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Drug Interactions between dexamethasone / ketorolac / moxifloxacin and Isovue-128

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

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Interactions between your drugs

Major

dexAMETHasone iopamidol

Applies to: dexamethasone / ketorolac / moxifloxacin and Isovue-128 (iopamidol)

The injection of steroids together with radiocontrast dyes into the spine is not recommended, as it may increase the risk of seizures, meningitis, and inflammation of the spinal membranes. They may be given together by other routes.

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Major

ketorolac iopamidol

Applies to: dexamethasone / ketorolac / moxifloxacin and Isovue-128 (iopamidol)

Before you undergo any imaging procedure where iopamidol may be given by injection, let your doctor know if you are currently being treated with ketorolac. Injection of iopamidol and similar contrast agents can sometimes cause kidney damage, and combining it with other medications that can also affect the kidney such as ketorolac may increase that risk. If you have been receiving ketorolac, your doctor may need to take special precautionary measures before, during and after the contrast injection, particularly if you also have other risk factors such as diabetes, preexisting kidney problems, dehydration, old age, congestive heart failure, low blood pressure, anemia, and multiple myeloma. Alternatively, if the risk is too great, your doctor may choose to perform a different imaging procedure where injection of a contrast is not needed. Following the procedure, you should drink plenty of fluids to keep yourself hydrated and to help flush the contrast agent out of your kidneys. Seek medical attention if you develop signs and symptoms that may suggest kidney damage such as nausea, vomiting, loss of appetite, increased or decreased urination, sudden weight gain or weight loss, fluid retention, swelling, shortness of breath, muscle cramps, tiredness, weakness, dizziness, confusion, and irregular heart rhythm. 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.

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Major

dexAMETHasone moxifloxacin

Applies to: dexamethasone / ketorolac / moxifloxacin and dexamethasone / ketorolac / moxifloxacin

Moxifloxacin and other medications in its class can cause tendinitis and tendon rupture, and the risk may be increased when combined with a steroid such as dexAMETHasone. Older adults over 60 years of age and those who have received a kidney, heart, and/or lung transplant may be particularly susceptible. Tendon rupture can occur during or up to several months after finishing moxifloxacin treatment and may require surgery or result in prolonged disability. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Stop taking moxifloxacin and call your doctor immediately if you experience pain, swelling, or inflammation of a tendon area such as the back of the ankle, shoulder, biceps, hand, or thumb. You should also avoid exercise or use of the affected area until further instruction from your doctor. 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.

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Major

iopamidol moxifloxacin

Applies to: Isovue-128 (iopamidol) and dexamethasone / ketorolac / moxifloxacin

Before you undergo any imaging procedure where iopamidol may be injected directly into the spine, let your doctor know if you are currently being treated with moxifloxacin. Injection of iopamidol into the spine can sometimes cause seizures, and the risk may be increased if you are also using other medications that can cause seizures such as moxifloxacin. You may be more susceptible if you are elderly, undergoing alcohol or drug withdrawal, have a history of seizures, or have a condition affecting the central nervous system such as a brain tumor or head trauma. Your doctor may want to withhold moxifloxacin for a certain length of time before and after the procedure, or you may need to be monitored more closely during the procedure. 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.

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Moderate

dexAMETHasone ketorolac

Applies to: dexamethasone / ketorolac / moxifloxacin and dexamethasone / ketorolac / moxifloxacin

Using dexAMETHasone together with ketorolac may increase the risk of side effects in the gastrointestinal tract such as inflammation, bleeding, ulceration, and rarely, perforation. Gastrointestinal perforation is a potentially fatal condition and medical emergency where a hole forms all the way through the stomach or intestine. You should take these medications with food to lessen the risk. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Your doctor may also be able to recommend medications to help protect the stomach and intestine if you are at high risk for developing serious gastrointestinal complications. You should seek immediate medical attention if you experience any unusual bleeding or bruising, or have other signs and symptoms of bleeding such as dizziness; lightheadedness; red or black, tarry stools; coughing up or vomiting fresh or dried blood that looks like coffee grounds; severe headache; and weakness. 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.

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Moderate

ketorolac moxifloxacin

Applies to: dexamethasone / ketorolac / moxifloxacin and dexamethasone / ketorolac / moxifloxacin

Moxifloxacin may rarely cause central nervous system side effects such as tremors, involuntary muscle movements, anxiety, confusion, depression, hallucinations or seizures, and combining it with other medications that can also affect the central nervous system such as ketorolac may increase that risk. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor 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.

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Drug and food interactions

Moderate

ketorolac food

Applies to: dexamethasone / ketorolac / moxifloxacin

Ask your doctor before using ketorolac together with ethanol. Do not drink alcohol while taking ketorolac. Alcohol can increase your risk of stomach bleeding caused by ketorolac. Call your doctor at once if you have symptoms of bleeding in your stomach or intestines. This includes black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds. 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.

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

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


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

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