Interactions between Duzallo and Lithium

Lithium has a major potential interaction with Alcoholism.

Antipsychotics can lower the seizure threshold and trigger seizures in a dose-dependent manner. Seizures have been reported in patients receiving antipsychotic therapy and may occur in epileptic patients even with maintenance of routine anticonvulsant treatment. Therapy with antipsychotics should be administered cautiously in patients with a history of seizures or other predisposing factors, such as head trauma, CNS abnormalities, and alcoholism. High dosages should be avoided if possible.

The allopurinol in Duzallo has a moderate potential interaction with Bone Marrow Depression/Low Blood Counts.

Bone marrow suppression has been reported in patients receiving allopurinol; however, most of these patients were receiving concomitant medications with the known potential to cause such an effect. The suppression has occurred from as early as 6 weeks to as long as 6 years after the initiation of allopurinol therapy. Therapy with allopurinol should be administered cautiously to patients with or predisposed to bone marrow suppression.

Lithium has a moderate potential interaction with Breast Cancer.

Antipsychotic drugs can elevate serum prolactin concentrations, and this elevation persists during chronic administration. This should be considered if therapy will be prescribed in patients with previously detected breast cancer as one-third of human breast cancers are prolactin-dependent in vitro. Associated disturbances such as galactorrhea, amenorrhea, gynecomastia, and impotence have been reported. Appropriate laboratory testing and follow-up is advised.

Lithium has a major potential interaction with Cardiovascular Conditions and Disorders.

Lithium should generally not be given to patients with significant cardiovascular disease since the risk of lithium toxicity is high in these patients. Additionally, there have been postmarketing reports of a possible association between lithium therapy and the unmasking of Brugada Syndrome, a disorder characterized by abnormal EKG findings and a risk of sudden death. Lithium should be avoided in patients with this diagnosis or suspicion of it, or that have risk factors, which include unexplained syncope, family history of this syndrome, or family history of unexplained sudden death before the age of 45 years.
Therapy with lithium should be administered with extreme caution in patients with preexisting cardiac disease. Consultation with a cardiologist is highly recommended and cardiac monitoring should be completed before and during treatment.

The lesinurad in Duzallo has a moderate potential interaction with Cardiovascular Conditions and Disorders.

Major adverse cardiovascular events (cardiovascular deaths, non- fatal myocardial infarctions and non- fatal strokes), were reported during clinical trials with some antihyperuricemic agents, such as febuxostat and lesinurad. Although a causal relationship has not been established, caution is advised when used in patients with cardiovascular disease. Monitoring for signs or symptoms of myocardial infarction or stroke is recommended.

Lithium has a major potential interaction with Central Nervous System Disorders.

Antipsychotics can lower the seizure threshold and trigger seizures in a dose-dependent manner. Seizures have been reported in patients receiving antipsychotic therapy and may occur in epileptic patients even with maintenance of routine anticonvulsant treatment. Therapy with antipsychotics should be administered cautiously in patients with a history of seizures or other predisposing factors, such as head trauma, CNS abnormalities, and alcoholism. High dosages should be avoided if possible.

Lithium has a major potential interaction with Dehydration.

Lithium reduces the ability of the kidney to concentrate urine and produces a mild diabetes insipidus and polyuria. Therefore, patients with preexisting dehydration are more prone to lithium retention and toxicity. Therapy with lithium should be administered cautiously in dehydrated patients and may need to be discontinued until improvement in hydration status. Careful monitoring of lithium levels are recommended. Patients with sweating, diarrhea or concomitant infection with fever may need a temporary reduction or cessation of medication.

The allopurinol in Duzallo has a moderate potential interaction with Dehydration.

Patients with pre-existing kidney conditions, including chronic kidney disease or a history of kidney stones, may be at increased risk for worsening of kidney function or acute kidney injury due to xanthine calculi during treatment with this drug. Ensure adequate hydration to maintain a daily urine output of at least 2 liters in adults and 2 liters/m2/day (or 100 mL/m2/hour) in pediatric patients. Maintaining a neutral to slightly alkaline urine pH is also recommended to prevent xanthine calculi and reduce urate precipitation. Renal function should be closely monitored, especially during the early stages of therapy.

