Can you take Istradefylline with Quinora?
1 drug interaction and 17 additional warnings found for the following 2 drugs:
- istradefylline
- Quinora (quinidine)
Drug interactions
Moderate drug interactions
Moderate:
quiNIDine istradefylline
Applies to: Quinora (quinidine) and istradefylline
Istradefylline may increase the blood levels and effects of quiNIDine. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects. 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:
quiNIDine Food/Lifestyle
Applies to: Quinora (quinidine)
Do not consume grapefruit or grapefruit juice during treatment with quiNIDine unless specifically directed otherwise by your doctor. Grapefruit and grapefruit juice can interact with quiNIDine and increase the levels of quiNIDine in your body. If you are already consuming grapefruit products, do not increase or decrease the amount of these products in your diet without first talking to your doctor.
Moderate:
istradefylline Food/Lifestyle
Applies to: istradefylline
Smoking tobacco may reduce the blood levels and effects of istradefylline. Contact your doctor if istradefylline is not adequately controlling your symptoms. It is best to avoid smoking during istradefylline therapy. Talk to a healthcare professional if you have any questions or concerns. If you start smoking or undergo smoking cessation, your doctor may need to monitor you more closely to determine if you need a dose adjustment of istradefylline. Your doctor may already be aware of the risks and may have taken appropriate precautions including adjusting your dose and monitoring you closely for any potential complications. 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
15 potential interactions Applies to: 13 conditions, including Heart Failure, Hypokalemia, Hypotension, Psychosis, and Myasthenia Gravis.
Glaucoma/Intraocular Hypertension
Major:
Quinora
The quiNIDine in Quinora has a major potential interaction with Glaucoma/Intraocular Hypertension.
The use of quinidine is contraindicated in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as myasthenia gravis, glaucoma, and urinary retention or obstruction.
Heart Block
Major:
Quinora
The quiNIDine in Quinora has a major potential interaction with Heart Block.
The use of quinidine is contraindicated for use in patients without a functioning artificial pacemaker whose cardiac rhythm is dependent upon a junctional or idioventricular pacemaker, including patients with complete AV block. Therapy with quinidine should be administered with caution in patients with severe sinus-node dysfunction such as sick sinus syndrome, bradycardia-tachycardia syndrome, or second- or third-degree heart block.
Heart Failure
Major:
Quinora
The quiNIDine in Quinora has a major potential interaction with Heart Failure.
Antiarrhythmic agents can induce severe hypotension (particularly with IV administration) or induce or worsen congestive heart failure (CHF). Patients with primary cardiomyopathy or inadequately compensated CHF are at increased risk. Antiarrhythmic agents should be administered cautiously and dosage and/or frequency of administration modified in patients with hypotension or adequately compensated CHF. Alternative therapy should be considered unless these conditions are secondary to cardiac arrhythmia.
Hyperkalemia
Moderate:
Quinora
The quiNIDine in Quinora has a moderate potential interaction with Hyperkalemia.
Electrolyte imbalance can alter the therapeutic effectiveness of antiarrhythmic agents. Hypokalemia and hypomagnesemia can reduce the effectiveness of antiarrhythmic agents. In some cases, these disorders can exaggerate the degree of QTc prolongation and increase the potential for torsade de pointes. Hyperkalemia can potentiate the toxic effects of antiarrhythmic agents. Electrolyte imbalance should be corrected prior to initiating antiarrhythmic therapy. Clinical monitoring of cardiac function and electrolyte concentrations is recommended.
Hypokalemia
Moderate:
Quinora
The quiNIDine in Quinora has a moderate potential interaction with Hypokalemia.
Electrolyte imbalance can alter the therapeutic effectiveness of antiarrhythmic agents. Hypokalemia and hypomagnesemia can reduce the effectiveness of antiarrhythmic agents. In some cases, these disorders can exaggerate the degree of QTc prolongation and increase the potential for torsade de pointes. Hyperkalemia can potentiate the toxic effects of antiarrhythmic agents. Electrolyte imbalance should be corrected prior to initiating antiarrhythmic therapy. Clinical monitoring of cardiac function and electrolyte concentrations is recommended.
Hypotension
Major:
Quinora
The quiNIDine in Quinora has a major potential interaction with Hypotension.
