Drug Interactions between desmopressin and moxifloxacin / triamcinolone

CONTRAINDICATED: Coadministration of desmopressin with loop diuretics or systemic or inhaled corticosteroids may increase the risk of severe hyponatremia. Loop diuretics and corticosteroids can potentiate the antidiuretic response to desmopressin by causing loss of sodium and water retention, respectively, thus coadministration may increase the risk of water intoxication and hyponatremia. Elderly patients may be particularly susceptible.

MANAGEMENT: Concomitant use of certain desmopressin products with loop diuretics or systemic or inhaled corticosteroids is considered contraindicated. Please consult individual product labeling for specific recommendations. Caution is advised when coadministration is required. Serum electrolytes, especially sodium, as well as BUN and creatinine should be monitored regularly and as often as clinically appropriate based on individual risk factors. Patients should be advised to seek medical attention if they develop signs and symptoms of water intoxication or hyponatremia such as anorexia, nausea, vomiting, headache, malaise, lethargy, irritability, difficulty concentrating, memory impairment, confusion, weakness, muscle spasm, unsteadiness (which may lead to falls), anuria, and weight gain. Severe hyponatremia can be life-threatening if it is not promptly diagnosed and treated; therefore, early treatment is important to help prevent progression to seizures, coma, respiratory arrest, and death.

MONITOR CLOSELY: Concomitant administration of corticosteroids may potentiate the risk of tendinitis and tendon rupture associated with fluoroquinolone treatment. The mechanism is unknown. Tendinitis and tendon rupture have most frequently involved the Achilles tendon, although cases involving the rotator cuff (the shoulder), the hand, the biceps, and the thumb have also been reported. Some have required surgical repair or resulted in prolonged disability. Tendon rupture can occur during or up to several months after completion of fluoroquinolone therapy.

MANAGEMENT: Caution is recommended if fluoroquinolones are prescribed in combination with corticosteroids, particularly in patients with other concomitant risk factors (e.g., age over 60 years; recipient of kidney, heart, and/or lung transplant). Patients should be advised to stop taking the fluoroquinolone, avoid exercise and use of the affected area, and promptly contact their physician if they experience pain, swelling, or inflammation of a tendon. In general, fluoroquinolones should only be used to treat conditions that are proven or strongly suspected to be caused by bacteria and only if the benefits outweigh the risks.