Lithium has a major potential interaction with Dementia.

Antipsychotic drugs are not approved for the treatment of patients with dementia-related psychosis. Older patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death; although the causes were varied, most of the deaths appeared to be either cardiovascular (e.g., heart failure, sudden death) or infectious (e.g., pneumonia) in nature. A causal relationship with antipsychotic use has not been established. In controlled trials in older patients with dementia-related psychosis, patients randomized to risperidone, aripiprazole, and olanzapine had higher incidence of cerebrovascular adverse events (e.g., stroke, transient ischemic attack), including fatalities, compared to patients treated with placebo.

Lithium has a major potential interaction with Diarrhea.

Lithium reduces the ability of the kidney to concentrate urine and produces a mild diabetes insipidus and polyuria. Therefore, patients with preexisting dehydration are more prone to lithium retention and toxicity. Therapy with lithium should be administered cautiously in dehydrated patients and may need to be discontinued until improvement in hydration status. Careful monitoring of lithium levels are recommended. Patients with sweating, diarrhea or concomitant infection with fever may need a temporary reduction or cessation of medication.

Lithium has a major potential interaction with Diarrhea.

The risk for lithium toxicity may be increased in patients with diarrhea and excessive sweating. Dehydration and sodium depletion may occur in these patients leading to lithium retention and toxicity. The use of lithium may need to be reduced or suspended until the condition resolves. Supplemental fluid and salt may need to be administered. Monitoring serum lithium levels is recommended.

The allopurinol in Duzallo has a moderate potential interaction with Diarrhea.

Patients with pre-existing kidney conditions, including chronic kidney disease or a history of kidney stones, may be at increased risk for worsening of kidney function or acute kidney injury due to xanthine calculi during treatment with this drug. Ensure adequate hydration to maintain a daily urine output of at least 2 liters in adults and 2 liters/m2/day (or 100 mL/m2/hour) in pediatric patients. Maintaining a neutral to slightly alkaline urine pH is also recommended to prevent xanthine calculi and reduce urate precipitation. Renal function should be closely monitored, especially during the early stages of therapy.

Lithium has a major potential interaction with Fever.

Lithium reduces the ability of the kidney to concentrate urine and produces a mild diabetes insipidus and polyuria. Therefore, patients with preexisting dehydration are more prone to lithium retention and toxicity. Therapy with lithium should be administered cautiously in dehydrated patients and may need to be discontinued until improvement in hydration status. Careful monitoring of lithium levels are recommended. Patients with sweating, diarrhea or concomitant infection with fever may need a temporary reduction or cessation of medication.

Lithium has a moderate potential interaction with Fever.

Patients with fever may have a lower tolerance to lithium due to increased fluid and sodium loss. Lithium dosage may need to be reduced or suspended in such patients. Monitoring lithium serum levels is recommended.

Lithium has a major potential interaction with Hyperhidrosis.

The risk for lithium toxicity may be increased in patients with diarrhea and excessive sweating. Dehydration and sodium depletion may occur in these patients leading to lithium retention and toxicity. The use of lithium may need to be reduced or suspended until the condition resolves. Supplemental fluid and salt may need to be administered. Monitoring serum lithium levels is recommended.

Lithium has a major potential interaction with Hyperhidrosis.

Lithium reduces the ability of the kidney to concentrate urine and produces a mild diabetes insipidus and polyuria. Therefore, patients with preexisting dehydration are more prone to lithium retention and toxicity. Therapy with lithium should be administered cautiously in dehydrated patients and may need to be discontinued until improvement in hydration status. Careful monitoring of lithium levels are recommended. Patients with sweating, diarrhea or concomitant infection with fever may need a temporary reduction or cessation of medication.

