Can you take Gadoxetate disodium with Penbutolol?
1 drug interaction and 33 additional warnings found for the following 2 drugs:
- gadoxetate disodium
- penbutolol
Drug interactions
Moderate drug interactions
Moderate:
penbutolol gadoxetate
Applies to: penbutolol and gadoxetate disodium
Before you have any imaging procedure where gadoxetate may be given by injection, tell your doctor if you are being treated with penbutolol. Injection of gadoxetate can sometimes cause severe allergic reactions or low blood pressure, and these reactions may be more serious or harder to treat if you are also using penbutolol. In addition, some treatments for allergic reactions may not work as well in people taking medications like penbutolol. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
penbutolol Alcohol (Ethanol)
Applies to: penbutolol
Ethanol and penbutolol may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, or changes in pulse or heart rate, especially when treatment is started, the dose is changed, or treatment is restarted. Tell your doctor promptly if these symptoms occur and seek urgent medical help if you faint or have severe dizziness. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Moderate:
penbutolol multivitamins with minerals
Applies to: penbutolol
Using penbutolol together with multivitamins with minerals may decrease the effects of penbutolol. Separate the administration times of penbutolol and multivitamins with minerals by at least 2 hours. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Disease interactions
31 potential interactions Applies to: 24 conditions, including High Blood Pressure, High Cholesterol, Allergies, Heart Failure, and Asthma.
Allergies
Major:
penbutolol
Penbutolol has a major potential interaction with Allergies.
The use of beta-adrenergic receptor blocking agents (aka beta-blockers) in patients with a history of allergic reactions or anaphylaxis may be associated with heightened reactivity to culprit allergens. The frequency and/or severity of attacks may be increased during beta-blocker therapy. In addition, these patients may be refractory to the usual doses of epinephrine used to treat acute hypersensitivity reactions and may require a beta-agonist such as isoproterenol.
Moderate:
gadoxetate disodium
The gadoxetate in gadoxetate disodium has a moderate potential interaction with Allergies.
Patients with history of bronchial asthma might have an increased risk for a hypersensitivity reaction to gadolinium-based contrast agents. Patients should always be assessed for any history of a reaction to contrast media, asthma or other allergic disorders before the administration of these agents.
Asthma
Major:
penbutolol
Penbutolol has a major potential interaction with Asthma.
Some beta-adrenergic receptor blocking agents (i.e., non-cardioselective beta-blockers) are contraindicated in patients with bronchial asthma or with a history of bronchial asthma, or severe chronic obstructive pulmonary disease. In general, beta-adrenergic receptor blocking agents should not be used in patients with bronchospastic diseases. Beta blockade may adversely affect pulmonary function by counteracting the bronchodilation produced by catecholamine stimulation of beta-2 receptors. If beta-blocker therapy is necessary in these patients, an agent with beta-1 selectivity (e.g., atenolol, metoprolol, betaxolol) is considered safer, but should be used with caution nonetheless. Cardioselectivity is not absolute and can be lost with larger doses.
Moderate:
gadoxetate disodium
The gadoxetate in gadoxetate disodium has a moderate potential interaction with Asthma.
Patients with history of bronchial asthma might have an increased risk for a hypersensitivity reaction to gadolinium-based contrast agents. Patients should always be assessed for any history of a reaction to contrast media, asthma or other allergic disorders before the administration of these agents.
Cardiogenic Shock
Major:
penbutolol
Penbutolol has a major potential interaction with Cardiogenic Shock.
The use of beta-adrenergic receptor blocking agents (aka beta-blockers) is contraindicated in patients with hypotension or cardiogenic shock. Due to their negative inotropic and chronotropic effects on the heart, the use of beta-blockers is likely to further depress cardiac output and blood pressure, which can be detrimental in these patients.
Cerebrovascular Insufficiency
Moderate:
penbutolol
Penbutolol has a moderate potential interaction with Cerebrovascular Insufficiency.
