Can you take Guanfacine with Troleandomycin?
1 drug interaction and 14 additional warnings found for the following 2 drugs:
- guanfacine
- troleandomycin
Drug interactions
Major drug interactions
Major:
guanFACINE troleandomycin
Applies to: guanfacine and troleandomycin
Troleandomycin may significantly increase the blood levels and effects of guanFACINE. 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.
Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications.
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.
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.
Disease interactions
13 potential interactions Applies to: 12 conditions, including Depression, Hypotension, Peripheral Arterial Disease, Liver Disease, and Heart Block.
Biliary Obstruction
Major:
troleandomycin
Troleandomycin has a major potential interaction with Biliary Obstruction.
Troleandomycin is primarily excreted by the liver and may accumulate in patients with impaired hepatic function. In addition, the use of troleandomycin has been associated with an allergic type of cholestatic hepatitis, particularly in patients receiving the drug for more than 2 weeks or given repeated courses. Therapy with troleandomycin should be administered cautiously in patients with liver and/or biliary disease. Liver function tests should be monitored during prolonged or repeated courses of therapy, and the drug discontinued if abnormalities develop.
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.
Liver Disease
Major:
troleandomycin
Troleandomycin has a major potential interaction with Liver Disease.
Troleandomycin is primarily excreted by the liver and may accumulate in patients with impaired hepatic function. In addition, the use of troleandomycin has been associated with an allergic type of cholestatic hepatitis, particularly in patients receiving the drug for more than 2 weeks or given repeated courses. Therapy with troleandomycin should be administered cautiously in patients with liver and/or biliary disease. Liver function tests should be monitored during prolonged or repeated courses of therapy, and the drug discontinued if abnormalities develop.
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.
Noninfectious Colitis
Major:
troleandomycin
Troleandomycin has a major potential interaction with Noninfectious Colitis.
Clostridioides difficile-associated diarrhea (CDAD), formerly pseudomembranous colitis, has been reported with almost all antibacterial drugs and may range from mild diarrhea to fatal colitis. The most common culprits include clindamycin and lincomycin. Antibacterial therapy alters the normal flora of the colon, leading to overgrowth of C difficile, whose toxins A and B contribute to CDAD development. Morbidity and mortality are increased with hypertoxin-producing strains of C difficile; these infections can be resistant to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea after antibacterial use. Since CDAD has been reported to occur more than 2 months after antibacterial use, careful medical history is necessary. Therapy with broad-spectrum antibacterials and other agents with significant antibacterial activity should be administered cautiously in patients with history of gastrointestinal disease, particularly colitis; pseudomembranous colitis (generally characterized by severe, persistent diarrhea and severe abdominal cramps, and sometimes associated with the passage of blood and mucus), if it occurs, may be more severe in these patients and may be associated with flares in underlying disease activity. Antibacterial drugs not directed against C difficile may need to be stopped if CDAD is suspected or confirmed. Appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C difficile, and surgical evaluation should be started as clinically indicated.
Peripheral Arterial Disease
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.
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.
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.
- Guanfacine is in the drug class antiadrenergic agents, centrally acting.
-
Guanfacine is used to treat the following conditions:
- ADHD
- High Blood Pressure
- Tourette's Syndrome (off-label)
troleandomycin
A total of 546 drugs are known to interact with troleandomycin.
- Troleandomycin is in the drug class macrolides.
- Troleandomycin 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.