Lithium has a moderate potential interaction with Hyperprolactinemia.

Antipsychotic drugs can elevate serum prolactin concentrations, and this elevation persists during chronic administration. This should be considered if therapy will be prescribed in patients with previously detected breast cancer as one-third of human breast cancers are prolactin-dependent in vitro. Associated disturbances such as galactorrhea, amenorrhea, gynecomastia, and impotence have been reported. Appropriate laboratory testing and follow-up is advised.

Lithium has a major potential interaction with Hyponatremia.

Lithium decreases sodium reabsorption by the renal tubules which could lead to sodium depletion. Therapy with lithium should be administered cautiously in patients with preexisting sodium depletion as the risk of lithium toxicity is increased. Lower dosages may be required. Patients should maintain a normal diet, including salt, and an adequate fluid intake. Monitoring lithium serum concentrations is recommended.

The lesinurad in Duzallo has a major potential interaction with Kidney Transplant.

The use of lesinurad is contraindicated in patients with severe renal impairment, end stage renal disease, kidney transplant recipient and patients on dialysis.

The lesinurad in Duzallo has a major potential interaction with Lesch-Nyhan Syndrome.

No studies with febuxostat or lesinurad have been conducted in patients with secondary hyperuricemia (including organ transplant recipients). The use of these drugs is contraindicated in patients where the uric acid formation is greatly increased, such as patients with malignant disease, tumor lysis syndrome or Lesch-Nyhan syndrome.

The lesinurad in Duzallo has a moderate potential interaction with Liver Disease.

No studies have been conducted in patients with severe hepatic impairment (Child-Pugh Class C), therefore caution should be exercised if using febuxostat or lesinurad on these patients. No dose adjustment is necessary in patients with mild or moderate hepatic impairment.

The allopurinol in Duzallo has a moderate potential interaction with Liver Disease.

Allopurinol may cause hepatotoxicity. In patients with pre-existing liver disease, monitor liver enzymes periodically during the early stages of therapy. Discontinue treatment in patients with elevated liver enzymes.

Lithium has a major potential interaction with Neuroleptic Malignant Syndrome.

Neuroleptic Malignant Syndrome (NMS), a potentially fatal symptom complex, has been reported in association with the use of antipsychotic drugs. The diagnostic evaluation is complicated and the management requires immediate discontinuation of the antipsychotic therapy and intensive symptomatic treatment and medical monitoring. If a patient that has recovered from NMS requires antipsychotic drug treatment again, the reintroduction of therapy should be carefully considered as NMS recurrences have been reported.

Lithium has a moderate potential interaction with Neutropenia.

The use of antipsychotics has been associated with events of leukopenia, neutropenia and agranulocytosis. Possible risk factors include preexisting low white blood cell count, and history of drug induced leukopenia/neutropenia. Patients with these risk factors should have complete blood count monitored frequently during the first few months of therapy. Patients should also be monitored for any signs or symptoms of infection. Treatment should be discontinued in any patient who develops a sore throat, fever, stomatitis, or other signs of infection along with a low WBC count or severe neutropenia (ANC < 1000/mm3).

The lesinurad in Duzallo has a major potential interaction with Organ Transplant.

No studies with febuxostat or lesinurad have been conducted in patients with secondary hyperuricemia (including organ transplant recipients). The use of these drugs is contraindicated in patients where the uric acid formation is greatly increased, such as patients with malignant disease, tumor lysis syndrome or Lesch-Nyhan syndrome.

The lesinurad in Duzallo has a major potential interaction with Renal Dysfunction.

The use of lesinurad is contraindicated in patients with severe renal impairment, end stage renal disease, kidney transplant recipient and patients on dialysis.

Lithium has a major potential interaction with Renal Dysfunction.

