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Can you take LetibotulinumtoxinA with Quinora?

1 drug interaction and 18 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

quiNIDine letibotulinumtoxinA

Applies to: Quinora (quinidine) and letibotulinumtoxinA

Using letibotulinumtoxinA together with quiNIDine may increase the risk of certain side effects such as excessive muscle weakness, paralysis, and difficulty breathing, swallowing, or speaking. In rare cases, swallowing and breathing difficulties may be life-threatening or fatal. 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. 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.

Disease interactions

17 potential interactions Applies to: 16 conditions, including Heart Failure, Hypokalemia, Hypotension, Myasthenia Gravis, and Urinary Retention.

Cardiovascular Conditions and Disorders

Moderate:

letibotulinumtoxinA

letibotulinumtoxinA has a moderate potential interaction with Cardiovascular Conditions and Disorders.

Use caution when administering letibotulinumtoxinA to patients with preexisting cardiovascular conditions. Adverse cardiovascular outcomes (some fatal), including arrhythmia and myocardial infarction, have been reported following administration of botulinum toxin products. In some cases, patients had risk factors including preexisting-existing cardiovascular disease.

Dysphagia

Major:

letibotulinumtoxinA

letibotulinumtoxinA has a major potential interaction with Dysphagia.

Treatment with botulinum toxin products, including abobotulinumtoxinA, incobotulinumtoxinA, onabotulinumtoxinA, daxibotulinumtoxinA, letibotulinumtoxinA and others can result in swallowing and breathing difficulties and in general increased neuromuscular compromise. Deaths due to severe dysphagia or respiratory failure have been reported after treatment with botulinum toxin. Care should be exercised with using these products in patients with pre- existing swallowing or respiratory disorders or peripheral motor neuropathic diseases or neuromuscular disorders (e.g., myasthenia gravis, amyotrophic lateral sclerosis), as they may be at increased risk of clinically significant effects including generalized muscle weakness, diplopia, ptosis, dysphonia, dysarthria, severe dysphagia and respiratory compromise. Patients treated with botulinum toxin may require immediate medical attention should they develop these complications. Caution is advised.

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.

History - Myocardial Infarction

Moderate:

letibotulinumtoxinA

letibotulinumtoxinA has a moderate potential interaction with History - Myocardial Infarction.

Use caution when administering letibotulinumtoxinA to patients with preexisting cardiovascular conditions. Adverse cardiovascular outcomes (some fatal), including arrhythmia and myocardial infarction, have been reported following administration of botulinum toxin products. In some cases, patients had risk factors including preexisting-existing cardiovascular disease.

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.

Infection

Major:

letibotulinumtoxinA

letibotulinumtoxinA has a major potential interaction with Infection.

Botulinum toxin products, including abobotulinumtoxinA, incobotulinumtoxinA, onabotulinumtoxinA, letibotulinumtoxinA, and others should not be used in the presence of infection at the proposed injection site(s) as it could lead to severe local or disseminated infection(s).

Liver Disease

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:

letibotulinumtoxinA

letibotulinumtoxinA has a major potential interaction with Myasthenia Gravis.

Treatment with botulinum toxin products, including abobotulinumtoxinA, incobotulinumtoxinA, onabotulinumtoxinA, daxibotulinumtoxinA, letibotulinumtoxinA and others can result in swallowing and breathing difficulties and in general increased neuromuscular compromise. Deaths due to severe dysphagia or respiratory failure have been reported after treatment with botulinum toxin. Care should be exercised with using these products in patients with pre- existing swallowing or respiratory disorders or peripheral motor neuropathic diseases or neuromuscular disorders (e.g., myasthenia gravis, amyotrophic lateral sclerosis), as they may be at increased risk of clinically significant effects including generalized muscle weakness, diplopia, ptosis, dysphonia, dysarthria, severe dysphagia and respiratory compromise. Patients treated with botulinum toxin may require immediate medical attention should they develop these complications. Caution is advised.

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.

Pulmonary Impairment

Major:

letibotulinumtoxinA

letibotulinumtoxinA has a major potential interaction with Pulmonary Impairment.

Treatment with botulinum toxin products, including abobotulinumtoxinA, incobotulinumtoxinA, onabotulinumtoxinA, daxibotulinumtoxinA, letibotulinumtoxinA and others can result in swallowing and breathing difficulties and in general increased neuromuscular compromise. Deaths due to severe dysphagia or respiratory failure have been reported after treatment with botulinum toxin. Care should be exercised with using these products in patients with pre- existing swallowing or respiratory disorders or peripheral motor neuropathic diseases or neuromuscular disorders (e.g., myasthenia gravis, amyotrophic lateral sclerosis), as they may be at increased risk of clinically significant effects including generalized muscle weakness, diplopia, ptosis, dysphonia, dysarthria, severe dysphagia and respiratory compromise. Patients treated with botulinum toxin may require immediate medical attention should they develop these complications. Caution is advised.

Renal Dysfunction

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.

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

letibotulinumtoxinA

A total of 148 drugs are known to interact with letibotulinumtoxinA.

Quinora

A total of 669 drugs are known to interact with Quinora.

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.