Antiarrhythmic agents can induce severe hypotension (particularly with IV administration) or induce or worsen congestive heart failure (CHF). Patients with primary cardiomyopathy or inadequately compensated CHF are at increased risk. Antiarrhythmic agents should be administered cautiously and dosage and/or frequency of administration modified in patients with hypotension or adequately compensated CHF. Alternative therapy should be considered unless these conditions are secondary to cardiac arrhythmia.
Liver Disease
Major:
istradefylline
Istradefylline has a major potential interaction with Liver Disease.
Istradefylline has not been studied in patients with severe hepatic impairment (Child-Pugh Class C), and its use should be avoided in these patients. In patients with moderate hepatic impairment (Child-Pugh B), the steady-state exposures were predicted to be 3.3-fold higher. Therefore, the maximum recommended dosage of istradefylline in patients with moderate hepatic impairment (Child-Pugh B) is 20 mg once daily. Patients should be closely monitored for adverse events when receiving treatment. No dose adjustment is needed in patients with mild hepatic impairment.
Moderate:
Quinora
The quiNIDine in Quinora has a moderate potential interaction with Liver Disease.
Quinidine is primarily metabolized by the liver to active and inactive forms. Hepatic dysfunction causes a slowed metabolism and elimination of the drug which can lead to quinidine toxicity if dosage is not appropriately reduced. Clinical monitoring of hepatic function is recommended.
Magnesium Imbalance
Moderate:
Quinora
The quiNIDine in Quinora has a moderate potential interaction with Magnesium Imbalance.
Electrolyte imbalance can alter the therapeutic effectiveness of antiarrhythmic agents. Hypokalemia and hypomagnesemia can reduce the effectiveness of antiarrhythmic agents. In some cases, these disorders can exaggerate the degree of QTc prolongation and increase the potential for torsade de pointes. Hyperkalemia can potentiate the toxic effects of antiarrhythmic agents. Electrolyte imbalance should be corrected prior to initiating antiarrhythmic therapy. Clinical monitoring of cardiac function and electrolyte concentrations is recommended.
Myasthenia Gravis
Major:
Quinora
The quiNIDine in Quinora has a major potential interaction with Myasthenia Gravis.
The use of quinidine is contraindicated in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as myasthenia gravis, glaucoma, and urinary retention or obstruction.
Psychosis
Moderate:
istradefylline
Istradefylline has a moderate potential interaction with Psychosis.
Because of the potential risk of exacerbating psychosis, patients with a major psychotic disorder should not be treated with istradefylline. Consider dosage reduction or discontinuation if a patient develops hallucinations or psychotic behaviors while taking this drug.
Renal Dysfunction
Moderate:
istradefylline
Istradefylline has a moderate potential interaction with Renal Dysfunction.
Istradefylline has not been evaluated in patients with end-stage renal disease (ESRD) (CrCl <15 mL/min) or ESRD requiring hemodialysis. Caution is advised if prescribed in these patients. No dosage adjustment is needed in patients with mild, moderate or severe renal impairment.
Moderate:
Quinora
The quiNIDine in Quinora has a moderate potential interaction with Renal Dysfunction.
Renal dysfunction causes a slowed elimination of quinidine which can lead to quinidine toxicity if dosage is not appropriately reduced. Therapy with quinidine should be administered cautiously and dosages reduced in patients with compromised renal function. Quinidine is not appreciably removed by hemodialysis.
Smoking
Moderate:
istradefylline
Istradefylline has a moderate potential interaction with Smoking.
Tobacco smoking decreased systemic exposure to istradefylline by 38% to 54%, which may decrease efficacy. Therefore, the recommended dosage in patients who smoke 20 or more cigarettes per day (or the equivalent amount of another tobacco product) should be increased to 40 mg once daily.
Urinary Retention
Major:
Quinora
The quiNIDine in Quinora has a major potential interaction with Urinary Retention.
The use of quinidine is contraindicated in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as myasthenia gravis, glaucoma, and urinary retention or obstruction.
More resources
istradefylline
A total of 209 drugs are known to interact with istradefylline.
- Istradefylline is in the drug class miscellaneous antiparkinson agents.
- Istradefylline is used to treat Parkinson's Disease.
Quinora
A total of 669 drugs are known to interact with Quinora.
- Quinora is in the drug class group I antiarrhythmics.
- Quinora 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.