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Drug Interactions between escitalopram and hydrochlorothiazide / triamterene

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

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Interactions between your drugs

Moderate

hydroCHLOROthiazide escitalopram

Applies to: hydrochlorothiazide / triamterene and escitalopram

MONITOR: Coadministration with diuretics may potentiate the risk of hyponatremia associated with the use of selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). The mechanism by which SSRIs and SNRIs produce hyponatremia has not been clearly established. In many cases, the hyponatremia appears to be secondary to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Cases with serum sodium lower than 110 mmol/L have been reported. These events are generally reversible following discontinuation of therapy and/or medical intervention. Elderly patients and patients taking diuretics or who are otherwise volume-depleted may be at greater risk of developing hyponatremia with SSRIs and SNRIs.

MONITOR: Antihypertensive agents such as diuretics may potentiate the orthostatic effect that is occasionally observed upon the initiation of SSRI or SNRI therapy. Syncope and orthostatic hypotension tend to occur within the first week of SNRI/SSRI therapy but can occur at any time during treatment, particularly after a dosage increase. The use of SSRIs or SNRIs may also cause sustained increases in blood pressure and heart rate, which may antagonize the therapeutic effects of antihypertensive medications. Cases of elevated blood pressure requiring immediate treatment have been reported in postmarketing experience.

MANAGEMENT: Caution is recommended if SSRIs or SNRIs are prescribed in combination with diuretics, particularly in the elderly. Patients should be advised to seek medical attention if they experience potential signs and symptoms of hyponatremia such as nausea, vomiting, headache, malaise, lethargy, irritability, difficulty concentrating, memory impairment, confusion, weakness, muscle spasm, and unsteadiness (which may lead to falls). More severe and/or acute cases may include hallucination, syncope, seizure, coma, respiratory arrest, and death. Discontinuation of SSRI/SNRI therapy should be considered in patients who develop symptomatic hyponatremia, and appropriate medical intervention instituted as necessary. Patients should also have their blood pressure and pulse monitored before and during SSRI/SNRI therapy, especially during the first few weeks and following a dosage increase. Patients should be advised to avoid rising abruptly from a sitting or recumbent position and to notify their doctor if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia. Patients should also avoid driving or operating hazardous machinery until they know how the medications affect them. Dose reduction or drug discontinuation should be considered in patients who experience a sustained increase in blood pressure or pulse rate during SSRI or SNRI therapy.

