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Can you take Guanfacine with Nitroprusside?

1 drug interaction and 21 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

sodium nitroprusside guanFACINE

Applies to: nitroprusside and guanfacine

Using sodium nitroprusside together with guanFACINE may result in a severe decrease in blood pressure.

This can cause dizziness or feeling like you might pass out, especially when getting up from a sitting or lying position.

If your doctor prescribes these medications together, you may need a dose adjustment or need your blood pressure checked more often 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.

Food/lifestyle interactions

Major food/lifestyle interactions

Major:

guanFACINE Food/Lifestyle

Applies to: guanfacine

Avoid consuming grapefruit or grapefruit juice during treatment with guanFACINE, as it may increase blood levels and effects of the medication. This may cause blood pressure to fall excessively, especially when you rise from a sitting or lying position. The risk of other side effects such as drowsiness, dizziness, lightheadedness, fainting, headache, palpitations, and heart rate changes may also increase.

Additionally, you should avoid or limit the use of alcohol while being treated with guanFACINE. Combining the medication with alcohol can intensify sedative and blood pressure lowering effects, which may increase the risk of falls and injury.

Avoid driving or operating hazardous machinery until you know how the medication affects you, and use caution when getting up from a sitting or lying position.

If you are using a long-acting or extended-release formulation of the medication, make sure you do not take it with a high-fat meal. Doing so results in increased absorption and elevated blood levels of the medication.

Talk to your doctor or pharmacist if you have any questions or concerns.

Moderate food/lifestyle interactions

Moderate:

sodium nitroprusside Alcohol (Ethanol)

Applies to: nitroprusside

Ethanol and sodium nitroprusside 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.

Disease interactions

19 potential interactions Applies to: 17 conditions, including Depression, Hypotension, Anemia, Peripheral Arterial Disease, and Pseudotumor Cerebri.

Anemia

Moderate:

nitroprusside

The sodium nitroprusside in nitroprusside has a moderate potential interaction with Anemia.

When sodium nitroprusside is used to control hypotension during anesthesia, the patient's capacity to compensate for anemia and hypovolemia may be diminished. If possible, preexisting anemia and hypovolemia should be corrected prior to administration of sodium nitroprusside.

Aortic Coarctation

Major:

nitroprusside

The sodium nitroprusside in nitroprusside has a major potential interaction with Aortic Coarctation.

Nitroprusside should not be used for the treatment of compensatory hypertension, such as that associated with aortic coarctation or arteriovenous shunt.

Arteriovenous Shunting

Major:

nitroprusside

The sodium nitroprusside in nitroprusside has a major potential interaction with Arteriovenous Shunting.

Nitroprusside should not be used for the treatment of compensatory hypertension, such as that associated with aortic coarctation or arteriovenous shunt.

Cerebral Vascular Disorder

Major:

nitroprusside

The sodium nitroprusside in nitroprusside has a major potential interaction with Cerebral Vascular Disorder.

The use of nitroprusside is contraindicated in patients with cerebral vascular insufficiency.

Cerebrovascular Insufficiency

Moderate:

guanfacine

guanFACINE has a moderate potential interaction with Cerebrovascular Insufficiency.

Central alpha-2 adrenoreceptor agonists reduce sympathetic outflow from the central nervous system, resulting in decreases in heart rate, peripheral and renovascular resistance, and blood pressure. Therapy with these agents should be administered cautiously in patients with hypotension or conditions that may be exacerbated by decreased blood pressure and perfusion, such as coronary insufficiency, peripheral vascular disease (e.g., Raynaud's syndrome), cerebrovascular disease, or recent myocardial infarction.

Depression

Moderate:

guanfacine

guanFACINE has a moderate potential interaction with Depression.

Central alpha-2 adrenoreceptor agonists may occasionally cause mental depression and should be used cautiously in patients with a history of depression.

Heart Block

Moderate:

guanfacine

guanFACINE has a moderate potential interaction with Heart Block.

Central alpha-2 adrenoreceptor agonists reduce sympathetic outflow from the central nervous system. Heart rate is decreased, which may lead to or exacerbate sinus bradycardia and atrioventricular block. Therapy with central alpha-2 adrenoreceptor agonists should be administered cautiously in patients with conduction disturbances such as sinus node dysfunction or AV nodal disease.

Hyperkinetic Syndrome of Childhood

Moderate:

guanfacine

guanFACINE has a moderate potential interaction with Hyperkinetic Syndrome of Childhood.

The safety and effectiveness of guanfacine in children under 12 years of age has not been demonstrated and its use in this age group is not recommended. However, there have been some spontaneous postmarketing reports of mania and aggressive behavioral changes in pediatric patients with attention- deficit hyperactivity disorder (ADHD) that received this drug. All patients had medical or family risks of bipolar disorder, and all of them recovered after treatment discontinuation. Hallucinations have also been reported in pediatric patients receiving guanfacine for the treatment of ADHD.

Hypotension

Moderate:

guanfacine

guanFACINE has a moderate potential interaction with Hypotension.

