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Drug Interactions between Endep and Omnipaque 180

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

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Interactions between your drugs

Major

amitriptyline iohexol

Applies to: Endep (amitriptyline) and Omnipaque 180 (iohexol)

GENERALLY AVOID: Intrathecal administration of iodinated contrast media may induce seizures. Although clinical data are generally lacking, there may be a theoretical risk of increased seizure potential when used with selective serotonin reuptake inhibitors (SSRI antidepressants or anorectics), monoamine oxidase inhibitors, neuroleptic agents, central nervous system stimulants, opioids, tricyclic antidepressants, other tricyclic compounds (e.g., cyclobenzaprine, phenothiazines), and/or any substance that can reduce the seizure threshold (e.g., carbapenems, cholinergic agents, fluoroquinolones, interferons, chloroquine, mefloquine, lindane, theophylline). These agents are often individually epileptogenic and may have additive effects when combined.

MANAGEMENT: Drugs that can lower the seizure threshold should preferably be withheld for at least 48 hours prior to and 24 hours following intrathecal administration of iodinated contrast media, provided that temporary interruption of therapy does not pose an undue risk to the patient. Otherwise, close monitoring is advised during and after contrast administration. The manufacturers typically recommend avoiding concomitant administration of phenothiazines (including those used for their antihistamine properties), monoamine oxidase inhibitors, tricyclic antidepressants, central nervous system stimulants, and psychoactive drugs.

References

  1. Hindmarsh T, Grepe A, Widen L "Metrizamide-phenothiazine interaction: report of a case with seizures following myelography." Acta Radiol Diagn (Stockh) 16 (1975): 129-35
  2. "Product Information. Amipaque (metrizamide)." Nycomed Inc PROD (2001):
  3. "Product Information. Osmovist 240 (iotrolan)." Berlex Canada Inc (2001):
  4. "Product Information. Omnipaque 180 (iohexol)." Amersham Health (2007):
  5. "Product Information. Isovue-M-200 (iopamidol)." Bracco Diagnostics Inc (2007):
View all 5 references

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Drug and food interactions

Moderate

amitriptyline food

Applies to: Endep (amitriptyline)

GENERALLY AVOID: Concomitant use of ethanol and a tricyclic antidepressant (TCA) may result altered TCA plasma levels and efficacy, and additive impairment of motor skills, especially driving skills. Acute ethanol ingestion may inhibit TCA metabolism, while chronic ingestion of large amounts of ethanol may induce hepatic TCA metabolism.

MANAGEMENT: Patients should be advised to avoid alcohol during TCA therapy. Alcoholics who have undergone detoxification should be monitored for decreased TCA efficacy. Dosage adjustments may be required.

References

  1. Dorian P, Sellers EM, Reed KL, et al. "Amitriptyline and ethanol: pharmacokinetic and pharmacodynamic interaction." Eur J Clin Pharmacol 25 (1983): 325-31
  2. Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7
  3. Sandoz M, Vandel S, Vandel B, Bonin B, Allers G, Volmat R "Biotransformation of amitriptyline in alcoholic depressive patients." Eur J Clin Pharmacol 24 (1983): 615-21
  4. Ciraulo DA, Barnhill JG, Jaffe JH "Clinical pharmacokinetics of imipramine and desipramine in alcoholics and normal volunteers." Clin Pharmacol Ther 43 (1988): 509-18
  5. Seppala T, Linnoila M, Elonen E, Mattila MJ, Makl M "Effect of tricyclic antidepressants and alcohol on psychomotor skills related to driving." Clin Pharmacol Ther 17 (1975): 515-22
  6. Ciraulo DA, Barnhill JG, Jaffe JH, Ciraulo AM, Tarmey MF "Intravenous pharmacokinetics of 2-hydroxyimipramine in alcoholics and normal controls." J Stud Alcohol 51 (1990): 366-72
  7. Ciraulo DA, Alderson LM, Chapron DJ, Jaffe JH, Subbarao B, Kramer PA "Imipramine disposition in alcoholics." J Clin Psychopharmacol 2 (1982): 2-7
View all 7 references

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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.


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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.