Drug Interactions between hydrochlorothiazide / methyldopa and Orap
This report displays the potential drug interactions for the following 2 drugs:
- hydrochlorothiazide/methyldopa
- Orap (pimozide)
Interactions between your drugs
hydroCHLOROthiazide pimozide
Applies to: hydrochlorothiazide / methyldopa and Orap (pimozide)
Using pimozide together with hydroCHLOROthiazide can increase the risk of an irregular heart rhythm that may be serious. If your doctor prescribes these medications together, you may need regular monitoring of your electrolyte (magnesium, potassium) levels as well as other tests to safely use both medications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, or fast or pounding heartbeats during treatment with pimozide. In addition, you should let your doctor know if you experience signs of electrolyte disturbance such as weakness, tiredness, drowsiness, confusion, muscle pain, cramps, dizziness, nausea, or vomiting. 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.
methyldopa pimozide
Applies to: hydrochlorothiazide / methyldopa and Orap (pimozide)
Consumer information for this interaction is not currently available.
MONITOR: Phenothiazines, tricyclic antidepressants (TCAs), and some antipsychotic (neuroleptic) agents may potentiate the blood pressure lowering capabilities of other drugs with hypotensive effects due to their peripheral alpha-1 adrenergic blocking activity. Orthostatic hypotension and syncope associated with vasodilation may occur, particularly during initial dosing and/or parenteral administration of the phenothiazine, TCA, or neuroleptic. The severity of this interaction may be affected by the agent's affinity for the alpha-1 adrenoceptor. One in vitro study demonstrated an affinity for the alpha-1 adrenoceptor for some of these medications that was similar to, or greater than, those of alpha blocker medications used to treat hypertension. Examples of drugs evaluated in this study with a high affinity included amitriptyline, clomipramine, chlorpromazine, clozapine, doxepin, flupenthixol, lurasidone, nortriptyline, perphenazine, paliperidone, quetiapine, risperidone, sertindole, and ziprasidone. On the other hand, examples of those with lower affinities included aripiprazole, lofepramine, protriptyline, sulpiride, and amisulpride.
MANAGEMENT: Close clinical monitoring for development of hypotension is recommended if phenothiazines, tricyclic antidepressants (TCAs), or certain antipsychotic (neuroleptic) agents are used in patients receiving antihypertensive medications or vasodilators. A lower starting dosage and slower titration of the phenothiazine, TCA, or neuroleptic may be appropriate, especially in the elderly. It may also be advisable to consider using a phenothiazine, TCA, or neuroleptic medication with a lower affinity for the alpha-1 adrenoceptor when possible. Patients should be counseled to avoid rising abruptly from a sitting or recumbent position and to notify their healthcare provider if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia. Patients should also avoid driving or operating hazardous machinery until they know how the medications affect them.
References
- Fruncillo R, Gibbons W, Vlasses P, Ferguson R "Severe hypotension associated with concurrent clonidine and antipsychotic medication." Am J Psychiatry 142 (1985): 274
- White WB "Hypotension with postural syncope secondary to the combination of chlorpromazine and captopril." Arch Intern Med 146 (1986): 1833-4
- "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals PROD (2001):
- "Product Information. Risperdal (risperidone)." Janssen Pharmaceuticals PROD (2001):
- Aronowitz JS, Chakos MH, Safferman AZ, Lieberman JA "Syncope associated with the combination of clozapine and enalapril." J Clin Psychopharmacol 14 (1994): 429-30
- Markowitz JS, Wells BG, Carson WH "Interactions between antipsychotic and antihypertensive drugs." Ann Pharmacother 29 (1995): 603-9
- "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company PROD (2001):
- "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals PROD (2001):
- "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals PROD (2001):
- "Product Information. Abilify (aripiprazole)." Bristol-Myers Squibb (2002):
- "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):
- Proudman RGW, Pupo AS, Baker JG "The affinity and selectivity of alpha-adrenoceptor antagonists, antidepressants, and antipsychotics for the human alpha1A, alpha1B, and alpha1D-adrenoceptors." Pharmacol Res Perspect 8 (2020): e00602
Drug and food interactions
pimozide food
Applies to: Orap (pimozide)
You should avoid the consumption of large amounts of grapefruits and grapefruit juice while taking pimozide. Grapefruit can raise the levels of pimozide in your body. This can affect the rhythm of your heart and cause other side effects. Call your doctor if you have symptoms of blurred vision or nausea. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or fast or pounding heartbeats during treatment with pimozide. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor. You should avoid or limit the use of alcohol while being treated with pimozide. Alcohol can increase the nervous system side effects of pimozide such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. Talk to your doctor or pharmacist if you have any questions or concerns.
methyldopa food
Applies to: hydrochlorothiazide / methyldopa
Methyldopa and ethanol may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. 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.
hydroCHLOROthiazide food
Applies to: hydrochlorothiazide / methyldopa
HydroCHLOROthiazide and ethanol may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. 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.
methyldopa food
Applies to: hydrochlorothiazide / methyldopa
Methyldopa and multivitamin with minerals should not be taken orally at the same time. Products that contain iron may interfere with the absorption of methyldopa and reduce its effectiveness. You should separate the dosing of these medications by as much as possible. Talk to your doctor if you have any questions or concerns. 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.
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
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.
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