References

  1. Hwang AS, Magraw RM "Syndrome of inappropriate secretion of antidiuretic hormone due to fluoxetine." Am J Psychiatry 146 (1989): 399
  2. Vishwanath BM, Navalgund AA, Cusano W, Navalgund KA "Fluoxetine as a cause of SIADH." Am J Psychiatry 148 (1991): 542-3
  3. Staab JP, Yerkes SA, Cheney EM, Clayton AH "Transient SIADH associated with fluoxetine." Am J Psychiatry 147 (1990): 1569-70
  4. Cohen BJ, Mahelsky M, Adler L "More cases of SIADH with fluoxetine." Am J Psychiatry 147 (1990): 948-9
  5. Spier SA, Frontera MA "Unexpected deaths in depressed medical inpatients treated with fluoxetine." J Clin Psychiatry 52 (1991): 377-82
  6. Feder R "Bradycardia and syncope induced by fluoxetine." J Clin Psychiatry 52 (1991): 139
  7. Ellison JM, Milofsky JE, Ely E "Fluoxetine-induced bradycardia and syncope in two patients." J Clin Psychiatry 51 (1990): 385-6
  8. Kazal LA, Jr Hall DL, Miller LG, Noel ML "Fluoxetine-induced SIADH: a geriatric occurrence?" J Fam Pract 36 (1993): 341-3
  9. Crews JR, Potts NL, Schreiber J, Lipper S "Hyponatremia in a patient treated with sertraline." Am J Psychiatry 150 (1993): 1564
  10. Blacksten JV, Birt JA "Syndrome of inappropriate secretion of antidiuretic hormone secondary to fluoxetine." Ann Pharmacother 27 (1993): 723-4
  11. "Product Information. Zoloft (sertraline)." Roerig Division PROD (2001):
  12. "Product Information. Prozac (fluoxetine)." Dista Products Company PROD (2001):
  13. "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories PROD (2001):
  14. Chua TP, Vong SK "Hyponatraemia associated with paroxetine." BMJ 306 (1993): 143
  15. Goddard C, Paton C "Hyponatraemia associated with paroxetine." BMJ 305 (1992): 1332
  16. "Product Information. Paxil (paroxetine)." GlaxoSmithKline PROD (2001):
  17. Doshi D, Borison R "Association of transient SIADH with sertraline." Am J Psychiatry 151 (1994): 779-80
  18. Baliga RR, McHardy KC "Syndrome of inappropriate antidiuretic hormone secretion due to fluvoxamine therapy [published erratum appears in Br J Clin Pract 1993 May-Jun;47(3):119]." Br J Clin Pract 47 (1993): 62-3
  19. "Product Information. Luvox (fluvoxamine)." Solvay Pharmaceuticals Inc PROD (2001):
  20. Llorente MD, Gorelick M, Silverman MA "Sertraline as the cause of inappropriate antidiuretic hormone secretion." J Clin Psychiatry 55 (1994): 543-4
  21. Thornton SL, Resch DS "SIADH associated with sertraline therapy." Am J Psychiatry 152 (1995): 809
  22. Jackson C, Carson W, Markowitz J, Mintzer J "SIADH associated with fluoxetine and sertraline therapy." Am J Psychiatry 152 (1995): 809-10
  23. Ayonrinde OT, Reutens SG, Sanfilippo FM "Paroxetine-induced SIADH." Med J Aust 163 (1995): 390
  24. Kessler J, Samuels SC "Sertraline and hyponatremia." N Engl J Med 335 (1996): 524
  25. Bradley ME, Foote EF, Lee EN, Merkle L "Sertraline-associated syndrome of inappropriate antidiuretic hormone: case report and review of the literature." Pharmacotherapy 16 (1996): 680-3
  26. "Selective serotonin reuptake inhibitors and SIADH." Med J Aust 164 (1996): 562
  27. Robinson D, Brooks J, Mahler E, Sheikh JI "SIADH--compulsive drinking or SSRI influence?" Ann Pharmacother 30 (1996): 885
  28. Schattner A, Skurnik Y "Fluoxetine-induced SIADH." J Am Geriatr Soc 44 (1996): 1413
  29. van Campen JP, Voets AJ "SIADH caused by paroxetine." Ann Pharmacother 30 (1996): 1499
  30. Woo MH, Smythe MA "Association of SIADH with selective serotonin reuptake inhibitors." Ann Pharmacother 31 (1997): 108-10
  31. Spigset O, hedenmalm K "Hyponatremia in relation to treatment with antidepressants: a survey of reports in the World Health Organization data base for spontaneous reporting of adverse drug reactions." Pharmacotherapy 17 (1997): 348-52
  32. Bouman WP, Johnson H, TrescoliSerrano C, Jones RG "Recurrent hyponatremia associated with sertraline and lofepramine." Am J Psychiatry 154 (1997): 580
  33. Girault C, Richard JC, Chevron V, Goulle JP, Droy JM, Bonmarchand G, Leroy J "Syndrome of inappropriate secretion of antidiuretic hormone in two elderly women with elevated serum fluoxetine." J Toxicol Clin Toxicol 35 (1997): 93-5
  34. Ayonrinde OT, Sanfilippo FM "SSRI antidepressants and SIADH." Aust N Z J Psychiatry 31 (1997): 306-7
  35. "Product Information. Celexa (citalopram)." Forest Pharmaceuticals PROD (2001):
  36. Madhusoodanan S, Brenner R, Brafman I, Bogunovic O "Hyponatremia associated with paroxetine use." South Med J 92 (1999): 843
  37. Odeh M, Seligmann H, Oliven A "Severe life-threatening hyponatremia during paroxetine therapy." J Clin Pharmacol 39 (1999): 1290-1
  38. Odeh M, Beny A, Oliven A "Severe symptomatic hyponatremia during citalopram therapy." Am J Med Sci 321 (2001): 159-60
  39. Rodriguez de la Torre B, Dreher J, Malevany I, et al. "Serum levels and cardiovascular effects of tricyclic antidepressants and selective serotonin reuptake inhibitors in depressed patients." Ther Drug Monit 23 (2001): 435-40
  40. "Product Information. Lexapro (escitalopram)." Forest Pharmaceuticals (2002):
  41. Barclay TS, Lee AJ "Citalopram-associated SIADH." Ann Pharmacother 36 (2002): 1558-63
  42. Rosner MH "Severe hyponatremia associated with the combined use of thiazide diuretics and selective serotonin reuptake inhibitors." Am J Med Sci 327 (2004): 109-11
  43. "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
  44. Jacob S, Spinler SA "Hyponatremia associated with selective serotonin-reuptake inhibitors in older adults." Ann Pharmacother 40 (2006): 1618-22
  45. Covyeou JA, Jackson CW "Hyponatremia associated with escitalopram." N Engl J Med 356 (2007): 94-5
  46. "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
  47. Fitzgerald MA "Hyponatremia associated with SSRI use in a 65-year-old woman." Nurse Pract 33 (2008): 11-2
  48. Esposito P, Rampino T, Gregorini M, et al. "Severe symptomatic hyponatremia during sibutramine therapy: a case report." Am J Kidney Dis 52 (2008): 137-9
  49. "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
  50. Pacher P, Kecskemeti V "Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns?" Curr Pharm Des 10 (2004): 2463-75
  51. Andrews C, Pinner G "Postural hypotension induced by paroxetine." BMJ 316 (1998): 595
  52. "Product Information. Viibryd (vilazodone)." Trovis Pharmaceuticals LLC (2011):
  53. "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
  54. "Product Information. Brintellix (vortioxetine)." Takeda Pharmaceuticals America (2013):
View all 54 references

