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Can you take Conjugated estrogens / meprobamate with Sotalol?

1 drug interaction and 72 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

meprobamate sotalol

Applies to: conjugated estrogens / meprobamate and sotalol

Meprobamate and sotalol 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.

Food/lifestyle interactions

Moderate food/lifestyle interactions

Moderate:

meprobamate Food/Lifestyle

Applies to: conjugated estrogens / meprobamate

Alcohol can increase the nervous system side effects of meprobamate such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with meprobamate. Do not use more than the recommended dose of meprobamate, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Moderate:

sotalol Alcohol (Ethanol)

Applies to: sotalol

Ethanol and sotalol 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:

sotalol multivitamins with minerals

Applies to: sotalol

Using sotalol together with multivitamins with minerals may decrease the effects of sotalol. Separate the administration times of sotalol and multivitamins with minerals by at least 2 hours. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both 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.

Minor food/lifestyle interactions

Minor:

conjugated estrogens Food/Lifestyle

Applies to: conjugated estrogens / meprobamate

Information for this minor interaction is available on the professional version.

Disease interactions

68 potential interactions Applies to: 54 conditions, including High Blood Pressure, High Cholesterol, Depression, Allergies, and Migraine.

Abnormal Electrocardiogram

Major:

sotalol

Sotalol has a major potential interaction with Abnormal Electrocardiogram.

The use of sotalol is contraindicated in patients with congenital or acquired QT interval prolongation syndromes. Sotalol has dose-dependent proarrhythmic effects related to prolongation of the QT interval. The risk of torsades de pointes is progressively increased as the degree of prolongation becomes greater. The manufacturer states that sotalol should be used with particular caution in patients whose QTc is greater than 500 msec on- therapy. Serious consideration should be given to reducing the dosage or discontinuing therapy when the QTc exceeds 550 msec.

The use of sotalol is contraindicated in patients with hypokalemia (< 4 meq/L). Electrolyte disturbances such as hypokalemia and hypomagnesemia may augment the prolongation effect of sotalol on the QT interval and should be corrected prior to institution of sotalol therapy. In addition, patients who experience frequent, severe, or prolonged diarrhea may be subject to electrolyte losses and should be followed closely and managed accordingly during therapy with sotalol.

Abnormal Uterine Bleeding

Major:

conjugated estrogens / meprobamate

The conjugated estrogens in conjugated estrogens / meprobamate has a major potential interaction with Abnormal Uterine Bleeding.

The use of estrogens is contraindicated in patients with undiagnosed, abnormal vaginal bleeding. Prolonged (greater than 1 year), unopposed estrogen use (i.e. estrogen without concomitant progestin therapy) has been associated with a significant, dose-related risk of endometrial carcinoma. The risk may be offset substantially by the addition of a progestin but may not be completely abolished. Prior to initiating estrogen therapy, appropriate diagnostic tests should be performed in patients with abnormal vaginal bleeding to rule out endometrial malignancy. The same applies if recurrent or persistent bleeding develops during estrogen therapy.

Acute Alcohol Intoxication

Major:

conjugated estrogens / meprobamate

The meprobamate in conjugated estrogens / meprobamate has a major potential interaction with Acute Alcohol Intoxication.

Anxiolytic, sedative, and hypnotic agents should generally not be given to patients with acute alcohol intoxication exhibiting depressed vital signs. The central nervous system depressant effects of these agents may be additive with those of alcohol. Severe respiratory depression and death may occur. Therapy with such agents should be administered cautiously in patients who might be prone to acute alcohol intake.

Alcoholism

Major:

conjugated estrogens / meprobamate

The meprobamate in conjugated estrogens / meprobamate has a major potential interaction with Alcoholism.

Anxiolytic, sedative, and hypnotic agents have the potential to cause dependence and abuse. Tolerance as well as physical and psychological dependence can develop, particularly after prolonged use of excessive dosages, and abrupt cessation and/or a reduction in dosage may precipitate withdrawal symptoms. In patients who have developed tolerance, overdosage can still produce respiratory depression and death. Therapy with anxiolytic, sedative, and hypnotic agents should be administered cautiously and for as brief a period as possible. Addiction-prone individuals, such as those with a history of alcohol or substance abuse, should be under careful surveillance or medical supervision when treated with these agents. In addition, it may be prudent to refrain from dispensing large quantities of medication to such patients. After prolonged use or if dependency is suspected, withdrawal of medication should be undertaken gradually using a dosage-tapering schedule.

Moderate:

conjugated estrogens / meprobamate

The meprobamate in conjugated estrogens / meprobamate has a moderate potential interaction with Alcoholism.

Physical dependence, psychological dependence, and abuse have occurred with the use of meprobamate. Chronic intoxication from prolonged use usually involves ingestion of greater than recommended doses, and it is manifested by ataxia, slurred speech, and vertigo. Careful supervision of dose and amounts prescribed is advised, as well as avoidance of prolonged administration, especially in alcoholics and other patients with known propensity for taking excessive quantities of drugs.

Allergies

Major:

sotalol

Sotalol has a major potential interaction with Allergies.

The use of beta-adrenergic receptor blocking agents (aka beta-blockers) in patients with a history of allergic reactions or anaphylaxis may be associated with heightened reactivity to culprit allergens. The frequency and/or severity of attacks may be increased during beta-blocker therapy. In addition, these patients may be refractory to the usual doses of epinephrine used to treat acute hypersensitivity reactions and may require a beta-agonist such as isoproterenol.

Angioedema

Moderate:

conjugated estrogens / meprobamate

The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with Angioedema.