Central alpha-2 adrenoreceptor agonists reduce sympathetic outflow from the central nervous system, resulting in decreases in heart rate, peripheral and renovascular resistance, and blood pressure. Therapy with these agents should be administered cautiously in patients with hypotension or conditions that may be exacerbated by decreased blood pressure and perfusion, such as coronary insufficiency, peripheral vascular disease (e.g., Raynaud's syndrome), cerebrovascular disease, or recent myocardial infarction.

Ischemic Heart Disease

Moderate:

guanfacine

guanFACINE has a moderate potential interaction with Ischemic Heart Disease.

Central alpha-2 adrenoreceptor agonists reduce sympathetic outflow from the central nervous system, resulting in decreases in heart rate, peripheral and renovascular resistance, and blood pressure. Therapy with these agents should be administered cautiously in patients with hypotension or conditions that may be exacerbated by decreased blood pressure and perfusion, such as coronary insufficiency, peripheral vascular disease (e.g., Raynaud's syndrome), cerebrovascular disease, or recent myocardial infarction.

Leber's Disease

Major:

nitroprusside

The sodium nitroprusside in nitroprusside has a major potential interaction with Leber's Disease.

The use of nitroprusside is contraindicated in patients with defective or absent rhodanase activity, such as patients with congenital (Leber's) optic atrophy or with tobacco amblyopia.

Liver Disease

Moderate:

guanfacine

guanFACINE has a moderate potential interaction with Liver Disease.

Normally, approximately 50% of a guanfacine dose is eliminated unchanged by the kidney and the rest metabolized by the liver. However, neither the parent drug nor its metabolites accumulate significantly during chronic dosing in patients with severe renal impairment due to increased hepatic metabolism of the drug in these patients. Thus, initial dosage adjustments are generally not necessary in renal impairment. Dosage titration, however, should be made cautiously if hepatic function is also compromised. The pharmacokinetics of guanfacine has not been studied in patients with liver disease. The manufacturer recommends caution when the drug is used in such patients.

Moderate:

nitroprusside

The sodium nitroprusside in nitroprusside has a moderate potential interaction with Liver Disease.

Use caution when administering sodium nitroprusside to patients with hepatic insufficiency.

Peripheral Arterial Disease

Major:

nitroprusside

The sodium nitroprusside in nitroprusside has a major potential interaction with Peripheral Arterial Disease.

Sodium nitroprusside should not be used for the treatment of acute congestive heart failure associated with reduced peripheral vascular resistance such as high- output heart failure that may be seen in endotoxic sepsis.

Moderate:

guanfacine

guanFACINE has a moderate potential interaction with Peripheral Arterial Disease.

Central alpha-2 adrenoreceptor agonists reduce sympathetic outflow from the central nervous system, resulting in decreases in heart rate, peripheral and renovascular resistance, and blood pressure. Therapy with these agents should be administered cautiously in patients with hypotension or conditions that may be exacerbated by decreased blood pressure and perfusion, such as coronary insufficiency, peripheral vascular disease (e.g., Raynaud's syndrome), cerebrovascular disease, or recent myocardial infarction.

Pseudotumor Cerebri

Moderate:

nitroprusside

The sodium nitroprusside in nitroprusside has a moderate potential interaction with Pseudotumor Cerebri.

Like other vasodilators, sodium nitroprusside can cause increases in intracranial pressure. In patients whose intracranial pressure is already elevated, sodium nitroprusside should be used only with extreme caution.

Renal Dysfunction

Moderate:

guanfacine

guanFACINE has a moderate potential interaction with Renal Dysfunction.

Normally, approximately 50% of a guanfacine dose is eliminated unchanged by the kidney and the rest metabolized by the liver. However, neither the parent drug nor its metabolites accumulate significantly during chronic dosing in patients with severe renal impairment due to increased hepatic metabolism of the drug in these patients. Thus, initial dosage adjustments are generally not necessary in renal impairment. Dosage titration, however, should be made cautiously if hepatic function is also compromised. The pharmacokinetics of guanfacine has not been studied in patients with liver disease. The manufacturer recommends caution when the drug is used in such patients.

Sepsis

Major:

nitroprusside

The sodium nitroprusside in nitroprusside has a major potential interaction with Sepsis.

Sodium nitroprusside should not be used for the treatment of acute congestive heart failure associated with reduced peripheral vascular resistance such as high- output heart failure that may be seen in endotoxic sepsis.

Sinus Node Dysfunction

Moderate:

guanfacine

guanFACINE has a moderate potential interaction with Sinus Node Dysfunction.

Central alpha-2 adrenoreceptor agonists reduce sympathetic outflow from the central nervous system. Heart rate is decreased, which may lead to or exacerbate sinus bradycardia and atrioventricular block. Therapy with central alpha-2 adrenoreceptor agonists should be administered cautiously in patients with conduction disturbances such as sinus node dysfunction or AV nodal disease.

More resources

guanfacine

A total of 535 drugs are known to interact with guanfacine.

nitroprusside

A total of 251 drugs are known to interact with nitroprusside.

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.