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Moderate

triamterene escitalopram

Applies to: hydrochlorothiazide / triamterene and escitalopram

MONITOR: Coadministration with diuretics may potentiate the risk of hyponatremia associated with the use of selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). The mechanism by which SSRIs and SNRIs produce hyponatremia has not been clearly established. In many cases, the hyponatremia appears to be secondary to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Cases with serum sodium lower than 110 mmol/L have been reported. These events are generally reversible following discontinuation of therapy and/or medical intervention. Elderly patients and patients taking diuretics or who are otherwise volume-depleted may be at greater risk of developing hyponatremia with SSRIs and SNRIs.

MONITOR: Antihypertensive agents such as diuretics may potentiate the orthostatic effect that is occasionally observed upon the initiation of SSRI or SNRI therapy. Syncope and orthostatic hypotension tend to occur within the first week of SNRI/SSRI therapy but can occur at any time during treatment, particularly after a dosage increase. The use of SSRIs or SNRIs may also cause sustained increases in blood pressure and heart rate, which may antagonize the therapeutic effects of antihypertensive medications. Cases of elevated blood pressure requiring immediate treatment have been reported in postmarketing experience.

MANAGEMENT: Caution is recommended if SSRIs or SNRIs are prescribed in combination with diuretics, particularly in the elderly. Patients should be advised to seek medical attention if they experience potential signs and symptoms of hyponatremia such as nausea, vomiting, headache, malaise, lethargy, irritability, difficulty concentrating, memory impairment, confusion, weakness, muscle spasm, and unsteadiness (which may lead to falls). More severe and/or acute cases may include hallucination, syncope, seizure, coma, respiratory arrest, and death. Discontinuation of SSRI/SNRI therapy should be considered in patients who develop symptomatic hyponatremia, and appropriate medical intervention instituted as necessary. Patients should also have their blood pressure and pulse monitored before and during SSRI/SNRI therapy, especially during the first few weeks and following a dosage increase. Patients should be advised to avoid rising abruptly from a sitting or recumbent position and to notify their doctor if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia. Patients should also avoid driving or operating hazardous machinery until they know how the medications affect them. Dose reduction or drug discontinuation should be considered in patients who experience a sustained increase in blood pressure or pulse rate during SSRI or SNRI therapy.

