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Drug Interactions between escitalopram and vasopressin

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

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Moderate

vasopressin escitalopram

Applies to: vasopressin and escitalopram

MONITOR: The antidiuretic response to vasopressin or desmopressin may be potentiated by certain drugs, including nonsteroidal anti-inflammatory agents, selective serotonin reuptake inhibitors, tricyclic/tetracyclic antidepressants, carbamazepine, chlorpropamide, chlorpromazine, clofibrate, eslicarbazepine, fludrocortisone, haloperidol, lamotrigine, oxcarbazepine, urea, and some antineoplastic agents (e.g., vinca alkaloids, cisplatin, cyclophosphamide). These drugs can occasionally cause fluid retention, in some cases secondary to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Coadministration with vasopressin or desmopressin may, therefore, increase the risk of water intoxication and/or hyponatremia. Seizure and coma in association with severe hyponatremia have been reported during concomitant use of desmopressin and imipramine or ibuprofen. In addition, indomethacin may prolong the effects of vasopressin on cardiac index and systemic vascular resistance. The elderly may be particularly susceptible.

MANAGEMENT: Caution is advised when vasopressin or desmopressin is used in combination with drugs that can cause fluid retention or SIADH. Some authorities recommend adjusting vasopressin dosage as needed. Serum electrolytes, especially sodium, as well as BUN and creatinine should be monitored regularly. Patients should be advised to seek medical attention if they develop signs and symptoms of water intoxication or hyponatremia such as anorexia, nausea, vomiting, headache, malaise, lethargy, irritability, difficulty concentrating, memory impairment, confusion, weakness, muscle spasm, unsteadiness (which may lead to falls), anuria, and weight gain. Severe hyponatremia can be life-threatening if it is not promptly diagnosed and treated; therefore, early treatment is important to help prevent progression to seizures, coma, respiratory arrest, and death.