Beta-adrenergic blocking agents (beta-blockers), should be used with caution in patients with cerebrovascular insufficiency because of their potential effects relative to blood pressure and pulse. If signs or symptoms suggesting reduced cerebral blood flow are observed, consideration should be given to discontinuing these agents.
COPD
Major:
penbutolol
Penbutolol has a major potential interaction with COPD.
Some beta-adrenergic receptor blocking agents (i.e., non-cardioselective beta-blockers) are contraindicated in patients with bronchial asthma or with a history of bronchial asthma, or severe chronic obstructive pulmonary disease. In general, beta-adrenergic receptor blocking agents should not be used in patients with bronchospastic diseases. Beta blockade may adversely affect pulmonary function by counteracting the bronchodilation produced by catecholamine stimulation of beta-2 receptors. If beta-blocker therapy is necessary in these patients, an agent with beta-1 selectivity (e.g., atenolol, metoprolol, betaxolol) is considered safer, but should be used with caution nonetheless. Cardioselectivity is not absolute and can be lost with larger doses.
Diabetes Mellitus
Major:
gadoxetate disodium
The gadoxetate in gadoxetate disodium has a major potential interaction with Diabetes Mellitus.
Gadolinium-based contrast agents (GBCAs) increase the risk for nephrogenic systemic fibrosis (NSF) among patients with impaired elimination of the drugs. Gadobenate ion is eliminated predominately via the kidneys. The risk for NSF appears highest among patients with chronic, severe kidney disease (GFR <30 mL/min/1.73m2), or acute kidney injury. It is recommended to avoid the use of GBCAs in these patients unless the diagnostic information is essential and not available with non-contrasted MRI or other processes. NSF may result in fatal or debilitating systemic fibrosis affecting the skin, muscle and internal organs. Consider screening patients for acute kidney injury and other conditions that may reduce renal function and for patients at risk for chronically reduced renal function (e.g., age > 60 years, hypertension or diabetes), estimate the glomerular filtration rate (GFR) through laboratory testing. For patients receiving hemodialysis, physicians may consider the prompt initiation of hemodialysis following the administration of a GBCA to enhance the contrast agent's elimination. The usefulness of hemodialysis in the prevention of NSF is unknown.
Major:
penbutolol
Penbutolol has a major potential interaction with Diabetes Mellitus.
Beta-adrenergic receptor blocking agents (aka beta-blockers) may mask symptoms of hypoglycemia such as tremors, tachycardia and blood pressure changes. In addition, the nonselective beta-blockers (e.g., propranolol, pindolol, timolol) may inhibit catecholamine-mediated glycogenolysis, thereby potentiating insulin-induced hypoglycemia and delaying the recovery of normal blood glucose levels. Since cardioselectivity is not absolute, larger doses of beta-1 selective agents may demonstrate these effects as well. Therapy with beta-blockers should be administered cautiously in patients with diabetes or predisposed to spontaneous hypoglycemia.
Glaucoma/Intraocular Hypertension
Moderate:
penbutolol
Penbutolol has a moderate potential interaction with Glaucoma/Intraocular Hypertension.
Systemic beta-adrenergic receptor blocking agents (aka beta-blockers) may lower intraocular pressure. Therefore, patients with glaucoma or intraocular hypertension may require adjustments in their ophthalmic regimen following a dosing change or discontinuation of beta-blocker therapy.
Heart Block
Major:
penbutolol
Penbutolol has a major potential interaction with Heart Block.
The use of beta-adrenergic receptor blocking agents (aka beta-blockers) is contraindicated in patients with sinus bradyarrhythmia or heart block greater than the first degree (unless a functioning pacemaker is present). Due to their negative inotropic and chronotropic effects on the heart, the use of beta-blockers is likely to exacerbate these conditions.
Heart Failure
Major:
penbutolol
Penbutolol has a major potential interaction with Heart Failure.