The use of exogenous estrogens may induce or exacerbate symptoms of angioedema, particularly in women with hereditary angioedema. Consider the risk versus benefits of estrogen therapy. Close monitoring is recommended when prescribing these agents to patients predisposed to angioedema.

Asphyxia

Moderate:

conjugated estrogens / meprobamate

The meprobamate in conjugated estrogens / meprobamate has a moderate potential interaction with Asphyxia.

Oral anxiolytic, sedative, and hypnotic agents may cause respiratory depression and apnea when given in high dosages or following acute overdose. However, some patients may be susceptible at commonly used dosages, including the elderly, debilitated or severely ill patients, those receiving other CNS depressants, and those with limited ventilatory reserve, chronic pulmonary insufficiency or other respiratory disorders. Therapy with anxiolytic, sedative, and hypnotic agents should be administered cautiously in these patients. Appropriate monitoring and individualization of dosage are recommended.

Asthma

Major:

sotalol

Sotalol has a major potential interaction with Asthma.

Some beta-adrenergic receptor blocking agents (i.e., non-cardioselective beta-blockers) are contraindicated in patients with bronchial asthma or with a history of bronchial asthma, or severe chronic obstructive pulmonary disease. In general, beta-adrenergic receptor blocking agents should not be used in patients with bronchospastic diseases. Beta blockade may adversely affect pulmonary function by counteracting the bronchodilation produced by catecholamine stimulation of beta-2 receptors. If beta-blocker therapy is necessary in these patients, an agent with beta-1 selectivity (e.g., atenolol, metoprolol, betaxolol) is considered safer, but should be used with caution nonetheless. Cardioselectivity is not absolute and can be lost with larger doses.

Moderate:

conjugated estrogens / meprobamate

The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with Asthma.

Estrogens and progestogens may cause fluid retention, particularly when given in high dosages or for prolonged periods. Therapy with these agents should be administered cautiously in patients who have preexisting problems with excess fluid. In addition, patients with conditions that may be adversely affected by fluid accumulation, such as asthma, epilepsy, migraine, and cardiovascular or renal dysfunction, should be observed for exacerbation of their condition during estrogen and/or progestogen therapy.

Breast Cancer

Major:

conjugated estrogens / meprobamate

The conjugated estrogens in conjugated estrogens / meprobamate has a major potential interaction with Breast Cancer.

When treated with an estrogen, patients with breast cancer and bone metastases may develop severe hypercalcemia, in which case the drug should be stopped and measures be taken to reduce serum calcium levels.

Cardiogenic Shock

Major:

sotalol

Sotalol has a major potential interaction with Cardiogenic Shock.

The use of beta-adrenergic receptor blocking agents (aka beta-blockers) is contraindicated in patients with hypotension or cardiogenic shock. Due to their negative inotropic and chronotropic effects on the heart, the use of beta-blockers is likely to further depress cardiac output and blood pressure, which can be detrimental in these patients.

Cerebral Vascular Disorder

Major:

conjugated estrogens / meprobamate

The conjugated estrogens in conjugated estrogens / meprobamate has a major potential interaction with Cerebral Vascular Disorder.

The use of estrogens is considered by manufacturers and some authorities to be contraindicated in patients with active thrombotic, thromboembolic, or thrombophilic disorders. The use of estrogen-containing oral contraceptives is additionally deemed contraindicated in patients with a history of such disorders and/or current cerebrovascular or coronary artery disease. Females with a history of migraines with aura are at an increased risk for stroke and this stroke risk may be further increased in females who have migraines with aura with use of combination oral contraceptives. Hypercoagulability and changes in various clotting factors and blood components have been observed in women receiving estrogen therapy. Known preexisting risk factors for increased thromboembolic or cardiovascular events include smoking, especially over age of 35; hypertension; hyperlipidemia; obesity; diabetes; age over 40; and lupus. Therapy with estrogens should be administered cautiously in the lowest effective dosage and only after careful consideration of risks and benefits. Estrogens should be avoided in patients with a history of thrombotic and thromboembolic disorders associated with estrogen use, except when used in the treatment of metastatic breast or prostatic malignancy.

Cerebrovascular Insufficiency

Moderate:

sotalol

Sotalol has a moderate potential interaction with Cerebrovascular Insufficiency.

Beta-adrenergic blocking agents (beta-blockers), should be used with caution in patients with cerebrovascular insufficiency because of their potential effects relative to blood pressure and pulse. If signs or symptoms suggesting reduced cerebral blood flow are observed, consideration should be given to discontinuing these agents.

COPD

Major:

sotalol

Sotalol has a major potential interaction with COPD.

Some beta-adrenergic receptor blocking agents (i.e., non-cardioselective beta-blockers) are contraindicated in patients with bronchial asthma or with a history of bronchial asthma, or severe chronic obstructive pulmonary disease. In general, beta-adrenergic receptor blocking agents should not be used in patients with bronchospastic diseases. Beta blockade may adversely affect pulmonary function by counteracting the bronchodilation produced by catecholamine stimulation of beta-2 receptors. If beta-blocker therapy is necessary in these patients, an agent with beta-1 selectivity (e.g., atenolol, metoprolol, betaxolol) is considered safer, but should be used with caution nonetheless. Cardioselectivity is not absolute and can be lost with larger doses.

Depression

Major:

conjugated estrogens / meprobamate

The meprobamate in conjugated estrogens / meprobamate has a major potential interaction with Depression.

