Can you take Ethosuximide with Tolterodine?

Ethosuximide has a major potential interaction with Bone Marrow Depression/Low Blood Counts.

Hematologic toxicities, some with fatal outcome, have been associated with the use of succinimide anticonvulsants. Leukopenia, agranulocytosis, aplastic anemia, thrombocytopenia, pancytopenia, and eosinophilia have been reported. Therapy with succinimide anticonvulsants should be administered cautiously in patients with preexisting blood dyscrasias and/or bone marrow suppression. Complete blood counts, including platelets, should be performed prior to initiating therapy and periodically during therapy. Marked depression of blood counts may be indication for withdrawal of succinimide therapy.

Tolterodine has a moderate potential interaction with Central Nervous System Disorders.

Tolterodine is associated with anticholinergic central nervous system (CNS) effects. If a patient experiences anticholinergic CNS effects, dose reduction or drug discontinuation should be considered. Tolterodine should be used with caution in patients with Parkinson's disease and in patients with preexisting dementia treated with cholinesterase inhibitors due to the risk of aggravation of symptoms.

Tolterodine has a moderate potential interaction with Dementia.

Tolterodine is associated with anticholinergic central nervous system (CNS) effects. If a patient experiences anticholinergic CNS effects, dose reduction or drug discontinuation should be considered. Tolterodine should be used with caution in patients with Parkinson's disease and in patients with preexisting dementia treated with cholinesterase inhibitors due to the risk of aggravation of symptoms.

Ethosuximide has a moderate potential interaction with Depression.

Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. AEDs should be administered cautiously in patients with depression or other psychiatric disorders; phentermine-topiramate should be avoided in patients with history of suicidal attempts or active suicidal ideation. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. If patients have symptoms of suicidal ideation or behavior, a dosage reduction or treatment discontinuation should be considered.

Tolterodine has a major potential interaction with Gastrointestinal Obstruction.

The use of tolterodine is contraindicated in patients with GI obstruction, ileus, or obstructive uropathy. Tolterodine exerts anticholinergic activity by competitive antagonism of muscarinic receptors.

Tolterodine has a major potential interaction with Glaucoma/Intraocular Hypertension.

The use of tolterodine is contraindicated in patients with uncontrolled angle-closure (narrow angle) glaucoma. Tolterodine exerts anticholinergic activity and can result in increased intraocular pressure and loss of accommodation.

Ethosuximide has a moderate potential interaction with Hemodialysis.

Ethosuximide has been shown to be removed by hemodialysis. Doses should either be scheduled for administration after dialysis or supplemental doses be given after dialysis.

Ethosuximide has a major potential interaction with Liver Disease.

Succinimide anticonvulsants have produced morphological and functional changes in the liver of animals. In humans, abnormalities in liver and renal function studies have been reported. Therapy with succinimide anticonvulsants should be administered with extreme caution in patients with known hepatic or renal diseases. Periodic urinalysis and liver function tests are recommended for all patients treated with these drugs.

Tolterodine has a moderate potential interaction with Liver Disease.

Tolterodine undergoes biotransformation in the liver of extensive metabolizers to an active metabolite. Poor metabolizers have a greater concentration of active parent and less active metabolite, however the net activity of tolterodine is expected to be the same. The pharmacokinetic disposition of tolterodine can be significantly altered in patients with hepatic dysfunction. Therapy with tolterodine should be administered cautiously in patients with severe hepatic impairment and dosage should be reduced to no greater than 1 mg twice daily.

Tolterodine has a moderate potential interaction with Long QT Syndrome.

Tolterodine has been associated with QT prolongation. The effect on QT interval correlates with plasma concentration of tolterodine. Caution is recommended when prescribing this agent to patients with a known history of QT prolongation or to patients who are taking Class IA (e.g., quinidine, procainamide) or Class III (e.g., amiodarone, sotalol) antiarrhythmic medications.

Ethosuximide has a major potential interaction with Lupus Erythematosus.

Cases of systemic lupus erythematosus (SLE) have been reported in association with the use of succinimide anticonvulsants, primarily ethosuximide. Some of the patients recovered promptly following discontinuation of the drug, while others continued to have active disease long after. Therapy with succinimide anticonvulsants should be administered cautiously in patients with a history of SLE.

Tolterodine has a moderate potential interaction with Myasthenia Gravis.

Tolterodine acts as a competitive antagonist of acetylcholine at postganglionic muscarinic receptors. Caution is recommended when using this agent in patients with myasthenia gravis, a disease characterized by decreased cholinergic activity at the neuromuscular junction.

Ethosuximide has a moderate potential interaction with Psychosis.

Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. AEDs should be administered cautiously in patients with depression or other psychiatric disorders; phentermine-topiramate should be avoided in patients with history of suicidal attempts or active suicidal ideation. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. If patients have symptoms of suicidal ideation or behavior, a dosage reduction or treatment discontinuation should be considered.

Ethosuximide has a major potential interaction with Renal Dysfunction.

Succinimide anticonvulsants have produced morphological and functional changes in the liver of animals. In humans, abnormalities in liver and renal function studies have been reported. Therapy with succinimide anticonvulsants should be administered with extreme caution in patients with known hepatic or renal diseases. Periodic urinalysis and liver function tests are recommended for all patients treated with these drugs.

Tolterodine has a moderate potential interaction with Renal Dysfunction.

The renal elimination of tolterodine and active metabolite is limited and a prolonged half-life is not anticipated in patients with renal impairment. However, the pharmacokinetic disposition of tolterodine has not been evaluated in patients with renal impairment and it is recommended that tolterodine be administered cautiously in patients with compromised renal function.

Tolterodine has a major potential interaction with Urinary Retention.

The use of tolterodine is contraindicated in patients with GI obstruction, ileus, or obstructive uropathy. Tolterodine exerts anticholinergic activity by competitive antagonism of muscarinic receptors.