Lithium is primarily eliminated by the kidneys and should generally not be administered to patients with significant renal dysfunction. Additionally, morphological changes with glomerular and interstitial fibrosis and nephron atrophy have been reported in patients on chronic lithium therapy, although the association has not been clearly established. Kidney function should be assessed in patients prior to starting therapy, during and thereafter and routine urinalysis and renal function tests are recommended. Progressive or sudden changes in renal function indicate the need for reevaluation of treatment. Monitoring lithium serum levels is also recommended.

The allopurinol in Duzallo has a moderate potential interaction with Renal Dysfunction.

Allopurinol and its primary active metabolite, oxipurinol, are eliminated by the kidneys, and any changes in renal function will likely increase exposure. Additionally, treatment with allopurinol may result in renal impairment due to formation of xanthine calculi or due to precipitation of urates in patients receiving concomitant uricosuric agents. Patients with pre-existing renal disease, may be at increased risk for worsening renal impairment due to xanthine calculi or precipitation of urates while receiving treatment. These patients require lower dosages of allopurinol than normal to control serum urate levels and close monitoring of laboratory parameters of renal function to reassess the patient's dosage. Treatment with allopurinol tablets has not been studied in pediatric patients with severe renal impairment (eGFR less than 20 mL/min) or on dialysis.

Lithium has a major potential interaction with Syncope.

Lithium should generally not be given to patients with significant cardiovascular disease since the risk of lithium toxicity is high in these patients. Additionally, there have been postmarketing reports of a possible association between lithium therapy and the unmasking of Brugada Syndrome, a disorder characterized by abnormal EKG findings and a risk of sudden death. Lithium should be avoided in patients with this diagnosis or suspicion of it, or that have risk factors, which include unexplained syncope, family history of this syndrome, or family history of unexplained sudden death before the age of 45 years.
Therapy with lithium should be administered with extreme caution in patients with preexisting cardiac disease. Consultation with a cardiologist is highly recommended and cardiac monitoring should be completed before and during treatment.

Lithium has a major potential interaction with Tachyarrhythmia.

Lithium should generally not be given to patients with significant cardiovascular disease since the risk of lithium toxicity is high in these patients. Additionally, there have been postmarketing reports of a possible association between lithium therapy and the unmasking of Brugada Syndrome, a disorder characterized by abnormal EKG findings and a risk of sudden death. Lithium should be avoided in patients with this diagnosis or suspicion of it, or that have risk factors, which include unexplained syncope, family history of this syndrome, or family history of unexplained sudden death before the age of 45 years.
Therapy with lithium should be administered with extreme caution in patients with preexisting cardiac disease. Consultation with a cardiologist is highly recommended and cardiac monitoring should be completed before and during treatment.

The lesinurad in Duzallo has a major potential interaction with Tumor Lysis Syndrome.

No studies with febuxostat or lesinurad have been conducted in patients with secondary hyperuricemia (including organ transplant recipients). The use of these drugs is contraindicated in patients where the uric acid formation is greatly increased, such as patients with malignant disease, tumor lysis syndrome or Lesch-Nyhan syndrome.

Lithium has a major potential interaction with Underactive Thyroid.

The use of lithium has been associated with hypothyroidism in 5% to 15% of patient as it blocks the release of thyroxine (T4) and triiodothyronine (T3) mediated by thyrotropin. Therapy with lithium should be administered cautiously in patients with preexisting hypothyroidism. Careful monitoring of the thyroid function is recommended and supplemental thyroid treatment may be required.

The allopurinol in Duzallo has a moderate potential interaction with Vomiting.

Patients with pre-existing kidney conditions, including chronic kidney disease or a history of kidney stones, may be at increased risk for worsening of kidney function or acute kidney injury due to xanthine calculi during treatment with this drug. Ensure adequate hydration to maintain a daily urine output of at least 2 liters in adults and 2 liters/m2/day (or 100 mL/m2/hour) in pediatric patients. Maintaining a neutral to slightly alkaline urine pH is also recommended to prevent xanthine calculi and reduce urate precipitation. Renal function should be closely monitored, especially during the early stages of therapy.