A variety of abnormal thinking and behavior changes have been reported to occur in association with the use of most anxiolytics, sedatives and hypnotics. Some of these changes include decreased inhibition, aggressiveness, agitation, and hallucinations. These drugs can cause or exacerbate mental depression and cause suicidal behavior and ideation. Therapy with these drugs should be administered cautiously in patients with a history of depression or other psychiatric disorders. Patients should be monitored for any changes in mood or behavior. It may be prudent to refrain from dispensing large quantities of medication to these patients.

Diabetes Mellitus

Major:

sotalol

Sotalol has a major potential interaction with Diabetes Mellitus.

Beta-adrenergic receptor blocking agents (aka beta-blockers) may mask symptoms of hypoglycemia such as tremors, tachycardia and blood pressure changes. In addition, the nonselective beta-blockers (e.g., propranolol, pindolol, timolol) may inhibit catecholamine-mediated glycogenolysis, thereby potentiating insulin-induced hypoglycemia and delaying the recovery of normal blood glucose levels. Since cardioselectivity is not absolute, larger doses of beta-1 selective agents may demonstrate these effects as well. Therapy with beta-blockers should be administered cautiously in patients with diabetes or predisposed to spontaneous hypoglycemia.

Moderate:

conjugated estrogens / meprobamate

The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with Diabetes Mellitus.

Impaired glucose tolerance has been observed in some patients administered oral contraceptives and appears to be related primarily to the estrogen dose. However, progestogens can increase insulin secretion and produce insulin resistance to varying degrees, depending on the agent. Caution and close monitoring are recommended in patients with diabetes mellitus during therapy with estrogens and/or progestogens, and adjustments made accordingly in their antidiabetic regimen.

Diarrhea

Major:

sotalol

Sotalol has a major potential interaction with Diarrhea.

The use of sotalol is contraindicated in patients with congenital or acquired QT interval prolongation syndromes. Sotalol has dose-dependent proarrhythmic effects related to prolongation of the QT interval. The risk of torsades de pointes is progressively increased as the degree of prolongation becomes greater. The manufacturer states that sotalol should be used with particular caution in patients whose QTc is greater than 500 msec on- therapy. Serious consideration should be given to reducing the dosage or discontinuing therapy when the QTc exceeds 550 msec.

The use of sotalol is contraindicated in patients with hypokalemia (< 4 meq/L). Electrolyte disturbances such as hypokalemia and hypomagnesemia may augment the prolongation effect of sotalol on the QT interval and should be corrected prior to institution of sotalol therapy. In addition, patients who experience frequent, severe, or prolonged diarrhea may be subject to electrolyte losses and should be followed closely and managed accordingly during therapy with sotalol.

Drug Dependence

Major:

conjugated estrogens / meprobamate

The meprobamate in conjugated estrogens / meprobamate has a major potential interaction with Drug Dependence.

Anxiolytic, sedative, and hypnotic agents have the potential to cause dependence and abuse. Tolerance as well as physical and psychological dependence can develop, particularly after prolonged use of excessive dosages, and abrupt cessation and/or a reduction in dosage may precipitate withdrawal symptoms. In patients who have developed tolerance, overdosage can still produce respiratory depression and death. Therapy with anxiolytic, sedative, and hypnotic agents should be administered cautiously and for as brief a period as possible. Addiction-prone individuals, such as those with a history of alcohol or substance abuse, should be under careful surveillance or medical supervision when treated with these agents. In addition, it may be prudent to refrain from dispensing large quantities of medication to such patients. After prolonged use or if dependency is suspected, withdrawal of medication should be undertaken gradually using a dosage-tapering schedule.

Moderate:

conjugated estrogens / meprobamate

The meprobamate in conjugated estrogens / meprobamate has a moderate potential interaction with Drug Dependence.

Physical dependence, psychological dependence, and abuse have occurred with the use of meprobamate. Chronic intoxication from prolonged use usually involves ingestion of greater than recommended doses, and it is manifested by ataxia, slurred speech, and vertigo. Careful supervision of dose and amounts prescribed is advised, as well as avoidance of prolonged administration, especially in alcoholics and other patients with known propensity for taking excessive quantities of drugs.

Electrolyte Abnormalities

Major:

sotalol

Sotalol has a major potential interaction with Electrolyte Abnormalities.

The use of sotalol is contraindicated in patients with congenital or acquired QT interval prolongation syndromes. Sotalol has dose-dependent proarrhythmic effects related to prolongation of the QT interval. The risk of torsades de pointes is progressively increased as the degree of prolongation becomes greater. The manufacturer states that sotalol should be used with particular caution in patients whose QTc is greater than 500 msec on- therapy. Serious consideration should be given to reducing the dosage or discontinuing therapy when the QTc exceeds 550 msec.

The use of sotalol is contraindicated in patients with hypokalemia (< 4 meq/L). Electrolyte disturbances such as hypokalemia and hypomagnesemia may augment the prolongation effect of sotalol on the QT interval and should be corrected prior to institution of sotalol therapy. In addition, patients who experience frequent, severe, or prolonged diarrhea may be subject to electrolyte losses and should be followed closely and managed accordingly during therapy with sotalol.

Fluid Retention

Moderate:

conjugated estrogens / meprobamate

The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with Fluid Retention.

Estrogens and progestogens may cause fluid retention, particularly when given in high dosages or for prolonged periods. Therapy with these agents should be administered cautiously in patients who have preexisting problems with excess fluid. In addition, patients with conditions that may be adversely affected by fluid accumulation, such as asthma, epilepsy, migraine, and cardiovascular or renal dysfunction, should be observed for exacerbation of their condition during estrogen and/or progestogen therapy.

Gallbladder Disease

Moderate:

conjugated estrogens / meprobamate

The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with Gallbladder Disease.