Beta-adrenergic receptor blocking agents (aka beta-blockers) in general should not be used in patients with overt congestive heart failure (CHF). Sympathetic stimulation may be important in maintaining the hemodynamic function in these patients, thus beta-blockade can worsen the heart failure. However, therapy with beta-blockers may be beneficial and can be administered cautiously in some CHF patients provided they are well compensated and receiving digitalis, diuretics, an ACE inhibitor, and/or nitrates. Carvedilol, specifically, is indicated for use with these agents in the treatment of mild to severe heart failure of ischemic or cardiomyopathic origin. There is also increasing evidence that the addition of a beta-blocker to standard therapy can improve morbidity and mortality in patients with advanced heart failure, although it is uncertain whether effectiveness varies significantly with the different agents. Data from one meta-analysis study suggest a greater reduction of mortality risk for nonselective beta-blockers than for beta-1 selective agents.
Hemodialysis
Major:
penbutolol
Penbutolol has a major potential interaction with Hemodialysis.
Therapy with beta-adrenergic receptor blocking agents (aka beta-blockers) should be administered cautiously in patients requiring hemodialysis. When given after dialysis, hemodynamic stability should be established prior to drug administration to avoid marked falls in blood pressure. The hemodynamic status should be closely monitored before and after the dose.
High Blood Pressure
Major:
gadoxetate disodium
The gadoxetate in gadoxetate disodium has a major potential interaction with High Blood Pressure.
Gadolinium-based contrast agents (GBCAs) increase the risk for nephrogenic systemic fibrosis (NSF) among patients with impaired elimination of the drugs. Gadobenate ion is eliminated predominately via the kidneys. The risk for NSF appears highest among patients with chronic, severe kidney disease (GFR <30 mL/min/1.73m2), or acute kidney injury. It is recommended to avoid the use of GBCAs in these patients unless the diagnostic information is essential and not available with non-contrasted MRI or other processes. NSF may result in fatal or debilitating systemic fibrosis affecting the skin, muscle and internal organs. Consider screening patients for acute kidney injury and other conditions that may reduce renal function and for patients at risk for chronically reduced renal function (e.g., age > 60 years, hypertension or diabetes), estimate the glomerular filtration rate (GFR) through laboratory testing. For patients receiving hemodialysis, physicians may consider the prompt initiation of hemodialysis following the administration of a GBCA to enhance the contrast agent's elimination. The usefulness of hemodialysis in the prevention of NSF is unknown.
High Cholesterol
Moderate:
penbutolol
Penbutolol has a moderate potential interaction with High Cholesterol.
Beta-adrenergic receptor blocking agents (aka beta-blockers) may alter serum lipid profiles. Increases in serum VLDL and LDL cholesterol and triglycerides, as well as decreases in HDL cholesterol, have been reported with some beta-blockers. Patients with preexisting hyperlipidemia may require closer monitoring during beta-blocker therapy, and adjustments made accordingly in their lipid-lowering regimen.
Hyperthyroidism
Moderate:
penbutolol
Penbutolol has a moderate potential interaction with Hyperthyroidism.
During chronic administration, the clearance of beta-blockers that are primarily metabolized by the liver (e.g., labetalol, metoprolol, penbutolol, propranolol) may be increased in patients with hyperthyroidism due to increased liver blood flow and enhanced activity of drug-metabolizing enzymes. Pharmacokinetic studies have demonstrated an approximately 50% increase in systemic clearance of propranolol during long-term therapy. In general, the dosage required to achieve therapeutic blood concentrations in such patients may be higher than that required in euthyroid patients and should be individualized.
Moderate:
penbutolol
Penbutolol has a moderate potential interaction with Hyperthyroidism.
When beta-adrenergic receptor blocking agents (aka beta-blockers) are used to alleviate symptoms of hyperthyroidism such as tachycardia, anxiety, tremor and heat intolerance, abrupt withdrawal can exacerbate thyrotoxicosis or precipitate a thyroid storm. To minimize this risk, cessation of beta-blocker therapy, when necessary, should occur gradually with incrementally reduced dosages over a period of 1 to 2 weeks. Patients should be advised not to discontinue treatment without first consulting with the physician. Close monitoring is recommended during and after therapy withdrawal.
Hypotension
Major:
penbutolol
Penbutolol has a major potential interaction with Hypotension.
