Can you take Lorcaserin with Tolterodine?

Lorcaserin has a moderate potential interaction with Bone Marrow Depression/Low Blood Counts.

Hematological changes, including decreases in hemoglobin and hematocrit counts, have been reported with the use of lorcaserin. Caution should be exercised when treating patients who have ongoing or a history of significant hematologic abnormalities. It is recommended to consider periodic monitoring of complete blood count during treatment.

Lorcaserin has a moderate potential interaction with Breast Cancer.

Lorcaserin can cause elevations in prolactin. In clinical trials of at least one year duration, elevations of prolactin greater than the upper limit of normal, two times the upper limit of normal, and five times the upper limit of normal occurred in 6.7%, 1.7%, and 0.1% of lorcaserin-treated patients, compared to 4.8%, 0.8%, and 0.0% of placebo-treated patients, respectively. One patient treated with lorcaserin developed a prolactinoma. Based on in vitro data, approximately one-third of human breast cancers are thought to be prolactin-dependent. The clinical significance of this observation with respect to long-term lorcaserin therapy is unknown. Chronic administration of other prolactin-stimulating drugs (e.g., neuroleptics, phenothiazines) has been associated with mammary tumorigenesis in rodent studies but not in human clinical or epidemiologic studies. Until further data are available, therapy with lorcaserin should be administered cautiously in patients with a previously detected breast cancer.

Tolterodine has a moderate potential interaction with Central Nervous System Disorders.

Tolterodine is associated with anticholinergic central nervous system (CNS) effects. If a patient experiences anticholinergic CNS effects, dose reduction or drug discontinuation should be considered. Tolterodine should be used with caution in patients with Parkinson's disease and in patients with preexisting dementia treated with cholinesterase inhibitors due to the risk of aggravation of symptoms.

Tolterodine has a moderate potential interaction with Dementia.

Tolterodine is associated with anticholinergic central nervous system (CNS) effects. If a patient experiences anticholinergic CNS effects, dose reduction or drug discontinuation should be considered. Tolterodine should be used with caution in patients with Parkinson's disease and in patients with preexisting dementia treated with cholinesterase inhibitors due to the risk of aggravation of symptoms.

Lorcaserin has a moderate potential interaction with Depression.

Drugs like lorcaserin that target the central nervous system have been associated with depression and suicidal ideation. Psychiatric events of euphoria, hallucination, and dissociation were observed with lorcaserin at supratherapeutic dosages in short-term studies. In clinical trials of at least one year duration, 0.2% of patients treated with lorcaserin developed euphoria, compared to <0.1% treated with placebo. Therapy with lorcaserin should be administered cautiously in patients with preexisting depression or psychiatric illnesses. Lorcaserin dosage should not exceed 10 mg twice a day, and patients should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior. Lorcaserin should be discontinued in patients who experience suicidal thoughts or behavior.

Tolterodine has a major potential interaction with Gastrointestinal Obstruction.

The use of tolterodine is contraindicated in patients with GI obstruction, ileus, or obstructive uropathy. Tolterodine exerts anticholinergic activity by competitive antagonism of muscarinic receptors.

Tolterodine has a major potential interaction with Glaucoma/Intraocular Hypertension.

The use of tolterodine is contraindicated in patients with uncontrolled angle-closure (narrow angle) glaucoma. Tolterodine exerts anticholinergic activity and can result in increased intraocular pressure and loss of accommodation.

Lorcaserin has a moderate potential interaction with Heart Block.

Lorcaserin may decrease heart rate. In clinical trials of at least one year duration, the mean decrease in heart rate was 1.2 beats per minute (bpm) in lorcaserin-treated and 0.4 bpm in placebo-treated patients without diabetes, and 2.0 bpm in lorcaserin-treated and 0.4 bpm in placebo-treated patients with type 2 diabetes. The incidence of heart rate less than 50 bpm was 5.3% in lorcaserin-treated and 3.2% in placebo-treated patients without diabetes, and 3.6% in lorcaserin-treated and 2.0% in placebo-treated patients with type 2 diabetes. In the combined population, adverse reactions of bradycardia occurred in 0.3% of lorcaserin-treated and 0.1% of placebo-treated patients. Therapy with lorcaserin should be administered cautiously in patients with bradycardia or a history of heart block greater than first degree.

Lorcaserin has a major potential interaction with Heart Failure.

