Interactions between Igalmi and Phenoxybenzamine
1 drug interaction and 14 additional warnings found for the following 2 drugs:
- Igalmi (dexmedetomidine)
- phenoxybenzamine
Drug interactions
Moderate drug interactions
Moderate:
phenoxybenzamine dexmedeTOMIDine
Applies to: phenoxybenzamine and Igalmi (dexmedetomidine)
Monitor
Dexmedetomidine has been associated with hypotensive and negative chronotropic effects. Coadministration with other agents causing these effects, especially vasodilators and alpha-2 agonists, may result in additive effects on blood pressure and heart rate. Data have been conflicting. Additive pharmacodynamic effects were not observed in some clinical studies.
Management
Caution and monitoring of the patient's hemodynamic status are recommended during coadministration.
References (5)
- (2001) "Product Information. Precedex (dexmedetomidine)." Abbott Pharmaceutical
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- Canadian Pharmacists Association (2006) e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink
- EMEA. European Medicines Agency (2007) EPARs. European Union Public Assessment Reports. http://www.ema.europa.eu/ema/index.jsp?curl=pages/includes/medicines/medicines_landingpage.jsp&mid
- Cerner Multum, Inc. "Australian Product Information."
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
dexmedeTOMIDine Food/Lifestyle
Applies to: Igalmi (dexmedetomidine)
Generally avoid
Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.
Management
Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
References (4)
- Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
- Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
- (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
- (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka America Pharmaceutical, Inc.
Moderate:
phenoxybenzamine Alcohol (Ethanol)
Applies to: phenoxybenzamine
Monitor
Certain psychotherapeutic and other CNS-active agents may have blood pressure-lowering effects and may cause dizziness, orthostatic hypotension, or syncope. These effects may be more likely during treatment initiation, dose escalation, or treatment restart. Coadministration with antihypertensives or other agents with blood pressure-lowering properties, particularly vasodilators and alpha-adrenergic blockers, may result in additive hypotensive or orthostatic effects.
Management
Monitor blood pressure and clinical response during concomitant use, especially when starting or increasing the dose of either agent. Patients should be advised to rise slowly from a sitting or lying position and to report dizziness, lightheadedness, fainting, orthostasis, palpitations, or troublesome changes in pulse or heart rate. Patients should be cautioned that alcohol may enhance blood pressure-lowering effects during concomitant use with antihypertensives or other agents with hypotensive properties. Patients should avoid driving or operating hazardous machinery until they know how the medications affect them.
References (13)
- Sternbach H (1991) "Fluoxetine-associated potentiation of calcium-channel blockers." J Clin Psychopharmacol, 11, p. 390-1
- Shook TL, Kirshenbaum JM, Hundley RF, Shorey JM, Lamas GA (1984) "Ethanol intoxication complicating intravenous nitroglycerin therapy." Ann Intern Med, 101, p. 498-9
- Feder R (1991) "Bradycardia and syncope induced by fluoxetine." J Clin Psychiatry, 52, p. 139
- Ellison JM, Milofsky JE, Ely E (1990) "Fluoxetine-induced bradycardia and syncope in two patients." J Clin Psychiatry, 51, p. 385-6
- Rodriguez de la Torre B, Dreher J, Malevany I, et al. (2001) "Serum levels and cardiovascular effects of tricyclic antidepressants and selective serotonin reuptake inhibitors in depressed patients." Ther Drug Monit, 23, p. 435-40
- Pacher P, Kecskemeti V (2004) "Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns?" Curr Pharm Des, 10, p. 2463-75
- Andrews C, Pinner G (1998) "Postural hypotension induced by paroxetine." BMJ, 316, p. 595
- (2023) "Product Information. Buprenorphine (buprenorphine)." G.L. Pharma UK Ltd
- (2023) "Product Information. Temgesic (buprenorphine)." Reckitt Benckiser Pty Ltd
- (2026) "Product Information. Urapidil (Carinopharm) (urapidil)." Imported (EU)
- (2020) "Product Information. URAPIDIL ACCORD (urapidil)." ACCORD HEALTHCARE LIMITED
- (2020) "Product Information. Ebrantil (urapidil)." CHEPLAPHARM ARZNEIMITTEL GMBH
- (2026) "Product Information. Urapidil (urapidil)." Imported (Switzerland)
Disease interactions
12 potential interactions Applies to: 12 conditions, including Depression, Heart Failure, Diabetes Mellitus, Urinary Retention, and Liver Disease.
Cardiovascular Conditions and Disorders
Moderate:
Igalmi
The dexmedeTOMIDine in Igalmi has a moderate potential interaction with Cardiovascular Conditions and Disorders.
The use of dexmedetomidine injection infusion decreases sympathetic nervous system activity and can cause hypotension, significant bradycardia and sinus arrest. Caution should be exercised when administered to patients with advanced heart block, severe ventricular dysfunction or any significant cardiovascular dysfunction. Hypotension or bradycardia can be expected to be more pronounced in patients with hypovolemia, diabetes mellitus, chronic hypertension and in the elderly.
Cerebral Vascular Disorder
Major:
phenoxybenzamine
Phenoxybenzamine has a major potential interaction with Cerebral Vascular Disorder.