A two- to four-fold increase in risk of gallbladder disease has been noted in women receiving postmenopausal estrogen therapy. The risk for gallbladder disease may be less for premenopausal women using oral contraceptives containing low-dose estrogens and/or progestins. Therapy with estrogens should be administered cautiously in patients with preexisting gallbladder disease or a history of pregnancy-related cholestasis.

Glaucoma/Intraocular Hypertension

Moderate:

conjugated estrogens / meprobamate

The meprobamate in conjugated estrogens / meprobamate has a moderate potential interaction with Glaucoma/Intraocular Hypertension.

Some hypnotic drugs can have an anticholinergic effect and should be used with caution in patients with glaucoma, and trouble urinating due to retention or enlarged prostate.

Moderate:

sotalol

Sotalol has a moderate potential interaction with Glaucoma/Intraocular Hypertension.

Systemic beta-adrenergic receptor blocking agents (aka beta-blockers) may lower intraocular pressure. Therefore, patients with glaucoma or intraocular hypertension may require adjustments in their ophthalmic regimen following a dosing change or discontinuation of beta-blocker therapy.

Heart Block

Major:

sotalol

Sotalol has a major potential interaction with Heart Block.

The use of beta-adrenergic receptor blocking agents (aka beta-blockers) is contraindicated in patients with sinus bradyarrhythmia or heart block greater than the first degree (unless a functioning pacemaker is present). Due to their negative inotropic and chronotropic effects on the heart, the use of beta-blockers is likely to exacerbate these conditions.

Heart Failure

Major:

sotalol

Sotalol has a major potential interaction with Heart Failure.

Beta-adrenergic receptor blocking agents (aka beta-blockers) in general should not be used in patients with overt congestive heart failure (CHF). Sympathetic stimulation may be important in maintaining the hemodynamic function in these patients, thus beta-blockade can worsen the heart failure. However, therapy with beta-blockers may be beneficial and can be administered cautiously in some CHF patients provided they are well compensated and receiving digitalis, diuretics, an ACE inhibitor, and/or nitrates. Carvedilol, specifically, is indicated for use with these agents in the treatment of mild to severe heart failure of ischemic or cardiomyopathic origin. There is also increasing evidence that the addition of a beta-blocker to standard therapy can improve morbidity and mortality in patients with advanced heart failure, although it is uncertain whether effectiveness varies significantly with the different agents. Data from one meta-analysis study suggest a greater reduction of mortality risk for nonselective beta-blockers than for beta-1 selective agents.

Moderate:

conjugated estrogens / meprobamate

The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with Heart Failure.

Estrogens and progestogens may cause fluid retention, particularly when given in high dosages or for prolonged periods. Therapy with these agents should be administered cautiously in patients who have preexisting problems with excess fluid. In addition, patients with conditions that may be adversely affected by fluid accumulation, such as asthma, epilepsy, migraine, and cardiovascular or renal dysfunction, should be observed for exacerbation of their condition during estrogen and/or progestogen therapy.

Hemodialysis

Major:

sotalol

Sotalol has a major potential interaction with Hemodialysis.

Therapy with sotalol should be administered cautiously in patients with renal failure undergoing hemodialysis. The half-life of sotalol is prolonged (up to 69 hours) in anuric patients. Although sotalol is partially removed by hemodialysis, a rebound in drug concentration often occurs after dialysis is complete. Sotalol should preferably be administered after dialysis and after hemodynamic stability has been established. Heart rate and ECG, particularly the QTc interval, must be closely monitored.

Hepatic Tumor

Major:

conjugated estrogens / meprobamate

The conjugated estrogens in conjugated estrogens / meprobamate has a major potential interaction with Hepatic Tumor.

The use of oral contraceptives is contraindicated in patients with liver tumors. An increased risk of benign hepatic adenomas and hepatocellular carcinomas has been associated with long-term, oral estrogen- progestin contraceptive use of at least 4 years and 8 years, respectively. Although these tumors are rare and have not been reported with other types of estrogen or progestogen therapies, any preparation containing estrogens and/or progestogens should probably be avoided in patients with existing tumors of the liver. Hepatic hemangiomas and nodular hyperplasia of the liver have been reported with isolated estrogen therapy.

High Blood Pressure

Major:

conjugated estrogens / meprobamate

The conjugated estrogens in conjugated estrogens / meprobamate has a major potential interaction with High Blood Pressure.

The risk of myocardial infarction and strokes, including those associated with oral contraceptive use and some estrogen use, is increased in patients with hypertension. Moreover, estrogens (and progestogens) may elevate blood pressure and worsen the hypertension, thus compounding the risk. Clinically significant blood pressure increases have been reported during estrogen therapy, particularly in patients receiving high dosages or treated with oral contraceptive combinations having high progestational activity. These effects also increase with duration of therapy and patient age. Therapy with estrogens should be administered cautiously in patients with preexisting hypertension. Some estrogen-based therapies, such as combined hormonal contraceptives, may be contraindicated in patients with uncontrolled hypertension or hypertension with vascular disease. Patients should be monitored for changes in cardiovascular status, and their antihypertensive regimen adjusted or estrogen therapy withdrawn as necessary. In patients requiring contraception, alternative methods should be considered for those who are hypertensive, over age 35, and smoke.

High Cholesterol

Moderate:

conjugated estrogens / meprobamate

The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with High Cholesterol.

Estrogens may cause adverse lipid changes. Use of estrogens has been associated with elevations in triglyceride levels, particularly in women with pre-existing hypertriglyceridemia. Discontinue therapy if elevated triglycerides lead to pancreatitis. Manage hypercholesterolemia appropriately as indicated.