Regurgitant cardiac valvular disease, primarily affecting the mitral and/or aortic valves, has been reported in patients who took serotonergic drugs with 5-HT2B receptor agonist activity. The etiology is thought to involve activation of 5-HT2B receptors on cardiac interstitial cells. At therapeutic concentrations, lorcaserin is selective for 5-HT2C receptors relative to 5-HT2B receptors, thus it is not known if lorcaserin can cause valvulopathy. In clinical trials of one year duration, 2.4% of patients receiving lorcaserin and 2.0% of patients receiving placebo developed echocardiographic criteria for valvular regurgitation at one year (mild or greater aortic regurgitation and/or moderate or greater mitral regurgitation). None of these patients was symptomatic. Lorcaserin has not been studied in patients with congestive heart failure or hemodynamically-significant valvular heart disease. Preliminary data suggest that 5-HT2B receptors may be overexpressed in congestive heart failure. Therapy with lorcaserin should be administered cautiously in patients with congestive heart failure or preexisting valvulopathy. Patients who develop signs and symptoms of valvular heart disease such as dizziness, fatigue, weakness, dyspnea, edema, or arrhythmia during treatment with lorcaserin should seek prompt medical attention. Discontinuation of lorcaserin should be considered.

Lorcaserin has a moderate potential interaction with Liver Disease.

Lorcaserin is extensively metabolized in the liver by multiple enzymatic pathways. In study subjects with varying degrees of hepatic function, lorcaserin peak plasma concentration (Cmax) was reduced by 7.8% and 14.3% in subjects with mild (Child-Pugh score 5 to 6) and moderate (Child-Pugh score 7 to 9) hepatic impairment, respectively, compared to subjects with normal hepatic function. Lorcaserin exposure (AUC) increased by approximately 22% and 30% in patients with mild and moderate hepatic impairment, respectively, and the half-life was prolonged by 59% to 19 hours in patients with moderate hepatic impairment. No dosage adjustment of lorcaserin is required in patients with mild to moderate hepatic impairment. The effect of severe hepatic impairment on the pharmacokinetics of lorcaserin was not evaluated. Therapy with lorcaserin should be administered cautiously in patients with severe hepatic impairment.

Tolterodine has a moderate potential interaction with Liver Disease.

Tolterodine undergoes biotransformation in the liver of extensive metabolizers to an active metabolite. Poor metabolizers have a greater concentration of active parent and less active metabolite, however the net activity of tolterodine is expected to be the same. The pharmacokinetic disposition of tolterodine can be significantly altered in patients with hepatic dysfunction. Therapy with tolterodine should be administered cautiously in patients with severe hepatic impairment and dosage should be reduced to no greater than 1 mg twice daily.

Tolterodine has a moderate potential interaction with Long QT Syndrome.

Tolterodine has been associated with QT prolongation. The effect on QT interval correlates with plasma concentration of tolterodine. Caution is recommended when prescribing this agent to patients with a known history of QT prolongation or to patients who are taking Class IA (e.g., quinidine, procainamide) or Class III (e.g., amiodarone, sotalol) antiarrhythmic medications.

Tolterodine has a moderate potential interaction with Myasthenia Gravis.

Tolterodine acts as a competitive antagonist of acetylcholine at postganglionic muscarinic receptors. Caution is recommended when using this agent in patients with myasthenia gravis, a disease characterized by decreased cholinergic activity at the neuromuscular junction.

Lorcaserin has a moderate potential interaction with Myeloproliferative Disorders.

Lorcaserin may cause priapism due to 5-HT2C receptor agonism. The condition is characterized by prolonged, often painful erections lasting longer than 4 hours. If not treated promptly, priapism can cause irreversible damage to the erectile tissue. Therapy with lorcaserin should be administered cautiously in patients with a history of priapism, conditions that may predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, leukemia, thalassemia), or anatomical deformations of the penis (e.g., angulation, cavernosal fibrosis, Peyronie's disease). Patients who experience an erection lasting longer than 4 hours, whether painful or not, should immediately discontinue the drug and seek emergency medical attention.

Lorcaserin has a moderate potential interaction with Penis Disorders.

Lorcaserin may cause priapism due to 5-HT2C receptor agonism. The condition is characterized by prolonged, often painful erections lasting longer than 4 hours. If not treated promptly, priapism can cause irreversible damage to the erectile tissue. Therapy with lorcaserin should be administered cautiously in patients with a history of priapism, conditions that may predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, leukemia, thalassemia), or anatomical deformations of the penis (e.g., angulation, cavernosal fibrosis, Peyronie's disease). Patients who experience an erection lasting longer than 4 hours, whether painful or not, should immediately discontinue the drug and seek emergency medical attention.

