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Drug Interactions between Candin and esmolol

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

esmolol candida albicans extract

Applies to: esmolol and Candin (candida albicans extract)

MONITOR: Beta-blockers may attenuate the response to epinephrine in the treatment of serious systemic reactions like anaphylaxis, which are possible following the administration of skin test antigens. During an anaphylactic reaction, the beneficial effects of epinephrine may be reduced due to impairment of compensatory cardiovascular responses and an increase in the release of mast cell mediators by the beta-blocker. Noncardioselective beta-blockers, in particular, can antagonize the bronchodilating effects of epinephrine by blocking beta-2 adrenergic receptors in the smooth muscles of the bronchial tree. Cardioselective beta-blockers may occasionally do the same, as beta-1 selectivity is not absolute and may be lost at higher dosages in susceptible patients. All beta-blockers can antagonize the cardiostimulatory effects of epinephrine by blocking beta-1 adrenergic receptors in the heart.

MANAGEMENT: Clinicians should be aware that patients receiving beta-blockers may be unresponsive to the usual doses of epinephrine used to treat serious allergic reactions like anaphylaxis, which could occur following the administration of skin test antigens. Some authorities suggest administration of glucagon in anaphylactic patients who are unresponsive to epinephrine. Relevant guidelines and product labeling should be consulted as indicated.

References (7)
  1. Richards DA, Prichard BN, Hernandez R (1979) "Circulatory effects of noradrenaline and adrenaline before and after labetalol." Br J Clin Pharmacol, 7, p. 371-8
  2. (2023) "Product Information. Spherusol (coccidioidin skin test)." Nielsen Biosciences Inc
  3. (2021) "Product Information. Tubersol (tuberculin purified protein derivative)." sanofi pasteur
  4. (2013) "Product Information. Aplisol (tuberculin purified protein derivative)." JHP Pharmaceuticals
  5. (2007) "Product Information. Trichophyton Extracts (trichophyton skin test)." Allermed Laboratories Inc
  6. Golden DBK, Wang J, Waserman S, et al. (2024) "Anaphylaxis: a 2023 practice parameter update." Ann Allergy Asthma Immunol, 132, P124-76
  7. Lieberman P, Nicklas RA, oppenheimer j, et al. (2010) "The diagnosis and management of anaphylaxis practice parameter: 2010 Update." J Allergy Clin Immunol, 126, P477-80

Drug and food interactions

Moderate

esmolol food

Applies to: esmolol

MONITOR: Many psychotherapeutic and CNS-active agents (e.g., anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics, opioids, alcohol, muscle relaxants) exhibit hypotensive effects, especially during initiation of therapy and dose escalation. Coadministration with antihypertensives and other hypotensive agents, in particular vasodilators and alpha-blockers, may result in additive effects on blood pressure and orthostasis.

MANAGEMENT: Caution and close monitoring for development of hypotension is advised during coadministration of these agents. Some authorities recommend avoiding alcohol in patients receiving vasodilating antihypertensive drugs. Patients should be advised to avoid rising abruptly from a sitting or recumbent position and to notify their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia. Patients should also avoid driving or operating hazardous machinery until they know how the medications affect them.

References (10)
  1. Sternbach H (1991) "Fluoxetine-associated potentiation of calcium-channel blockers." J Clin Psychopharmacol, 11, p. 390-1
  2. Shook TL, Kirshenbaum JM, Hundley RF, Shorey JM, Lamas GA (1984) "Ethanol intoxication complicating intravenous nitroglycerin therapy." Ann Intern Med, 101, p. 498-9
  3. Feder R (1991) "Bradycardia and syncope induced by fluoxetine." J Clin Psychiatry, 52, p. 139
  4. Ellison JM, Milofsky JE, Ely E (1990) "Fluoxetine-induced bradycardia and syncope in two patients." J Clin Psychiatry, 51, p. 385-6
  5. Rodriguez de la Torre B, Dreher J, Malevany I, et al. (2001) "Serum levels and cardiovascular effects of tricyclic antidepressants and selective serotonin reuptake inhibitors in depressed patients." Ther Drug Monit, 23, p. 435-40
  6. Cerner Multum, Inc. "Australian Product Information."
  7. Pacher P, Kecskemeti V (2004) "Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns?" Curr Pharm Des, 10, p. 2463-75
  8. Andrews C, Pinner G (1998) "Postural hypotension induced by paroxetine." BMJ, 316, p. 595
  9. (2023) "Product Information. Buprenorphine (buprenorphine)." G.L. Pharma UK Ltd
  10. (2023) "Product Information. Temgesic (buprenorphine)." Reckitt Benckiser Pty Ltd

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor 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.
Unknown No interaction information available.

Further information

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