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Can you take Clomid with Ser-Ap-Es?

3 drug interactions and 48 additional warnings found for the following 2 drugs:

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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

45 potential interactions Applies to: 37 conditions, including High Cholesterol, Depression, Asthma, Gout, and Diarrhea.

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.

Abnormal Uterine Bleeding

Major:

Clomid

The clomiPHENE in Clomid has a major potential interaction with Abnormal Uterine Bleeding.

The use of clomiphene is contraindicated in patients with undiagnosed, abnormal genital bleeding. Patients should be evaluated to ensure that neoplastic lesions are not present.

Adrenal Insufficiency

Major:

Clomid

The clomiPHENE in Clomid has a major potential interaction with Adrenal Insufficiency.

The use of clomiphene is contraindicated in patients with uncontrolled adrenal function. Alterations of adrenal function can impede pregnancy. Clomiphene therapy can result in alteration in steroid synthesis and/or fluid regulation.

Major:

Clomid

The clomiPHENE in Clomid has a major potential interaction with Adrenal Insufficiency.

The use of clomiphene is contraindicated in patients with uncontrolled thyroid or adrenal dysfunction or an organic intracranial lesion such as a pituitary tumor. Clomiphene interacts with estrogen receptors in various tissues, including the pituitary, the response of which is an increase in the release of pituitary gonadotropins.

Adrenal Tumor

Major:

Clomid

The clomiPHENE in Clomid has a major potential interaction with Adrenal Tumor.

The use of clomiphene is contraindicated in patients with uncontrolled adrenal function. Alterations of adrenal function can impede pregnancy. Clomiphene therapy can result in alteration in steroid synthesis and/or fluid regulation.

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.

Brain Tumor

Major:

Clomid

The clomiPHENE in Clomid has a major potential interaction with Brain Tumor.

The use of clomiphene is contraindicated in patients with uncontrolled thyroid or adrenal dysfunction or an organic intracranial lesion such as a pituitary tumor. Clomiphene interacts with estrogen receptors in various tissues, including the pituitary, the response of which is an increase in the release of pituitary gonadotropins.

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.

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:

Clomid

The clomiPHENE in Clomid has a moderate potential interaction with High Cholesterol.

Cases of hypertriglyceridemia have been reported in patients receiving clomiphene treatment. Preexisting or family history of hyperlipidemia and use of higher than recommended dose and/or longer duration of treatment with clomiphene citrate are associated with a risk of hypertriglyceridemia. Periodic monitoring of plasma triglycerides is recommended in patients with preexisting or family history of hyperlipidemia. Pretreatment screening of triglyceride levels is recommended in patients initiating clomiphene citrate therapy.

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

Hyperadrenocorticism

Major:

Clomid

The clomiPHENE in Clomid has a major potential interaction with Hyperadrenocorticism.

The use of clomiphene is contraindicated in patients with uncontrolled adrenal function. Alterations of adrenal function can impede pregnancy. Clomiphene therapy can result in alteration in steroid synthesis and/or fluid regulation.

Hyperaldosteronism

Major:

Clomid

The clomiPHENE in Clomid has a major potential interaction with Hyperaldosteronism.

The use of clomiphene is contraindicated in patients with uncontrolled adrenal function. Alterations of adrenal function can impede pregnancy. Clomiphene therapy can result in alteration in steroid synthesis and/or fluid regulation.

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.

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:

Clomid

The clomiPHENE in Clomid has a major potential interaction with Liver Disease.

The use of clomiphene is contraindicated in patients with liver disease or history of hepatic dysfunction.. Clomiphene undergoes enterohepatic circulation and is metabolized by the liver. The serum concentration of clomiphene may be increased and the half-life prolonged in patients with compromised hepatic function.

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.

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.

Pituitary Tumor

Major:

Clomid

The clomiPHENE in Clomid has a major potential interaction with Pituitary Tumor.

The use of clomiphene is contraindicated in patients with uncontrolled thyroid or adrenal dysfunction or an organic intracranial lesion such as a pituitary tumor. Clomiphene interacts with estrogen receptors in various tissues, including the pituitary, the response of which is an increase in the release of pituitary gonadotropins.

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

Major:

Clomid

The clomiPHENE in Clomid has a major potential interaction with Thyroid Disease.

The use of clomiphene is contraindicated in patients with uncontrolled thyroid or adrenal dysfunction or an organic intracranial lesion such as a pituitary tumor. Clomiphene interacts with estrogen receptors in various tissues, including the pituitary, the response of which is an increase in the release of pituitary gonadotropins.

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.

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.

More resources

Clomid

A total of 15 drugs are known to interact with Clomid.

Ser-Ap-Es

A total of 738 drugs are known to interact with Ser-Ap-Es.

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

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.