Moderate:

sotalol

Sotalol has a moderate potential interaction with High Cholesterol.

Beta-adrenergic receptor blocking agents (aka beta-blockers) may alter serum lipid profiles. Increases in serum VLDL and LDL cholesterol and triglycerides, as well as decreases in HDL cholesterol, have been reported with some beta-blockers. Patients with preexisting hyperlipidemia may require closer monitoring during beta-blocker therapy, and adjustments made accordingly in their lipid-lowering regimen.

History, Thrombotic/Thromboembolic Disorder

Major:

conjugated estrogens / meprobamate

The conjugated estrogens in conjugated estrogens / meprobamate has a major potential interaction with History, Thrombotic/Thromboembolic Disorder.

The use of estrogens is considered by manufacturers and some authorities to be contraindicated in patients with active thrombotic, thromboembolic, or thrombophilic disorders. The use of estrogen-containing oral contraceptives is additionally deemed contraindicated in patients with a history of such disorders and/or current cerebrovascular or coronary artery disease. Females with a history of migraines with aura are at an increased risk for stroke and this stroke risk may be further increased in females who have migraines with aura with use of combination oral contraceptives. Hypercoagulability and changes in various clotting factors and blood components have been observed in women receiving estrogen therapy. Known preexisting risk factors for increased thromboembolic or cardiovascular events include smoking, especially over age of 35; hypertension; hyperlipidemia; obesity; diabetes; age over 40; and lupus. Therapy with estrogens should be administered cautiously in the lowest effective dosage and only after careful consideration of risks and benefits. Estrogens should be avoided in patients with a history of thrombotic and thromboembolic disorders associated with estrogen use, except when used in the treatment of metastatic breast or prostatic malignancy.

Hyperthyroidism

Moderate:

sotalol

Sotalol has a moderate potential interaction with Hyperthyroidism.

When beta-adrenergic receptor blocking agents (aka beta-blockers) are used to alleviate symptoms of hyperthyroidism such as tachycardia, anxiety, tremor and heat intolerance, abrupt withdrawal can exacerbate thyrotoxicosis or precipitate a thyroid storm. To minimize this risk, cessation of beta-blocker therapy, when necessary, should occur gradually with incrementally reduced dosages over a period of 1 to 2 weeks. Patients should be advised not to discontinue treatment without first consulting with the physician. Close monitoring is recommended during and after therapy withdrawal.

Hypokalemia

Major:

sotalol

Sotalol has a major potential interaction with Hypokalemia.

The use of sotalol is contraindicated in patients with congenital or acquired QT interval prolongation syndromes. Sotalol has dose-dependent proarrhythmic effects related to prolongation of the QT interval. The risk of torsades de pointes is progressively increased as the degree of prolongation becomes greater. The manufacturer states that sotalol should be used with particular caution in patients whose QTc is greater than 500 msec on- therapy. Serious consideration should be given to reducing the dosage or discontinuing therapy when the QTc exceeds 550 msec.

The use of sotalol is contraindicated in patients with hypokalemia (< 4 meq/L). Electrolyte disturbances such as hypokalemia and hypomagnesemia may augment the prolongation effect of sotalol on the QT interval and should be corrected prior to institution of sotalol therapy. In addition, patients who experience frequent, severe, or prolonged diarrhea may be subject to electrolyte losses and should be followed closely and managed accordingly during therapy with sotalol.

Hypoparathyroidism

Moderate:

conjugated estrogens / meprobamate

The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with Hypoparathyroidism.

Estrogens should be used with caution in individuals with severe hypocalcemia or hypoparathyroidism. Estrogen-induced hypocalcemia may occur in patients with hypoparathyroidism; consider whether the benefits of estrogen therapy outweigh the risks.

Hypotension

Major:

sotalol

Sotalol has a major potential interaction with Hypotension.

The use of beta-adrenergic receptor blocking agents (aka beta-blockers) is contraindicated in patients with hypotension or cardiogenic shock. Due to their negative inotropic and chronotropic effects on the heart, the use of beta-blockers is likely to further depress cardiac output and blood pressure, which can be detrimental in these patients.

Ischemic Heart Disease

Major:

conjugated estrogens / meprobamate

The conjugated estrogens in conjugated estrogens / meprobamate has a major potential interaction with Ischemic Heart Disease.

The use of estrogens is considered by manufacturers and some authorities to be contraindicated in patients with active thrombotic, thromboembolic, or thrombophilic disorders. The use of estrogen-containing oral contraceptives is additionally deemed contraindicated in patients with a history of such disorders and/or current cerebrovascular or coronary artery disease. Females with a history of migraines with aura are at an increased risk for stroke and this stroke risk may be further increased in females who have migraines with aura with use of combination oral contraceptives. Hypercoagulability and changes in various clotting factors and blood components have been observed in women receiving estrogen therapy. Known preexisting risk factors for increased thromboembolic or cardiovascular events include smoking, especially over age of 35; hypertension; hyperlipidemia; obesity; diabetes; age over 40; and lupus. Therapy with estrogens should be administered cautiously in the lowest effective dosage and only after careful consideration of risks and benefits. Estrogens should be avoided in patients with a history of thrombotic and thromboembolic disorders associated with estrogen use, except when used in the treatment of metastatic breast or prostatic malignancy.

Major:

sotalol

Sotalol has a major potential interaction with Ischemic Heart Disease.

