Skip to main content

Drug Interactions between doxepin topical and guanadrel

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

Edit list (add/remove drugs)

Interactions between your drugs

Moderate

guanadrel doxepin topical

Applies to: guanadrel and doxepin topical

GENERALLY AVOID: Tricyclic antidepressants (TCAs) may reduce the antihypertensive effects of guanethidine. Loss of blood pressure control may result. The mechanism is TCA-induced inhibition of guanethidine uptake into adrenergic neurons. Hypotensive reactions may occur when the tricyclic antidepressant is discontinued. Other adrenergic neurone blockers may also be affected.

MANAGEMENT: Either a different antidepressant or a different antihypertensive agent (such as an ACE inhibitor or beta-blocker) should be considered. If patients do receive this combination, their blood pressure should be closely monitored when initiating or discontinuing either drug.

References

  1. Meyer JF, McAllister CK, Goldberg LI (1970) "Insidious and prolonged antagonism of guanethidine by amitriptyline." JAMA, 213, p. 1487-8
  2. Ober KF, Wang RI (1973) "Drug interactions with guanethidine." Clin Pharmacol Ther, 14, p. 190-5
  3. MacLennan WJ (1974) "Drug interactions." Gerontol Clin (Basel), 16, p. 18-24
  4. Poe TE, Edwards JL, Taylor RB (1979) "Hypertensive crisis possibly due to drug interaction." Postgrad Med, 66, p. 235-7
  5. Koe BK, Constantine JW (1972) "Blocking H 3 -norepinephrine uptake and some guanethidine-induced effects with tricyclic psychotherapeutic drugs." Arch Int Pharmacodyn Ther, 195, p. 71-80
  6. Gokhale SD, Gulati OD, Udwadia BP (1966) "Antagonism of the adrenergic neurone blocking action of guanethidine by certain antidepressant and antihistamine drugs." Arch Int Pharmacodyn Ther, 160, p. 321-9
  7. Leishman AW, Matthews HL, Smith AJ (1963) "Antagonism of guanethidine by imipramine." Lancet, 1, p. 112
  8. Stone CA, Porter CC, Stavorski JM, et al. (1964) "Antagonism of certain effects of catecholamine-depleting agents by antidepressant and related drugs." J Pharmacol Exp Ther, 144, p. 196-204
  9. Mitchell JR, Cavanaugh JH, Arias L, Oates JA (1970) "Guanethidine and related agents. III: antagonism by drugs which inhibit the norepinephrine pump in man." J Clin Invest, 49, p. 1596-604
View all 9 references

Switch to consumer interaction data

Drug and food interactions

Moderate

guanadrel food

Applies to: guanadrel

MONITOR: Many psychotherapeutic and CNS-active agents (e.g., anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics, opioids, alcohol, muscle relaxants) exhibit hypotensive effects, especially during initiation of therapy and dose escalation. Coadministration with antihypertensives and other hypotensive agents, in particular vasodilators and alpha-blockers, may result in additive effects on blood pressure and orthostasis.

MANAGEMENT: Caution and close monitoring for development of hypotension is advised during coadministration of these agents. Some authorities recommend avoiding alcohol in patients receiving vasodilating antihypertensive drugs. Patients should be advised to avoid rising abruptly from a sitting or recumbent position and to notify their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia.

References

  1. Sternbach H (1991) "Fluoxetine-associated potentiation of calcium-channel blockers." J Clin Psychopharmacol, 11, p. 390-1
  2. Shook TL, Kirshenbaum JM, Hundley RF, Shorey JM, Lamas GA (1984) "Ethanol intoxication complicating intravenous nitroglycerin therapy." Ann Intern Med, 101, p. 498-9
  3. Feder R (1991) "Bradycardia and syncope induced by fluoxetine." J Clin Psychiatry, 52, p. 139
  4. Ellison JM, Milofsky JE, Ely E (1990) "Fluoxetine-induced bradycardia and syncope in two patients." J Clin Psychiatry, 51, p. 385-6
  5. Rodriguez de la Torre B, Dreher J, Malevany I, et al. (2001) "Serum levels and cardiovascular effects of tricyclic antidepressants and selective serotonin reuptake inhibitors in depressed patients." Ther Drug Monit, 23, p. 435-40
  6. Cerner Multum, Inc. "Australian Product Information."
  7. Pacher P, Kecskemeti V (2004) "Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns?" Curr Pharm Des, 10, p. 2463-75
  8. Andrews C, Pinner G (1998) "Postural hypotension induced by paroxetine." BMJ, 316, p. 595
View all 8 references

Switch to consumer interaction data

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

Report options

Loading...
QR code containing a link to this page

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.

Medical Disclaimer