complications. Caution is advised.
Peptic Ulcer
Major:
Ser-Ap-Es
The reserpine in Ser-Ap-Es has a major potential interaction with Peptic Ulcer.
The use of rauwolfia alkaloids is contraindicated in patients with active peptic ulcer or ulcerative colitis. Since rauwolfia alkaloids increase gastrointestinal motility and secretion, these conditions may be aggravated. Therapy with rauwolfia alkaloids should be administered cautiously in patients with a history of peptic ulcer or ulcerative colitis because of the risk of reactivation.
Pulmonary Impairment
Major:
Botox Cosmetic
The onabotulinumtoxinA in Botox Cosmetic has a major potential interaction with Pulmonary Impairment.
Treatment with botulinum toxin products, including abobotulinumtoxinA, incobotulinumtoxinA, onabotulinumtoxinA, daxibotulinumtoxinA, letibotulinumtoxinA and others can result in swallowing and breathing difficulties and in general increased neuromuscular compromise. Deaths due to severe dysphagia or respiratory failure have been reported after treatment with botulinum toxin. Care should be exercised with using these products in patients with pre- existing swallowing or respiratory disorders or peripheral motor neuropathic diseases or neuromuscular disorders (e.g., myasthenia gravis, amyotrophic lateral sclerosis), as they may be at increased risk of clinically significant effects including generalized muscle weakness, diplopia, ptosis, dysphonia, dysarthria, severe dysphagia and respiratory compromise. Patients treated with botulinum toxin may require immediate medical attention should they develop these complications. Caution is advised.
Renal Dysfunction
Major:
Ser-Ap-Es
The hydroCHLOROthiazide in Ser-Ap-Es 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:
Ser-Ap-Es
The reserpine in Ser-Ap-Es has a moderate potential interaction with Renal Dysfunction.
In general, lowering the blood pressure may cause some decrease in renal function. Therefore, rauwolfia alkaloids should be used with caution in patients with renal impairment, since these patients may adjust poorly to the hypotensive effects of these agents.
Moderate:
Ser-Ap-Es
The hydrALAZINE in Ser-Ap-Es 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:
Ser-Ap-Es
The hydroCHLOROthiazide in Ser-Ap-Es 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.
Urinary Retention
Major:
Botox Cosmetic
The onabotulinumtoxinA in Botox Cosmetic has a major potential interaction with Urinary Retention.
Botox (brand of onabotulinumtoxinA), a botulinum toxin product for the treatment of overactive bladder or detrusor overactivity associated with a neurologic condition should not be used in patients who have a urinary tract infection, in patients with urinary retention and in patients with post-void residual urine volume >200 mL, who are not routinely performing clean intermittent self-catheterization.
Urinary Tract Infection
Major:
Botox Cosmetic
The onabotulinumtoxinA in Botox Cosmetic has a major potential interaction with Urinary Tract Infection.
Botox (brand of onabotulinumtoxinA), a botulinum toxin product for the treatment of overactive bladder or detrusor overactivity associated with a neurologic condition should not be used in patients who have a urinary tract infection, in patients with urinary retention and in patients with post-void residual urine volume >200 mL, who are not routinely performing clean intermittent self-catheterization.
Valvular Heart Disease
Major:
Ser-Ap-Es
The hydrALAZINE in Ser-Ap-Es 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:
Ser-Ap-Es
The hydroCHLOROthiazide in Ser-Ap-Es 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.
Vomiting
Major:
Ser-Ap-Es
The hydroCHLOROthiazide in Ser-Ap-Es 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.
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Botox Cosmetic
A total of 148 drugs are known to interact with Botox Cosmetic.
- Botox cosmetic is in the drug class skeletal muscle relaxants.
- Botox cosmetic is used to treat the following conditions:
Ser-Ap-Es
A total of 738 drugs are known to interact with Ser-Ap-Es.
- Ser-ap-es is in the drug class miscellaneous antihypertensive combinations.
- Ser-ap-es is used to treat High Blood Pressure.
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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