The use of beta-adrenergic receptor blocking agents (aka beta-blockers) is contraindicated in patients with hypotension or cardiogenic shock. Due to their negative inotropic and chronotropic effects on the heart, the use of beta-blockers is likely to further depress cardiac output and blood pressure, which can be detrimental in these patients.
Ischemic Heart Disease
Major:
penbutolol
Penbutolol has a major potential interaction with Ischemic Heart Disease.
Heightened sensitivity to catecholamines may occur after prolonged use of beta-adrenergic receptor blocking agents (aka beta-blockers). Exacerbation of angina, myocardial infarction and ventricular arrhythmias have been reported in patients with coronary artery disease following abrupt withdrawal of therapy. Cessation of beta-blocker therapy, whenever necessary, should occur gradually with incrementally reduced dosages over a period of 1 to 2 weeks in patients with coronary insufficiency. Patients should be advised not to discontinue treatment without first consulting with the physician. In patients who experience an exacerbation of angina following discontinuation of beta-blocker therapy, the medication should generally be reinstituted, at least temporarily, along with other clinically appropriate measures.
Liver Disease
Major:
penbutolol
Penbutolol has a major potential interaction with Liver Disease.
Penbutolol is primarily metabolized by the liver. Patients with liver disease may be at greater risk for adverse effects from penbutolol due to decreased drug clearance. Therapy with penbutolol should be administered cautiously in patients with liver disease. Dosage adjustments may be necessary.
Moderate:
gadoxetate disodium
The gadoxetate in gadoxetate disodium has a moderate potential interaction with Liver Disease.
The use of certain Gadolinium-based contrast agents (GBCAs) in patients with severe renal or hepatic impairment may impair imaging performance. If GBCAs are used in these patients, complete MRI no later than 60 minutes after GBCAs administration and use a paired non-contrast and contrast MRI set for diagnosis. It is recommended to exercise caution when interpreting contrast MR images in the absence of companion non-contrast MR images
Myasthenia Gravis
Moderate:
penbutolol
Penbutolol has a moderate potential interaction with Myasthenia Gravis.
Beta-adrenergic receptor blocking agents (aka beta-blockers) may potentiate muscle weakness consistent with certain myasthenic symptoms such as diplopia, ptosis, and generalized weakness. Several beta-blockers have been associated rarely with aggravation of muscle weakness in patients with preexisting myasthenia gravis or myasthenic symptoms. Use cautiously in patients with myasthenia gravis.
Peripheral Arterial Disease
Major:
penbutolol
Penbutolol has a major potential interaction with Peripheral Arterial Disease.
Due to their negative inotropic and chronotropic effects on the heart, beta-adrenergic receptor blocking agents (aka beta-blockers) reduce cardiac output and may precipitate or aggravate symptoms of arterial insufficiency in patients with peripheral vascular disease. In addition, the nonselective beta-blockers (e.g., propranolol, pindolol, timolol) may attenuate catecholamine-mediated vasodilation during exercise by blocking beta-2 receptors in peripheral vessels. Therapy with beta-blockers should be administered cautiously in patients with peripheral vascular disease. Close monitoring for progression of arterial obstruction is advised.
Pheochromocytoma
Moderate:
penbutolol
Penbutolol has a moderate potential interaction with Pheochromocytoma.
Administration of beta-blockers alone in the setting of pheochromocytoma has been associated with a paradoxical increase in blood pressure due to the attenuation of beta receptor-mediated vasodilatation in skeletal muscle. In patients with pheochromocytoma, an alpha-blocking agent should be initiated prior to the use of any beta-blocking agent. Caution should be taken in the administration of these agents to patients suspected of having pheochromocytoma.
Prinzmetal's Angina
Moderate:
penbutolol
Penbutolol has a moderate potential interaction with Prinzmetal's Angina.
Agents with non-selective beta-blocking activity may provoke chest pain in patients with Prinzmetal's variant angina. the use of non-selective beta blockers is not recommended in these patients. Caution should be taken in the administration of these agents to patients suspected of having Prinzmetal's variant angina.
