Drug Interactions between diflunisal and vasopressin

Consumer information for this interaction is not currently available.

MONITOR: The antidiuretic response to vasopressin or desmopressin may be potentiated by certain drugs, including nonsteroidal anti-inflammatory agents, selective serotonin reuptake inhibitors, tricyclic/tetracyclic antidepressants, carbamazepine, chlorpropamide, chlorpromazine, clofibrate, eslicarbazepine, fludrocortisone, haloperidol, lamotrigine, oxcarbazepine, urea, and some antineoplastic agents (e.g., vinca alkaloids, cisplatin, cyclophosphamide). These drugs can occasionally cause fluid retention, in some cases secondary to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Coadministration with vasopressin or desmopressin may, therefore, increase the risk of water intoxication and/or hyponatremia. Seizure and coma in association with severe hyponatremia have been reported during concomitant use of desmopressin and imipramine or ibuprofen. In addition, indomethacin may prolong the effects of vasopressin on cardiac index and systemic vascular resistance. The elderly may be particularly susceptible.

MANAGEMENT: Caution is advised when vasopressin or desmopressin is used in combination with drugs that can cause fluid retention or SIADH. Some authorities recommend adjusting vasopressin dosage as needed. Serum electrolytes, especially sodium, as well as BUN and creatinine should be monitored regularly. 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.