References

  1. Hwang AS, Magraw RM "Syndrome of inappropriate secretion of antidiuretic hormone due to fluoxetine." Am J Psychiatry 146 (1989): 399
  2. Vishwanath BM, Navalgund AA, Cusano W, Navalgund KA "Fluoxetine as a cause of SIADH." Am J Psychiatry 148 (1991): 542-3
  3. Staab JP, Yerkes SA, Cheney EM, Clayton AH "Transient SIADH associated with fluoxetine." Am J Psychiatry 147 (1990): 1569-70
  4. Cohen BJ, Mahelsky M, Adler L "More cases of SIADH with fluoxetine." Am J Psychiatry 147 (1990): 948-9
  5. Spier SA, Frontera MA "Unexpected deaths in depressed medical inpatients treated with fluoxetine." J Clin Psychiatry 52 (1991): 377-82
  6. Feder R "Bradycardia and syncope induced by fluoxetine." J Clin Psychiatry 52 (1991): 139
  7. Ellison JM, Milofsky JE, Ely E "Fluoxetine-induced bradycardia and syncope in two patients." J Clin Psychiatry 51 (1990): 385-6
  8. Kazal LA, Jr Hall DL, Miller LG, Noel ML "Fluoxetine-induced SIADH: a geriatric occurrence?" J Fam Pract 36 (1993): 341-3
  9. Crews JR, Potts NL, Schreiber J, Lipper S "Hyponatremia in a patient treated with sertraline." Am J Psychiatry 150 (1993): 1564
  10. Blacksten JV, Birt JA "Syndrome of inappropriate secretion of antidiuretic hormone secondary to fluoxetine." Ann Pharmacother 27 (1993): 723-4
  11. "Product Information. Zoloft (sertraline)." Roerig Division PROD (2001):
  12. "Product Information. Prozac (fluoxetine)." Dista Products Company PROD (2001):
  13. "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories PROD (2001):
  14. Chua TP, Vong SK "Hyponatraemia associated with paroxetine." BMJ 306 (1993): 143
  15. Goddard C, Paton C "Hyponatraemia associated with paroxetine." BMJ 305 (1992): 1332
  16. "Product Information. Paxil (paroxetine)." GlaxoSmithKline PROD (2001):
  17. Doshi D, Borison R "Association of transient SIADH with sertraline." Am J Psychiatry 151 (1994): 779-80
  18. Baliga RR, McHardy KC "Syndrome of inappropriate antidiuretic hormone secretion due to fluvoxamine therapy [published erratum appears in Br J Clin Pract 1993 May-Jun;47(3):119]." Br J Clin Pract 47 (1993): 62-3
  19. "Product Information. Luvox (fluvoxamine)." Solvay Pharmaceuticals Inc PROD (2001):
  20. Llorente MD, Gorelick M, Silverman MA "Sertraline as the cause of inappropriate antidiuretic hormone secretion." J Clin Psychiatry 55 (1994): 543-4
  21. Thornton SL, Resch DS "SIADH associated with sertraline therapy." Am J Psychiatry 152 (1995): 809
  22. Jackson C, Carson W, Markowitz J, Mintzer J "SIADH associated with fluoxetine and sertraline therapy." Am J Psychiatry 152 (1995): 809-10
  23. Ayonrinde OT, Reutens SG, Sanfilippo FM "Paroxetine-induced SIADH." Med J Aust 163 (1995): 390
  24. Kessler J, Samuels SC "Sertraline and hyponatremia." N Engl J Med 335 (1996): 524
  25. Bradley ME, Foote EF, Lee EN, Merkle L "Sertraline-associated syndrome of inappropriate antidiuretic hormone: case report and review of the literature." Pharmacotherapy 16 (1996): 680-3
  26. "Selective serotonin reuptake inhibitors and SIADH." Med J Aust 164 (1996): 562
  27. Robinson D, Brooks J, Mahler E, Sheikh JI "SIADH--compulsive drinking or SSRI influence?" Ann Pharmacother 30 (1996): 885
  28. Schattner A, Skurnik Y "Fluoxetine-induced SIADH." J Am Geriatr Soc 44 (1996): 1413
  29. van Campen JP, Voets AJ "SIADH caused by paroxetine." Ann Pharmacother 30 (1996): 1499
  30. Woo MH, Smythe MA "Association of SIADH with selective serotonin reuptake inhibitors." Ann Pharmacother 31 (1997): 108-10
  31. Spigset O, hedenmalm K "Hyponatremia in relation to treatment with antidepressants: a survey of reports in the World Health Organization data base for spontaneous reporting of adverse drug reactions." Pharmacotherapy 17 (1997): 348-52
  32. Bouman WP, Johnson H, TrescoliSerrano C, Jones RG "Recurrent hyponatremia associated with sertraline and lofepramine." Am J Psychiatry 154 (1997): 580
  33. Girault C, Richard JC, Chevron V, Goulle JP, Droy JM, Bonmarchand G, Leroy J "Syndrome of inappropriate secretion of antidiuretic hormone in two elderly women with elevated serum fluoxetine." J Toxicol Clin Toxicol 35 (1997): 93-5
  34. Ayonrinde OT, Sanfilippo FM "SSRI antidepressants and SIADH." Aust N Z J Psychiatry 31 (1997): 306-7
  35. "Product Information. Celexa (citalopram)." Forest Pharmaceuticals PROD (2001):
  36. Madhusoodanan S, Brenner R, Brafman I, Bogunovic O "Hyponatremia associated with paroxetine use." South Med J 92 (1999): 843
  37. Odeh M, Seligmann H, Oliven A "Severe life-threatening hyponatremia during paroxetine therapy." J Clin Pharmacol 39 (1999): 1290-1
  38. Odeh M, Beny A, Oliven A "Severe symptomatic hyponatremia during citalopram therapy." Am J Med Sci 321 (2001): 159-60
  39. Rodriguez de la Torre B, Dreher J, Malevany I, et al. "Serum levels and cardiovascular effects of tricyclic antidepressants and selective serotonin reuptake inhibitors in depressed patients." Ther Drug Monit 23 (2001): 435-40
  40. "Product Information. Lexapro (escitalopram)." Forest Pharmaceuticals (2002):
  41. Barclay TS, Lee AJ "Citalopram-associated SIADH." Ann Pharmacother 36 (2002): 1558-63
  42. Rosner MH "Severe hyponatremia associated with the combined use of thiazide diuretics and selective serotonin reuptake inhibitors." Am J Med Sci 327 (2004): 109-11
  43. "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company (2004):
  44. Jacob S, Spinler SA "Hyponatremia associated with selective serotonin-reuptake inhibitors in older adults." Ann Pharmacother 40 (2006): 1618-22
  45. Covyeou JA, Jackson CW "Hyponatremia associated with escitalopram." N Engl J Med 356 (2007): 94-5
  46. "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories (2008):
  47. Fitzgerald MA "Hyponatremia associated with SSRI use in a 65-year-old woman." Nurse Pract 33 (2008): 11-2
  48. Esposito P, Rampino T, Gregorini M, et al. "Severe symptomatic hyponatremia during sibutramine therapy: a case report." Am J Kidney Dis 52 (2008): 137-9
  49. "Product Information. Savella (milnacipran)." Forest Pharmaceuticals (2009):
  50. Pacher P, Kecskemeti V "Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns?" Curr Pharm Des 10 (2004): 2463-75
  51. Andrews C, Pinner G "Postural hypotension induced by paroxetine." BMJ 316 (1998): 595
  52. "Product Information. Viibryd (vilazodone)." Trovis Pharmaceuticals LLC (2011):
  53. "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals (2013):
  54. "Product Information. Brintellix (vortioxetine)." Takeda Pharmaceuticals America (2013):
View all 54 references

