Can you take Donepezil with Isovue-250?
1 drug interaction and 25 additional warnings found for the following 2 drugs:
- donepezil
- Isovue-250 (iopamidol)
Drug interactions
Major drug interactions
Major:
iopamidol donepezil
Applies to: Isovue-250 (iopamidol) and donepezil
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 donepezil. 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 donepezil. 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 donepezil 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.
Food/lifestyle interactions
No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
Disease interactions
25 potential interactions Applies to: 19 conditions, including High Blood Pressure, Allergies, Heart Failure, Asthma, and COPD.
Allergies
Moderate:
Isovue-250
The iopamidol in Isovue-250 has a moderate potential interaction with Allergies.
Iodinated contrast media such as ioversol, can cause life-threatening or fatal hypersensitivity reactions including anaphylaxis and anaphylactic shock. Manifestations include respiratory arrest, laryngospasm, bronchospasm, angioedema, and shock. Most severe reactions develop shortly after the start of the injection (e.g. within 1 to 3 minutes), but delayed reactions may occur. There is an increased risk in patients with a history of a previous reaction to contrast agent, and known allergies (i.e., bronchial asthma, drug, or food allergies), and other hypersensitivities. Caution is advised on these patients. Premedication with antihistamines or corticosteroids to avoid or minimize possible allergic reactions may reduce both their incidence and severity.
Moderate:
Isovue-250
The iopamidol in Isovue-250 has a moderate potential interaction with Allergies.
The possibility of a reaction, including serious, life-threatening, fatal, anaphylactoid or cardiovascular reactions, should always be considered when using iopamidol. Patients at increased risk include those with a history of a previous reaction to a contrast medium, patients with a known sensitivity to iodine per se, and patients with a known clinical hypersensitivity (bronchial asthma, hay fever, and food allergies). Caution and monitoring is advised. Competent personnel and emergency facilities should be available for at least 30 to 60 minutes since severe delayed reactions may occur.
Arrhythmia
Major:
donepezil
Donepezil has a major potential interaction with Arrhythmia.
Due to their pharmacological action, cholinesterase inhibitors can have a vagotonic effect on the sinoatrial and atrioventricular nodes producing bradycardia or heart block. Therapy with cholinesterase inhibitors should be administered cautiously in patients with preexisting bradycardia or underlying cardiac conduction abnormalities. Syncopal episodes have been reported. Atropine may be used to reverse bradycardia produced by cholinesterase inhibitors.
Asthma
Major:
donepezil
Donepezil has a major potential interaction with Asthma.
Cholinesterase inhibitors inhibit the hydrolysis of acetylcholine. The enhanced effect of acetylcholine produces constriction of the bronchi, increased bronchial secretions, and bronchospasm. Therapy with cholinesterase inhibitors should be administered cautiously in patients with respiratory dysfunction, history of asthma, or obstructive pulmonary disease. Respiratory function should be closely monitored for the occurrence of respiratory adverse reactions. Use of atropine along with discontinuation of the cholinesterase inhibitor may be required for serious respiratory distress.
Moderate:
Isovue-250
The iopamidol in Isovue-250 has a moderate potential interaction with Asthma.
Iodinated contrast media such as ioversol, can cause life-threatening or fatal hypersensitivity reactions including anaphylaxis and anaphylactic shock. Manifestations include respiratory arrest, laryngospasm, bronchospasm, angioedema, and shock. Most severe reactions develop shortly after the start of the injection (e.g. within 1 to 3 minutes), but delayed reactions may occur. There is an increased risk in patients with a history of a previous reaction to contrast agent, and known allergies (i.e., bronchial asthma, drug, or food allergies), and other hypersensitivities. Caution is advised on these patients. Premedication with antihistamines or corticosteroids to avoid or minimize possible allergic reactions may reduce both their incidence and severity.
Moderate:
Isovue-250
The iopamidol in Isovue-250 has a moderate potential interaction with Asthma.
The possibility of a reaction, including serious, life-threatening, fatal, anaphylactoid or cardiovascular reactions, should always be considered when using iopamidol. Patients at increased risk include those with a history of a previous reaction to a contrast medium, patients with a known sensitivity to iodine per se, and patients with a known clinical hypersensitivity (bronchial asthma, hay fever, and food allergies). Caution and monitoring is advised. Competent personnel and emergency facilities should be available for at least 30 to 60 minutes since severe delayed reactions may occur.