The use of phenoxybenzamine is contraindicated when a decrease in blood pressure may be undesirable, such as in patients with marked cerebrovascular or coronary insufficiency in whom ischemia may be aggravated. Also, phenoxybenzamine- induced reflex tachycardia can precipitate frank congestive heart failure (CHF) and angina in patients with compensated CHF or coronary artery disease. Phenoxybenzamine should be used with caution under such circumstances.
Depression
Major:
Igalmi
The dexmedeTOMIDine in Igalmi has a major potential interaction with Depression.
A variety of abnormal thinking and behavior changes have been reported to occur in association with the use of most anxiolytics, sedatives and hypnotics. Some of these changes include decreased inhibition, aggressiveness, agitation, and hallucinations. These drugs can cause or exacerbate mental depression and cause suicidal behavior and ideation. Therapy with these drugs should be administered cautiously in patients with a history of depression or other psychiatric disorders. Patients should be monitored for any changes in mood or behavior. It may be prudent to refrain from dispensing large quantities of medication to these patients.
Diabetes Mellitus
Moderate:
Igalmi
The dexmedeTOMIDine in Igalmi has a moderate potential interaction with Diabetes Mellitus.
The use of dexmedetomidine injection infusion decreases sympathetic nervous system activity and can cause hypotension, significant bradycardia and sinus arrest. Caution should be exercised when administered to patients with advanced heart block, severe ventricular dysfunction or any significant cardiovascular dysfunction. Hypotension or bradycardia can be expected to be more pronounced in patients with hypovolemia, diabetes mellitus, chronic hypertension and in the elderly.
Glaucoma/Intraocular Hypertension
Moderate:
Igalmi
The dexmedeTOMIDine in Igalmi has a moderate potential interaction with Glaucoma/Intraocular Hypertension.
Some hypnotic drugs can have an anticholinergic effect and should be used with caution in patients with glaucoma, and trouble urinating due to retention or enlarged prostate.
Heart Block
Moderate:
Igalmi
The dexmedeTOMIDine in Igalmi has a moderate potential interaction with Heart Block.
The use of dexmedetomidine injection infusion decreases sympathetic nervous system activity and can cause hypotension, significant bradycardia and sinus arrest. Caution should be exercised when administered to patients with advanced heart block, severe ventricular dysfunction or any significant cardiovascular dysfunction. Hypotension or bradycardia can be expected to be more pronounced in patients with hypovolemia, diabetes mellitus, chronic hypertension and in the elderly.
Heart Failure
Major:
phenoxybenzamine
Phenoxybenzamine has a major potential interaction with Heart Failure.
The use of phenoxybenzamine is contraindicated when a decrease in blood pressure may be undesirable, such as in patients with marked cerebrovascular or coronary insufficiency in whom ischemia may be aggravated. Also, phenoxybenzamine- induced reflex tachycardia can precipitate frank congestive heart failure (CHF) and angina in patients with compensated CHF or coronary artery disease. Phenoxybenzamine should be used with caution under such circumstances.
Ischemic Heart Disease
Major:
phenoxybenzamine
Phenoxybenzamine has a major potential interaction with Ischemic Heart Disease.
The use of phenoxybenzamine is contraindicated when a decrease in blood pressure may be undesirable, such as in patients with marked cerebrovascular or coronary insufficiency in whom ischemia may be aggravated. Also, phenoxybenzamine- induced reflex tachycardia can precipitate frank congestive heart failure (CHF) and angina in patients with compensated CHF or coronary artery disease. Phenoxybenzamine should be used with caution under such circumstances.
Liver Disease
Moderate:
Igalmi
The dexmedeTOMIDine in Igalmi has a moderate potential interaction with Liver Disease.
In general, anxiolytics, sedatives and hypnotics are extensively metabolized by the liver. Their plasma clearance may be decreased and their half-life prolonged in patients with impaired hepatic function. Therapy with these drugs should be administered cautiously in patients with liver disease (some are not recommended in severe liver impairment), and the dosage should be adjusted accordingly. Laboratory testing is recommended prior and during treatment.
Pleuropulmonary Infection
Moderate:
phenoxybenzamine
Phenoxybenzamine has a moderate potential interaction with Pleuropulmonary Infection.
The adrenergic blocking effect of phenoxybenzamine may aggravate the symptoms of respiratory infections. Caution is recommended when treating patients with respiratory infections.
Renal Dysfunction
Moderate:
phenoxybenzamine
Phenoxybenzamine has a moderate potential interaction with Renal Dysfunction.
Phenoxybenzamine should be administered with caution in patients with marked renal damage.
Urinary Retention
Moderate:
Igalmi
The dexmedeTOMIDine in Igalmi has a moderate potential interaction with Urinary Retention.
Some hypnotic drugs can have an anticholinergic effect and should be used with caution in patients with glaucoma, and trouble urinating due to retention or enlarged prostate.
Report options
More resources
Igalmi
A total of 366 drugs are known to interact with Igalmi.
- Igalmi is in the drug class miscellaneous anxiolytics, sedatives and hypnotics.
- Igalmi is used to treat Agitation.
phenoxybenzamine
A total of 237 drugs are known to interact with phenoxybenzamine.
- Phenoxybenzamine is in the drug class miscellaneous cardiovascular agents.
- Phenoxybenzamine is used to treat Pheochromocytoma.
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
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