Lorcaserin has a moderate potential interaction with Peyronie Disease.

Lorcaserin may cause priapism due to 5-HT2C receptor agonism. The condition is characterized by prolonged, often painful erections lasting longer than 4 hours. If not treated promptly, priapism can cause irreversible damage to the erectile tissue. Therapy with lorcaserin should be administered cautiously in patients with a history of priapism, conditions that may predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, leukemia, thalassemia), or anatomical deformations of the penis (e.g., angulation, cavernosal fibrosis, Peyronie's disease). Patients who experience an erection lasting longer than 4 hours, whether painful or not, should immediately discontinue the drug and seek emergency medical attention.

Lorcaserin has a moderate potential interaction with Priapism.

Lorcaserin may cause priapism due to 5-HT2C receptor agonism. The condition is characterized by prolonged, often painful erections lasting longer than 4 hours. If not treated promptly, priapism can cause irreversible damage to the erectile tissue. Therapy with lorcaserin should be administered cautiously in patients with a history of priapism, conditions that may predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, leukemia, thalassemia), or anatomical deformations of the penis (e.g., angulation, cavernosal fibrosis, Peyronie's disease). Patients who experience an erection lasting longer than 4 hours, whether painful or not, should immediately discontinue the drug and seek emergency medical attention.

Lorcaserin has a moderate potential interaction with Psychosis.

Drugs like lorcaserin that target the central nervous system have been associated with depression and suicidal ideation. Psychiatric events of euphoria, hallucination, and dissociation were observed with lorcaserin at supratherapeutic dosages in short-term studies. In clinical trials of at least one year duration, 0.2% of patients treated with lorcaserin developed euphoria, compared to <0.1% treated with placebo. Therapy with lorcaserin should be administered cautiously in patients with preexisting depression or psychiatric illnesses. Lorcaserin dosage should not exceed 10 mg twice a day, and patients should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior. Lorcaserin should be discontinued in patients who experience suicidal thoughts or behavior.

Lorcaserin has a moderate potential interaction with Pulmonary Heart or Vascular Disease.

Lorcaserin is believed to promote satiety by selectively activating serotonin 2C receptors on anorexigenic pro-opiomelanocortin neurons located in the hypothalamus. Certain centrally-acting weight loss agents that act on the serotonin system have been associated with pulmonary hypertension, a rare but lethal disease. Care should be taken when prescribing this drug to patients at risk or with pulmonary hypertension.

Lorcaserin has a moderate potential interaction with Renal Dysfunction.

Lorcaserin is extensively metabolized in the liver by multiple enzymatic pathways, and the metabolites are primarily eliminated by the kidney. In patients with varying degrees of renal function, lorcaserin systemic exposure (AUC) was not significantly different, but AUC of the sulfamate metabolite (M1) was increased by approximately 1.7-fold in mild (CrCl 50 to 80 mL/min), 2.3-fold in moderate (CrCl 30 to 50 mL/min), and 10.5-fold in severe renal impairment (CrCl <30 mL/min) compared to normal renal function (CrCl >80 mL/min), while AUC of the N-carbamoyl-glucuronide metabolite (M5) was increased by approximately 1.5-, 2.5-, and 5.1-fold, respectively. No dosage adjustment of lorcaserin is required in patients with mild renal impairment, but caution is advised when used in patients with moderate renal impairment. Use in patients with severe renal impairment or end stage renal disease is not recommended.

Tolterodine has a moderate potential interaction with Renal Dysfunction.

The renal elimination of tolterodine and active metabolite is limited and a prolonged half-life is not anticipated in patients with renal impairment. However, the pharmacokinetic disposition of tolterodine has not been evaluated in patients with renal impairment and it is recommended that tolterodine be administered cautiously in patients with compromised renal function.

Lorcaserin has a moderate potential interaction with Sickle Cell Anemia.

Lorcaserin may cause priapism due to 5-HT2C receptor agonism. The condition is characterized by prolonged, often painful erections lasting longer than 4 hours. If not treated promptly, priapism can cause irreversible damage to the erectile tissue. Therapy with lorcaserin should be administered cautiously in patients with a history of priapism, conditions that may predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, leukemia, thalassemia), or anatomical deformations of the penis (e.g., angulation, cavernosal fibrosis, Peyronie's disease). Patients who experience an erection lasting longer than 4 hours, whether painful or not, should immediately discontinue the drug and seek emergency medical attention.

