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Drug Interactions between E-Z-Gas II and tolvaptan

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

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Interactions between your drugs

Moderate

sodium bicarbonate tolvaptan

Applies to: E-Z-Gas II (citric acid / simethicone / sodium bicarbonate) and tolvaptan

GENERALLY AVOID: The use of tolvaptan with other treatments for hyponatremia or medications that increase serum sodium concentration may increase the risk of rapid correction of sodium levels due to additive effects. Other products with high sodium content such as oral sodium, effervescent analgesic preparations,or treatments for dyspepsia may also increase serum sodium concentration.

MANAGEMENT: The concomitant use of tolvaptan with hypertonic saline is not recommended. Caution and monitoring are recommended for patients who have received other medications that increase serum sodium levels.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  2. Canadian Pharmacists Association "e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink" (2006):
  3. "Product Information. Samsca (tolvaptan)." Otsuka American Pharmaceuticals Inc (2009):

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Drug and food interactions

Moderate

tolvaptan food

Applies to: tolvaptan

GENERALLY AVOID: Grapefruit juice may significantly increase the plasma concentrations of tolvaptan. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. According to the product labeling, administration of tolvaptan with grapefruit juice resulted in a 1.8-fold increase in tolvaptan systemic exposure. The clinical significance is unknown, although increased pharmacologic effects may be expected. Too rapid correction of hyponatremia increases the risk of osmotic demyelination syndrome, which is associated with dysarthria, mutism, dysphagia, lethargy, affective changes, spastic quadriparesis, seizures, coma, and death.

MANAGEMENT: Patients treated with tolvaptan should avoid consumption of grapefruits and grapefruit juice.

References

  1. "Product Information. Samsca (tolvaptan)." Otsuka American Pharmaceuticals Inc (2009):

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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.

See also

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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.

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