COPD
Major:
donepezil
Donepezil has a major potential interaction with COPD.
Cholinesterase inhibitors inhibit the hydrolysis of acetylcholine. The enhanced effect of acetylcholine produces constriction of the bronchi, increased bronchial secretions, and bronchospasm. Therapy with cholinesterase inhibitors should be administered cautiously in patients with respiratory dysfunction, history of asthma, or obstructive pulmonary disease. Respiratory function should be closely monitored for the occurrence of respiratory adverse reactions. Use of atropine along with discontinuation of the cholinesterase inhibitor may be required for serious respiratory distress.
Dehydration
Moderate:
Isovue-250
The iopamidol in Isovue-250 has a moderate potential interaction with Dehydration.
When using iopamidol, preparatory dehydration is dangerous and may contribute to acute renal failure in patients with advanced vascular disease, diabetic patients, and in susceptible nondiabetic patients (often elderly with preexisting renal disease). Patients should be well hydrated prior to and following iopamidol administration.
Heart Failure
Moderate:
Isovue-250
The iopamidol in Isovue-250 has a moderate potential interaction with Heart Failure.
After parenteral administration of a radiopaque agent such as iopamidol, competent personnel and emergency facilities should be available for at least 30 to 60 minutes since severe delayed reactions may occur. Caution should be exercised in hydrating patients with underlying conditions that may be worsened by fluid overload, such as congestive heart failure.
Moderate:
Isovue-250
The iopamidol in Isovue-250 has a moderate potential interaction with Heart Failure.
In patients with advanced renal disease, iodinated contrast media should be used with caution, and only when the need for the examination dictates, since the excretion of the medium may be impaired. Patients with combined renal and hepatic disease, severe hypertension or congestive heart failure, and those with recent renal transplant may present an additional risk.
High Blood Pressure
Moderate:
Isovue-250
The iopamidol in Isovue-250 has a moderate potential interaction with High Blood Pressure.
In patients with advanced renal disease, iodinated contrast media should be used with caution, and only when the need for the examination dictates, since the excretion of the medium may be impaired. Patients with combined renal and hepatic disease, severe hypertension or congestive heart failure, and those with recent renal transplant may present an additional risk.
Hyperthyroidism
Major:
Isovue-250
The iopamidol in Isovue-250 has a major potential interaction with Hyperthyroidism.
Reports of thyroid storm following the use of iodinated diagnostic agents in patients with hyperthyroidism or with an autonomously functioning thyroid nodule suggest that this additional risk be evaluated in such patients before the use of any contrast medium. Some agents such as ioversol are contraindicated in symptomatic hyperthyroidism.
Moderate:
donepezil
Donepezil has a moderate potential interaction with Hyperthyroidism.
Many of the manifestations of hyperthyroidism may be exacerbated by increased levels of acetylcholine produced by cholinesterase inhibitors. Therapy with cholinesterase inhibitors should be administered cautiously to patients with hyperthyroidism. Monitoring of thyroid levels is recommended.
Ischemic Heart Disease
Major:
donepezil
Donepezil has a major potential interaction with Ischemic Heart Disease.
The use of cholinesterase inhibitors has been associated with a constriction of coronary arteries. Therapy with cholinesterase inhibitors should be administered cautiously in patients with coronary artery disease.
Kidney Transplant
Moderate:
Isovue-250
The iopamidol in Isovue-250 has a moderate potential interaction with Kidney Transplant.
In patients with advanced renal disease, iodinated contrast media should be used with caution, and only when the need for the examination dictates, since the excretion of the medium may be impaired. Patients with combined renal and hepatic disease, severe hypertension or congestive heart failure, and those with recent renal transplant may present an additional risk.
Liver Disease
Moderate:
donepezil
Donepezil has a moderate potential interaction with Liver Disease.
Donepezil is extensively metabolized by the liver (CYP450-2D6/3A4) to two active and various minor forms. The clearance of donepezil was decreased 20% in patients with stable alcoholic cirrhosis compared to healthy patients. Care should be exercised when using donepezil in patients with liver disease.
Moderate:
Isovue-250
The iopamidol in Isovue-250 has a moderate potential interaction with Liver Disease.