Lorcaserin has a moderate potential interaction with Sinus Node Dysfunction.

Lorcaserin may decrease heart rate. In clinical trials of at least one year duration, the mean decrease in heart rate was 1.2 beats per minute (bpm) in lorcaserin-treated and 0.4 bpm in placebo-treated patients without diabetes, and 2.0 bpm in lorcaserin-treated and 0.4 bpm in placebo-treated patients with type 2 diabetes. The incidence of heart rate less than 50 bpm was 5.3% in lorcaserin-treated and 3.2% in placebo-treated patients without diabetes, and 3.6% in lorcaserin-treated and 2.0% in placebo-treated patients with type 2 diabetes. In the combined population, adverse reactions of bradycardia occurred in 0.3% of lorcaserin-treated and 0.1% of placebo-treated patients. Therapy with lorcaserin should be administered cautiously in patients with bradycardia or a history of heart block greater than first degree.

Lorcaserin has a moderate potential interaction with Thalassemia.

Lorcaserin may cause priapism due to 5-HT2C receptor agonism. The condition is characterized by prolonged, often painful erections lasting longer than 4 hours. If not treated promptly, priapism can cause irreversible damage to the erectile tissue. Therapy with lorcaserin should be administered cautiously in patients with a history of priapism, conditions that may predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, leukemia, thalassemia), or anatomical deformations of the penis (e.g., angulation, cavernosal fibrosis, Peyronie's disease). Patients who experience an erection lasting longer than 4 hours, whether painful or not, should immediately discontinue the drug and seek emergency medical attention.

Lorcaserin has a moderate potential interaction with Type 2 Diabetes.

Obese, type 2 diabetic patients who achieve weight loss may demonstrate improved metabolic control of their disease as a result of their reduced weight. Therefore, patients with type 2 diabetes mellitus should be monitored during weight-reduction therapy (or therapy that may be expected to induce significant weight loss as a secondary effect) for hypoglycemia and reduced need for oral hypoglycemic medication or insulin, and the dosages of these agents adjusted accordingly. Patients should be apprised of the risk of hypoglycemia and be alert to potential signs and symptoms such as headache, dizziness, drowsiness, nervousness, confusion, tremor, hunger, weakness, perspiration, and palpitation.

Tolterodine has a major potential interaction with Urinary Retention.

The use of tolterodine is contraindicated in patients with GI obstruction, ileus, or obstructive uropathy. Tolterodine exerts anticholinergic activity by competitive antagonism of muscarinic receptors.

Lorcaserin has a major potential interaction with Valvular Heart Disease.

Regurgitant cardiac valvular disease, primarily affecting the mitral and/or aortic valves, has been reported in patients who took serotonergic drugs with 5-HT2B receptor agonist activity. The etiology is thought to involve activation of 5-HT2B receptors on cardiac interstitial cells. At therapeutic concentrations, lorcaserin is selective for 5-HT2C receptors relative to 5-HT2B receptors, thus it is not known if lorcaserin can cause valvulopathy. In clinical trials of one year duration, 2.4% of patients receiving lorcaserin and 2.0% of patients receiving placebo developed echocardiographic criteria for valvular regurgitation at one year (mild or greater aortic regurgitation and/or moderate or greater mitral regurgitation). None of these patients was symptomatic. Lorcaserin has not been studied in patients with congestive heart failure or hemodynamically-significant valvular heart disease. Preliminary data suggest that 5-HT2B receptors may be overexpressed in congestive heart failure. Therapy with lorcaserin should be administered cautiously in patients with congestive heart failure or preexisting valvulopathy. Patients who develop signs and symptoms of valvular heart disease such as dizziness, fatigue, weakness, dyspnea, edema, or arrhythmia during treatment with lorcaserin should seek prompt medical attention. Discontinuation of lorcaserin should be considered.

Lorcaserin has a moderate potential interaction with Vascular Disorders of Penis.

Lorcaserin may cause priapism due to 5-HT2C receptor agonism. The condition is characterized by prolonged, often painful erections lasting longer than 4 hours. If not treated promptly, priapism can cause irreversible damage to the erectile tissue. Therapy with lorcaserin should be administered cautiously in patients with a history of priapism, conditions that may predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, leukemia, thalassemia), or anatomical deformations of the penis (e.g., angulation, cavernosal fibrosis, Peyronie's disease). Patients who experience an erection lasting longer than 4 hours, whether painful or not, should immediately discontinue the drug and seek emergency medical attention.