Heightened sensitivity to catecholamines may occur after prolonged use of beta-adrenergic receptor blocking agents (aka beta-blockers). Exacerbation of angina, myocardial infarction and ventricular arrhythmias have been reported in patients with coronary artery disease following abrupt withdrawal of therapy. Cessation of beta-blocker therapy, whenever necessary, should occur gradually with incrementally reduced dosages over a period of 1 to 2 weeks in patients with coronary insufficiency. Patients should be advised not to discontinue treatment without first consulting with the physician. In patients who experience an exacerbation of angina following discontinuation of beta-blocker therapy, the medication should generally be reinstituted, at least temporarily, along with other clinically appropriate measures.

Liver Disease

Moderate:

conjugated estrogens / meprobamate

The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with Liver Disease.

Estrogens are primarily metabolized by the liver. Use of estrogen therapy is contraindicated in patients with liver dysfunction or disease. Patients with impaired hepatic function may be at increased risk for adverse effects associated with estrogen administration due to decreased drug clearance. Patients with hepatic hemangiomas are at increased risk of exacerbation with use of estrogens. Therapy with estrogens should be administered cautiously in patients with cholestatic jaundice associated with past estrogen use or with pregnancy. In addition, clinicians should be aware that estrogen therapy may affect liver function tests.

Moderate:

conjugated estrogens / meprobamate

The meprobamate in conjugated estrogens / meprobamate has a moderate potential interaction with Liver Disease.

Some anxiolytics, sedatives and hypnotics are extensively metabolized by the liver, and excreted in the urine. Patients with impaired renal and/or hepatic function may be at greater risk for adverse effects, including central nervous system and respiratory depression, due to drug and metabolite accumulation. Therapy with these drugs should be administered cautiously in such patients, with careful dose selection usually starting at the low end of the dosing range.

Moderate:

conjugated estrogens / meprobamate

The meprobamate in conjugated estrogens / meprobamate has a moderate potential interaction with Liver Disease.

In general, anxiolytics, sedatives and hypnotics are extensively metabolized by the liver. Their plasma clearance may be decreased and their half-life prolonged in patients with impaired hepatic function. Therapy with these drugs should be administered cautiously in patients with liver disease (some are not recommended in severe liver impairment), and the dosage should be adjusted accordingly. Laboratory testing is recommended prior and during treatment.

Long QT Syndrome

Major:

sotalol

Sotalol has a major potential interaction with Long QT Syndrome.

The use of sotalol is contraindicated in patients with congenital or acquired QT interval prolongation syndromes. Sotalol has dose-dependent proarrhythmic effects related to prolongation of the QT interval. The risk of torsades de pointes is progressively increased as the degree of prolongation becomes greater. The manufacturer states that sotalol should be used with particular caution in patients whose QTc is greater than 500 msec on- therapy. Serious consideration should be given to reducing the dosage or discontinuing therapy when the QTc exceeds 550 msec.

The use of sotalol is contraindicated in patients with hypokalemia (< 4 meq/L). Electrolyte disturbances such as hypokalemia and hypomagnesemia may augment the prolongation effect of sotalol on the QT interval and should be corrected prior to institution of sotalol therapy. In addition, patients who experience frequent, severe, or prolonged diarrhea may be subject to electrolyte losses and should be followed closely and managed accordingly during therapy with sotalol.

Magnesium Imbalance

Major:

sotalol

Sotalol has a major potential interaction with Magnesium Imbalance.

The use of sotalol is contraindicated in patients with congenital or acquired QT interval prolongation syndromes. Sotalol has dose-dependent proarrhythmic effects related to prolongation of the QT interval. The risk of torsades de pointes is progressively increased as the degree of prolongation becomes greater. The manufacturer states that sotalol should be used with particular caution in patients whose QTc is greater than 500 msec on- therapy. Serious consideration should be given to reducing the dosage or discontinuing therapy when the QTc exceeds 550 msec.

The use of sotalol is contraindicated in patients with hypokalemia (< 4 meq/L). Electrolyte disturbances such as hypokalemia and hypomagnesemia may augment the prolongation effect of sotalol on the QT interval and should be corrected prior to institution of sotalol therapy. In addition, patients who experience frequent, severe, or prolonged diarrhea may be subject to electrolyte losses and should be followed closely and managed accordingly during therapy with sotalol.

Migraine

Major:

conjugated estrogens / meprobamate

The conjugated estrogens in conjugated estrogens / meprobamate has a major potential interaction with Migraine.

The use of estrogens is considered by manufacturers and some authorities to be contraindicated in patients with active thrombotic, thromboembolic, or thrombophilic disorders. The use of estrogen-containing oral contraceptives is additionally deemed contraindicated in patients with a history of such disorders and/or current cerebrovascular or coronary artery disease. Females with a history of migraines with aura are at an increased risk for stroke and this stroke risk may be further increased in females who have migraines with aura with use of combination oral contraceptives. Hypercoagulability and changes in various clotting factors and blood components have been observed in women receiving estrogen therapy. Known preexisting risk factors for increased thromboembolic or cardiovascular events include smoking, especially over age of 35; hypertension; hyperlipidemia; obesity; diabetes; age over 40; and lupus. Therapy with estrogens should be administered cautiously in the lowest effective dosage and only after careful consideration of risks and benefits. Estrogens should be avoided in patients with a history of thrombotic and thromboembolic disorders associated with estrogen use, except when used in the treatment of metastatic breast or prostatic malignancy.

Moderate:

conjugated estrogens / meprobamate

The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with Migraine.

