Drug Interactions between Conray-400 and nebivolol / valsartan
This report displays the potential drug interactions for the following 2 drugs:
- Conray-400 (iothalamate)
- nebivolol/valsartan
Interactions between your drugs
iothalamate nebivolol
Applies to: Conray-400 (iothalamate) and nebivolol / valsartan
MONITOR: Limited data suggest that patients receiving beta-blockers may have an increased risk of severe hypotensive and/or hypersensitivity reactions to parenteral iodinated contrast media. In addition, allergic/anaphylactoid reactions in these patients may be more difficult to treat. The mechanism is unknown. Theoretically, beta-blocker ophthalmic solutions may also interact, as they are systemically absorbed and can produce clinically significant systemic effects even at low or undetectable plasma levels.
MANAGEMENT: Patients who have received beta-blockers should be closely monitored for adverse reactions to iodinated contrast media. If anaphylaxis occurs, clinicians should be aware that beta-blockers may attenuate the response to epinephrine. Thus, larger doses of epinephrine may be necessary to overcome the bronchospasm, although such large doses can also cause excessive alpha-adrenergic stimulation resulting in hypertension, reflex bradycardia, heart block, and possible potentiation of bronchospasm. Alternative treatments recommended include vigorous supportive care (e.g., fluids) and the use of parenteral beta-agonists for bronchospasm and norepinephrine for hypotension.
References
- (2001) "Product Information. Ultravist (iopromide)." Berlex Laboratories
- (2001) "Product Information. Visipaque (iodixanol)." Nycomed Inc
- (2001) "Product Information. Osmovist 240 (iotrolan)." Berlex Canada Inc
- Costa N (2004) "Understanding contrast media." J Infus Nurs, 27, p. 302-12
valsartan nebivolol
Applies to: nebivolol / valsartan and nebivolol / valsartan
GENERALLY AVOID: In the Valsartan Heart Failure Trial, the combination of valsartan with a beta-blocker and an ACE inhibitor was associated with unfavorable outcomes on morbidity and mortality in heart failure patients. The mechanism is unknown.
MANAGEMENT: The manufacturer recommends that the triple combination of valsartan with a beta-blocker and an ACE inhibitor be avoided in heart failure patients.
References
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- Cerner Multum, Inc. "Australian Product Information."
Drug and food interactions
valsartan food
Applies to: nebivolol / valsartan
GENERALLY AVOID: Moderate-to-high dietary intake of potassium, especially salt substitutes, may increase the risk of hyperkalemia in some patients who are using angiotensin II receptor blockers (ARBs). ARBs can promote hyperkalemia through inhibition of angiotensin II-induced aldosterone secretion. Patients with diabetes, heart failure, dehydration, or renal insufficiency have a greater risk of developing hyperkalemia.
MANAGEMENT: Patients should receive dietary counseling and be advised to not use potassium-containing salt substitutes or over-the-counter potassium supplements without consulting their physician. If salt substitutes are used concurrently, regular monitoring of serum potassium levels is recommended. Patients should also be advised to seek medical attention if they experience symptoms of hyperkalemia such as weakness, irregular heartbeat, confusion, tingling of the extremities, or feelings of heaviness in the legs.
References
- (2001) "Product Information. Cozaar (losartan)." Merck & Co., Inc
- (2001) "Product Information. Diovan (valsartan)." Novartis Pharmaceuticals
Therapeutic duplication warnings
No warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
See also
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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