Psoriasis
Moderate:
penbutolol
Penbutolol has a moderate potential interaction with Psoriasis.
The use of beta-blockers in psoriatic patients should be carefully weighed since the use of these agents may cause an aggravation in psoriasis.
Renal Dysfunction
Major:
gadoxetate disodium
The gadoxetate in gadoxetate disodium has a major potential interaction with Renal Dysfunction.
Gadolinium based contrast agents (GBCAs) increase the risk for nephrogenic systemic fibrosis (NSF) among patients with impaired elimination of the drugs. Use of these agents should be avoided in these patients unless the diagnostic information is essential and unavailable with non- contrasted MRI or other diagnostic modalities. NSF may result in fatal or debilitating fibrosis affecting the skin, muscle and internal organs. The risk of NSF appears to be higher in patients with chronic severe renal disease and patients with acute kidney injury. Patients should be screened for acute renal injury and other conditions that might affect renal function such as age >60 years old, hypertension, and diabetes.
Major:
gadoxetate disodium
The gadoxetate in gadoxetate disodium has a major potential interaction with Renal Dysfunction.
Gadolinium-based contrast agents (GBCAs) increase the risk for nephrogenic systemic fibrosis (NSF) among patients with impaired elimination of the drugs. Gadobenate ion is eliminated predominately via the kidneys. The risk for NSF appears highest among patients with chronic, severe kidney disease (GFR <30 mL/min/1.73m2), or acute kidney injury. It is recommended to avoid the use of GBCAs in these patients unless the diagnostic information is essential and not available with non-contrasted MRI or other processes. NSF may result in fatal or debilitating systemic fibrosis affecting the skin, muscle and internal organs. Consider screening patients for acute kidney injury and other conditions that may reduce renal function and for patients at risk for chronically reduced renal function (e.g., age > 60 years, hypertension or diabetes), estimate the glomerular filtration rate (GFR) through laboratory testing. For patients receiving hemodialysis, physicians may consider the prompt initiation of hemodialysis following the administration of a GBCA to enhance the contrast agent's elimination. The usefulness of hemodialysis in the prevention of NSF is unknown.
Moderate:
gadoxetate disodium
The gadoxetate in gadoxetate disodium has a moderate potential interaction with Renal Dysfunction.
The use of certain Gadolinium-based contrast agents (GBCAs) in patients with severe renal or hepatic impairment may impair imaging performance. If GBCAs are used in these patients, complete MRI no later than 60 minutes after GBCAs administration and use a paired non-contrast and contrast MRI set for diagnosis. It is recommended to exercise caution when interpreting contrast MR images in the absence of companion non-contrast MR images
Sinus Node Dysfunction
Major:
penbutolol
Penbutolol has a major potential interaction with Sinus Node Dysfunction.
The use of beta-adrenergic receptor blocking agents (aka beta-blockers) is contraindicated in patients with sinus bradyarrhythmia or heart block greater than the first degree (unless a functioning pacemaker is present). Due to their negative inotropic and chronotropic effects on the heart, the use of beta-blockers is likely to exacerbate these conditions.
Tachyarrhythmia
Moderate:
penbutolol
Penbutolol has a moderate potential interaction with Tachyarrhythmia.
Beta-adrenergic blockade in patients with Wolff-Parkinson-White syndrome and tachycardia has been associated with severe bradycardia requiring treatment with a pacemaker. In one case, this result was reported after an initial dose of 5 mg propranolol. The use of beta-adrenergic receptor blocking agents (aka beta-blockers) should be administered cautiously in these patients.
More resources
gadoxetate disodium
A total of 47 drugs are known to interact with gadoxetate disodium.
- Gadoxetate disodium is in the drug class magnetic resonance imaging contrast media.
- Gadoxetate disodium is used to treat Liver Magnetic Resonance Imaging.
penbutolol
A total of 496 drugs are known to interact with penbutolol.
- Penbutolol is in the drug class non-cardioselective beta blockers.
- Penbutolol is used to treat the following conditions:
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.