Estrogens and progestogens may cause fluid retention, particularly when given in high dosages or for prolonged periods. Therapy with these agents should be administered cautiously in patients who have preexisting problems with excess fluid. In addition, patients with conditions that may be adversely affected by fluid accumulation, such as asthma, epilepsy, migraine, and cardiovascular or renal dysfunction, should be observed for exacerbation of their condition during estrogen and/or progestogen therapy.

Myasthenia Gravis

Moderate:

sotalol

Sotalol has a moderate potential interaction with Myasthenia Gravis.

Beta-adrenergic receptor blocking agents (aka beta-blockers) may potentiate muscle weakness consistent with certain myasthenic symptoms such as diplopia, ptosis, and generalized weakness. Several beta-blockers have been associated rarely with aggravation of muscle weakness in patients with preexisting myasthenia gravis or myasthenic symptoms. Use cautiously in patients with myasthenia gravis.

Neoplasia, Estrogen Dependent

Major:

conjugated estrogens / meprobamate

The conjugated estrogens in conjugated estrogens / meprobamate has a major potential interaction with Neoplasia, Estrogen Dependent.

The use of estrogens is generally contraindicated in patients with known or suspected estrogen-dependent neoplasia such as breast and endometrial cancer, since it may stimulate tumor proliferation. High dosages of estrogens may be used for the palliative treatment of inoperable, metastatic breast cancer, but only in appropriately selected men and postmenopausal women.

Pancreatitis

Moderate:

conjugated estrogens / meprobamate

The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with Pancreatitis.

Estrogens may cause adverse lipid changes. Use of estrogens has been associated with elevations in triglyceride levels, particularly in women with pre-existing hypertriglyceridemia. Discontinue therapy if elevated triglycerides lead to pancreatitis. Manage hypercholesterolemia appropriately as indicated.

Peripheral Arterial Disease

Major:

sotalol

Sotalol has a major potential interaction with Peripheral Arterial Disease.

Due to their negative inotropic and chronotropic effects on the heart, beta-adrenergic receptor blocking agents (aka beta-blockers) reduce cardiac output and may precipitate or aggravate symptoms of arterial insufficiency in patients with peripheral vascular disease. In addition, the nonselective beta-blockers (e.g., propranolol, pindolol, timolol) may attenuate catecholamine-mediated vasodilation during exercise by blocking beta-2 receptors in peripheral vessels. Therapy with beta-blockers should be administered cautiously in patients with peripheral vascular disease. Close monitoring for progression of arterial obstruction is advised.

Pheochromocytoma

Moderate:

sotalol

Sotalol has a moderate potential interaction with Pheochromocytoma.

Administration of beta-blockers alone in the setting of pheochromocytoma has been associated with a paradoxical increase in blood pressure due to the attenuation of beta receptor-mediated vasodilatation in skeletal muscle. In patients with pheochromocytoma, an alpha-blocking agent should be initiated prior to the use of any beta-blocking agent. Caution should be taken in the administration of these agents to patients suspected of having pheochromocytoma.

Porphyria

Major:

conjugated estrogens / meprobamate

The meprobamate in conjugated estrogens / meprobamate has a major potential interaction with Porphyria.

The use of meprobamate is contraindicated in patients with acute intermittent porphyria. Meprobamate has been reported to precipitate acute attacks of porphyria in susceptible patients.

Prinzmetal's Angina

Moderate:

sotalol

Sotalol has a moderate potential interaction with Prinzmetal's Angina.

Agents with non-selective beta-blocking activity may provoke chest pain in patients with Prinzmetal's variant angina. the use of non-selective beta blockers is not recommended in these patients. Caution should be taken in the administration of these agents to patients suspected of having Prinzmetal's variant angina.

Psoriasis

Moderate:

sotalol

Sotalol has a moderate potential interaction with Psoriasis.

The use of beta-blockers in psoriatic patients should be carefully weighed since the use of these agents may cause an aggravation in psoriasis.

Pulmonary Impairment

Moderate:

conjugated estrogens / meprobamate

The meprobamate in conjugated estrogens / meprobamate has a moderate potential interaction with Pulmonary Impairment.

Oral anxiolytic, sedative, and hypnotic agents may cause respiratory depression and apnea when given in high dosages or following acute overdose. However, some patients may be susceptible at commonly used dosages, including the elderly, debilitated or severely ill patients, those receiving other CNS depressants, and those with limited ventilatory reserve, chronic pulmonary insufficiency or other respiratory disorders. Therapy with anxiolytic, sedative, and hypnotic agents should be administered cautiously in these patients. Appropriate monitoring and individualization of dosage are recommended.

Renal Dysfunction

Major:

sotalol

Sotalol has a major potential interaction with Renal Dysfunction.

Sotalol is primarily eliminated by the kidney. Patients with renal impairment may be at greater risk for adverse effects from sotalol, including torsade de pointes and worsened ventricular tachycardia, due to decreased drug clearance. Therapy with sotalol should be administered cautiously in patients with renal impairment. Dosage adjustments (i.e. prolongation of dosing interval) are recommended in patients with moderate to severe renal dysfunction (CrCl <= 60 mL/min), and dosage escalations should occur not more often than after administration of every 5 to 6 doses. Heart rate and ECG, particularly the QTc interval, should be closely monitored.

Moderate:

conjugated estrogens / meprobamate

The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with Renal Dysfunction.

Estrogens and progestogens may cause fluid retention, particularly when given in high dosages or for prolonged periods. Therapy with these agents should be administered cautiously in patients who have preexisting problems with excess fluid. In addition, patients with conditions that may be adversely affected by fluid accumulation, such as asthma, epilepsy, migraine, and cardiovascular or renal dysfunction, should be observed for exacerbation of their condition during estrogen and/or progestogen therapy.