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Drug and food interactions

Moderate

escitalopram food

Applies to: escitalopram

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc. (1990):
  3. "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
  4. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):
View all 4 references

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Moderate

hydroCHLOROthiazide food

Applies to: hydrochlorothiazide / triamterene

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 "Fluoxetine-associated potentiation of calcium-channel blockers." J Clin Psychopharmacol 11 (1991): 390-1
  2. Shook TL, Kirshenbaum JM, Hundley RF, Shorey JM, Lamas GA "Ethanol intoxication complicating intravenous nitroglycerin therapy." Ann Intern Med 101 (1984): 498-9
  3. Feder R "Bradycardia and syncope induced by fluoxetine." J Clin Psychiatry 52 (1991): 139
  4. Ellison JM, Milofsky JE, Ely E "Fluoxetine-induced bradycardia and syncope in two patients." J Clin Psychiatry 51 (1990): 385-6
  5. Rodriguez de la Torre B, Dreher J, Malevany I, et al. "Serum levels and cardiovascular effects of tricyclic antidepressants and selective serotonin reuptake inhibitors in depressed patients." Ther Drug Monit 23 (2001): 435-40
  6. Cerner Multum, Inc. "Australian Product Information." O 0
  7. Pacher P, Kecskemeti V "Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns?" Curr Pharm Des 10 (2004): 2463-75
  8. Andrews C, Pinner G "Postural hypotension induced by paroxetine." BMJ 316 (1998): 595
View all 8 references

Switch to consumer interaction data

Moderate

triamterene food

Applies to: hydrochlorothiazide / triamterene

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 "Fluoxetine-associated potentiation of calcium-channel blockers." J Clin Psychopharmacol 11 (1991): 390-1
  2. Shook TL, Kirshenbaum JM, Hundley RF, Shorey JM, Lamas GA "Ethanol intoxication complicating intravenous nitroglycerin therapy." Ann Intern Med 101 (1984): 498-9
  3. Feder R "Bradycardia and syncope induced by fluoxetine." J Clin Psychiatry 52 (1991): 139
  4. Ellison JM, Milofsky JE, Ely E "Fluoxetine-induced bradycardia and syncope in two patients." J Clin Psychiatry 51 (1990): 385-6
  5. Rodriguez de la Torre B, Dreher J, Malevany I, et al. "Serum levels and cardiovascular effects of tricyclic antidepressants and selective serotonin reuptake inhibitors in depressed patients." Ther Drug Monit 23 (2001): 435-40
  6. Cerner Multum, Inc. "Australian Product Information." O 0
  7. Pacher P, Kecskemeti V "Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns?" Curr Pharm Des 10 (2004): 2463-75
  8. Andrews C, Pinner G "Postural hypotension induced by paroxetine." BMJ 316 (1998): 595
View all 8 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.