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  158. Kimura T, Shoju M, et al. (1995) "Chlorpropamide-induced ADH release, hyponatremia and central pontine myelinolysis in diabetes mellitus." Tohoku J Exp Med, 177, p. 303-13
  159. Guay DR (2010) Hyponatremia associated with selective serotonin reuptake inhibitors. http://www.ascp.com/publications/tcp/2000/feb/cr_hypo.shtml
  160. Adlakha A, Manocha AP, Bechard DL (1991) "Imipramine-induced syndrome of inappropriate antidiuretic hormone secretion." South Med J, 84, p. 1507-9
  161. Agrawal NK, Rastogi A, Goyal R, Singh SK (2007) "Sertraline-induced hyponatremia in the elderly." CJEM, 9, p. 415
  162. Ritch PS (1988) "Cis-dichlorodiammineplatinum II-induced syndrome of inappropriate secretion of antidiuretic hormone." Cancer, 61, p. 448-50
  163. Levin L, Sealy R, Barron J (1982) "Syndrome of inappropriate antidiuretic hormone secretion following cis-dichlorodiammineplatinum II in a patient with malignant thymoma." Cancer, 50, p. 2279-82
  164. Littlewood TJ, Smith AP (1984) "Syndrome of inappropriate antidiuretic hormone secretion due to treatment of lung cancer with cisplatin." Thorax, 39, p. 636-7
  165. Iyer AV, Krasnow SH, Dufour DR, Arcenas AS (2003) "Sodium-wasting nephropathy caused by cisplatin in a patient with small-cell lung cancer." Clin Lung Cancer, 5, p. 187-9
  166. Okamoto M, Nako Y, Tachibana A, et al. (2002) "Efficacy of phenytoin against hyponatremic seizures due to SIADH after administration of anticancer drugs in a neonate." J Perinatol, 22, p. 247-8
  167. Kagawa K, Fujitaka K, Isobe T, et al. (2001) "Syndrome of inappropriate secretion of ADH (SIADH) following cisplatin administration in a pulmonary adenocarcinoma patient with a malignant pleural effusion." Intern Med, 40, p. 1020-3
  168. Moses AM, Howanitz J, van Gemert M, Miller M (1973) "Clofibrate-induced antidiuresis." J Clin Invest, 52, p. 535-42
  169. O'Regan S, Carson S, Chesney RW, Drummond KN (1977) "Electrolyte and acid-base disturbances in the management of leukemia." Blood, 49, p. 345-53
  170. McCarron M, Wright GD, Roberts SD (1995) "Water intoxication after low dose cyclophosphamide." BMJ, 311, p. 292
  171. Harlow PJ, DeClerck YA, Shore NA, Ortega JA, Carranza A, Heuser E (1979) "A fatal case of inappropriate ADH secretion induced by cyclophosphamide therapy." Cancer, 44, p. 896-8
  172. Kato A, Sugiura T, Yamamoto T, et al. (2008) "Water intoxication induced by low-dose oral cyclophosphamide in a patient with anti-neutrophil cytoplasmic antibody-related glomerulonephritis." NDT Plus, 1, p. 286-8
  173. Jayachandran NV, Chandrasekhara PK, Thomas J, Agrawal S, Narsimulu G (2009) "Cyclophosphamide-associated complications: we need to be aware of SIADH and central pontine myelinolysis." Rheumatology, 48, p. 89-90
  174. Lazarevic V, Hagg E, Wahlin A (2007) "Hiccups and severe hyponatremia associated with high-dose cyclophosphamide in conditioning regimen for allogeneic stem cell transplantation." Am J Hematol, 82, p. 88
  175. DeFronzo RA, Colvin OM, Braine H, Robertson GL, Davis PJ (1974) "Proceedings: cyclophosphamide and the kidney." Cancer, 33, p. 483-91
  176. Munro AH, Crompton GK (1972) "Inappropriate antidiuretic hormone secretion in oat-cell carcinoma of bronchus. Aggravation of hyponatraemia by intravenous cyclophosphamide." Thorax, 27, p. 640-2
  177. Bourgeois JA (2005) "Reversible hyponatremia and venlafaxine." Psychosomatics, 46, p. 495-6
  178. Vanhees SL, Paridaens R, Vansteenkiste JF (2000) "Syndrome of inappropriate antidiuretic hormone associated with chemotherapy-induced tumour lysis in small-cell lung cancer: case report and literature review." Ann Oncol, 11, p. 1061-5
  179. Instituto de Salud Pública de Chile (2013) Sistema de Consulta de Productos Registrados. http://registrosanitario.ispch.gob.cl/
  180. (2017) "Product Information. Vasostrict (vasopressin)." Par Pharmaceutical Inc
  181. (2018) "Product Information. Vasopressin (vasopressin)." APP (Abraxis Pharmaceutical Products)
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Drug and food interactions

Moderate

vasopressin food

Applies to: vasopressin

MONITOR: Alcohol may decrease the antidiuretic effect of vasopressin. Clinical studies found that plasma vasopressin levels often decrease during alcohol consumption and increase upon cessation of consumption. In addition, alcoholics were found to have a more pronounced decrease in plasma vasopressin levels when drinking and suppressed vasopressin levels even during alcohol withdrawal as compared to non-alcoholic individuals. The mechanism of this interaction is not fully understood.

MANAGEMENT: Patients should be advised to abstain from alcohol during vasopressin treatment. Hemodynamic monitoring is suggested for patients known to drink alcohol while receiving vasopressin.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. Cerner Multum, Inc. "Australian Product Information."
  3. (2017) "Product Information. Vasostrict (vasopressin)." Par Pharmaceutical Inc
  4. Taivainen H, Laitinen K, Tahtela R, Kilanmaa K, Valimaki MJ (1995) "Role of plasma vasopressin in changes of water balance accompanying acute alcohol intoxication." Alcohol Clin Exp Res, 19, p. 759-62
  5. Collins GB, Brosnihan KB, Zuti RA, Messina M, Gupta MK (1992) "Neuroendocrine, fluid balance, and thirst responses to alcohol in alcoholics." Alcohol Clin Exp Res, 16, p. 228-32
  6. Hirschl MM, Derfler K, Bieglmayer C, et al. (1994) "Hormonal derangements in patients with severe alcohol intoxication." Alcohol Clin Exp Res, 18, p. 761-6
  7. Harper KM, Knapp DJ, Criswell HE, Breese GR (2018) "Vasopressin and alcohol: A multifaceted relationship." Psychopharmacology (Berl), 235, p. 3363-79
View all 7 references

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

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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