Moderate:

conjugated estrogens / meprobamate

The meprobamate in conjugated estrogens / meprobamate has a moderate potential interaction with Renal Dysfunction.

Some anxiolytics, sedatives and hypnotics are extensively metabolized by the liver, and excreted in the urine. Patients with impaired renal and/or hepatic function may be at greater risk for adverse effects, including central nervous system and respiratory depression, due to drug and metabolite accumulation. Therapy with these drugs should be administered cautiously in such patients, with careful dose selection usually starting at the low end of the dosing range.

Respiratory Arrest

Moderate:

conjugated estrogens / meprobamate

The meprobamate in conjugated estrogens / meprobamate has a moderate potential interaction with Respiratory Arrest.

Oral anxiolytic, sedative, and hypnotic agents may cause respiratory depression and apnea when given in high dosages or following acute overdose. However, some patients may be susceptible at commonly used dosages, including the elderly, debilitated or severely ill patients, those receiving other CNS depressants, and those with limited ventilatory reserve, chronic pulmonary insufficiency or other respiratory disorders. Therapy with anxiolytic, sedative, and hypnotic agents should be administered cautiously in these patients. Appropriate monitoring and individualization of dosage are recommended.

Seizures

Moderate:

conjugated estrogens / meprobamate

The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with Seizures.

Estrogens and progestogens may cause fluid retention, particularly when given in high dosages or for prolonged periods. Therapy with these agents should be administered cautiously in patients who have preexisting problems with excess fluid. In addition, patients with conditions that may be adversely affected by fluid accumulation, such as asthma, epilepsy, migraine, and cardiovascular or renal dysfunction, should be observed for exacerbation of their condition during estrogen and/or progestogen therapy.

Moderate:

conjugated estrogens / meprobamate

The meprobamate in conjugated estrogens / meprobamate has a moderate potential interaction with Seizures.

Meprobamate may occasionally precipitate seizures in epileptic patients. Therapy with meprobamate should be administered cautiously in patients with a history of epilepsy.

Sinus Node Dysfunction

Major:

sotalol

Sotalol has a major potential interaction with Sinus Node Dysfunction.

The use of beta-adrenergic receptor blocking agents (aka beta-blockers) is contraindicated in patients with sinus bradyarrhythmia or heart block greater than the first degree (unless a functioning pacemaker is present). Due to their negative inotropic and chronotropic effects on the heart, the use of beta-blockers is likely to exacerbate these conditions.

Tachyarrhythmia

Moderate:

sotalol

Sotalol has a moderate potential interaction with Tachyarrhythmia.

Beta-adrenergic blockade in patients with Wolff-Parkinson-White syndrome and tachycardia has been associated with severe bradycardia requiring treatment with a pacemaker. In one case, this result was reported after an initial dose of 5 mg propranolol. The use of beta-adrenergic receptor blocking agents (aka beta-blockers) should be administered cautiously in these patients.

Thrombotic/Thromboembolic Disorder

Major:

conjugated estrogens / meprobamate

The conjugated estrogens in conjugated estrogens / meprobamate has a major potential interaction with Thrombotic/Thromboembolic Disorder.

The use of estrogens is considered by manufacturers and some authorities to be contraindicated in patients with active thrombotic, thromboembolic, or thrombophilic disorders. The use of estrogen-containing oral contraceptives is additionally deemed contraindicated in patients with a history of such disorders and/or current cerebrovascular or coronary artery disease. Females with a history of migraines with aura are at an increased risk for stroke and this stroke risk may be further increased in females who have migraines with aura with use of combination oral contraceptives. Hypercoagulability and changes in various clotting factors and blood components have been observed in women receiving estrogen therapy. Known preexisting risk factors for increased thromboembolic or cardiovascular events include smoking, especially over age of 35; hypertension; hyperlipidemia; obesity; diabetes; age over 40; and lupus. Therapy with estrogens should be administered cautiously in the lowest effective dosage and only after careful consideration of risks and benefits. Estrogens should be avoided in patients with a history of thrombotic and thromboembolic disorders associated with estrogen use, except when used in the treatment of metastatic breast or prostatic malignancy.

Thyroid Disease

Moderate:

conjugated estrogens / meprobamate

The conjugated estrogens in conjugated estrogens / meprobamate has a moderate potential interaction with Thyroid Disease.

When administering estrogen and/or progestogen therapy in patients with thyroid disorders, clinicians should be aware that these hormones may affect thyroid function tests. Patients on thyroid replacement therapy may require higher doses of thyroid hormone and appropriate monitoring. Changes have mostly been reported with the use of combination oral contraceptives. Specifically, thyroid-binding globulin (TBG) may be increased, resulting in elevated circulating total thyroid hormone, as measured by PBI (protein-bound iodine), T4 by column or radioimmunoassay, or T3 by radioimmunoassay. Free T3 resin uptake may be decreased. On the contrary, a decrease in TBG and, consequently, thyroxine concentration, has been reported by the manufacturers of the progestin-only (norethindrone) oral contraceptives.

Urinary Retention

Moderate:

conjugated estrogens / meprobamate

The meprobamate in conjugated estrogens / meprobamate has a moderate potential interaction with Urinary Retention.

Some hypnotic drugs can have an anticholinergic effect and should be used with caution in patients with glaucoma, and trouble urinating due to retention or enlarged prostate.

More resources

conjugated estrogens / meprobamate

A total of 695 drugs are known to interact with conjugated estrogens / meprobamate.

sotalol

A total of 669 drugs are known to interact with sotalol.

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.