In patients with advanced renal disease, iodinated contrast media should be used with caution, and only when the need for the examination dictates, since the excretion of the medium may be impaired. Patients with combined renal and hepatic disease, severe hypertension or congestive heart failure, and those with recent renal transplant may present an additional risk.
Multiple Myeloma
Moderate:
Isovue-250
The iopamidol in Isovue-250 has a moderate potential interaction with Multiple Myeloma.
A definite risk exists in the use of intravascular contrast agents in patients who are known to have multiple myeloma. In such cases, anuria has developed resulting in progressive uremia, renal failure and eventually death. Although neither the contrast agent nor dehydration has separately proved to be the cause of anuria in myeloma, it has been speculated that the combination of both may be causative factors. The risk in patients with myeloma is not a contraindication to the procedure; however, partial dehydration in the preparation of these patients for the examination is not recommended since this may predispose to precipitation of myeloma protein in the renal tubules. Myeloma, which occurs most commonly in persons over 40, should be considered before instituting intravascular administration of contrast agents.
Myasthenia Gravis
Moderate:
Isovue-250
The iopamidol in Isovue-250 has a moderate potential interaction with Myasthenia Gravis.
The administration of iodinated contrast media may aggravate the symptoms of myasthenia gravis. Caution is advised when using these agents in patients with this condition.
Parkinsonism
Major:
donepezil
Donepezil has a major potential interaction with Parkinsonism.
Cholinesterase inhibitors should be used with caution in patients with parkinsonism. Some of these drugs might be contraindicated in these patients (refer to specific prescribing information). Symptoms of Parkinson's disease may be exacerbated with the increase in cholinergic activity. Caregivers and patients should be advised.
Peptic Ulcer
Moderate:
donepezil
Donepezil has a moderate potential interaction with Peptic Ulcer.
The use of cholinesterase inhibitors is associated with an increase in gastric acid secretion and gastric contractions. Monitor for symptoms of active or occult gastrointestinal bleeding, especially in patients at increased risk for developing ulcers (e.g., history of ulcer disease or concurrent use of nonsteroidal anti-inflammatory drugs).
Pheochromocytoma
Major:
Isovue-250
The iopamidol in Isovue-250 has a major potential interaction with Pheochromocytoma.
Administration of radiopaque materials to patients known or suspected of having pheochromocytoma should be performed with extreme caution. If, in the opinion of the physician, the possible benefits of such procedures outweigh the considered risk, the procedures should be performed with the absolute minimum amount of injected radiopaque medium. The blood pressure should be assessed throughout the procedure and measures for treatment of a hypertensive crisis should be available.
Renal Dysfunction
Moderate:
Isovue-250
The iopamidol in Isovue-250 has a moderate potential interaction with Renal Dysfunction.
In patients with advanced renal disease, iodinated contrast media should be used with caution, and only when the need for the examination dictates, since the excretion of the medium may be impaired. Patients with combined renal and hepatic disease, severe hypertension or congestive heart failure, and those with recent renal transplant may present an additional risk.
Seizures
Moderate:
donepezil
Donepezil has a moderate potential interaction with Seizures.
Cholinesterase inhibitors have been associated with convulsions and tremor. Therapy with cholinesterase inhibitors should be administered cautiously in patients with seizure disorders. Patients with Alzheimer's disease should be closely monitored for seizures.
Sickle Cell Anemia
Moderate:
Isovue-250
The iopamidol in Isovue-250 has a moderate potential interaction with Sickle Cell Anemia.
Some contrast agents have shown to promote the phenomenon of sickling (blood cell rupture) in individuals who are homozygous for sickle cell disease when administered intravenously or intra- arterially. Caution is advised.
More resources
donepezil
A total of 547 drugs are known to interact with donepezil.
- Donepezil is in the drug class cholinesterase inhibitors.
-
Donepezil is used to treat the following conditions:
- Alzheimer's Disease
- Lewy Body Dementia (off-label)
- Mild Cognitive Impairment (off-label)
Isovue-250
A total of 333 drugs are known to interact with Isovue-250.
- Isovue-250 is in the drug class non-ionic iodinated contrast media.
- Isovue-250 is used to treat Endoscopy or Radiology Premedication.
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.