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Drug Interactions between Nitro-Dur and sapropterin

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

nitroglycerin sapropterin

Applies to: Nitro-Dur (nitroglycerin) and sapropterin

MONITOR: Sapropterin may potentiate the hypotensive effects of vasodilators, including phosphodiesterase-5 (PDE5) inhibitors and drugs that affect nitric oxide-mediated vasodilation. Theoretically, the additive effects on vasodilation could lead to a reduction in blood pressure, although combined use of these medications has not been evaluated in humans. In animal studies, no effect on blood pressure was observed during coadministration of these agents.

MANAGEMENT: Caution is advised if sapropterin is used in combination with vasodilators, including topical drugs. Patients should be advised to contact their physician if they experience signs of hypotension such as dizziness, fainting, tachycardia, and headache.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. 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
  3. (2007) "Product Information. Kuvan (sapropterin)." BioMarin Pharmaceutical Inc

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Drug and food interactions

Moderate

sapropterin food

Applies to: sapropterin

ADJUST DOSING INTERVAL: Food increases the gastrointestinal absorption of sapropterin.

MANAGEMENT: Sapropterin should be administered with food, preferably at the same time each day. Sapropterin tablets should be dissolved in 4 to 8 ounces (120 to 240 mL) of water or apple juice and taken within 15 minutes of dissolution.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. Canadian Pharmacists Association (2006) e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink
  3. (2007) "Product Information. Kuvan (sapropterin)." BioMarin Pharmaceutical Inc
  4. Cerner Multum, Inc. "Australian Product Information."
View all 4 references

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Moderate

nitroglycerin food

Applies to: Nitro-Dur (nitroglycerin)

MONITOR: Many psychotherapeutic and CNS-active agents (e.g., anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics, opioids, alcohol, muscle relaxants) exhibit hypotensive effects, especially during initiation of therapy and dose escalation. Coadministration with antihypertensives and other hypotensive agents, in particular vasodilators and alpha-blockers, may result in additive effects on blood pressure and orthostasis.

MANAGEMENT: Caution and close monitoring for development of hypotension is advised during coadministration of these agents. Some authorities recommend avoiding alcohol in patients receiving vasodilating antihypertensive drugs. Patients should be advised to avoid rising abruptly from a sitting or recumbent position and to notify their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia.

References

  1. Sternbach H (1991) "Fluoxetine-associated potentiation of calcium-channel blockers." J Clin Psychopharmacol, 11, p. 390-1
  2. Shook TL, Kirshenbaum JM, Hundley RF, Shorey JM, Lamas GA (1984) "Ethanol intoxication complicating intravenous nitroglycerin therapy." Ann Intern Med, 101, p. 498-9
  3. Feder R (1991) "Bradycardia and syncope induced by fluoxetine." J Clin Psychiatry, 52, p. 139
  4. Ellison JM, Milofsky JE, Ely E (1990) "Fluoxetine-induced bradycardia and syncope in two patients." J Clin Psychiatry, 51, p. 385-6
  5. 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
  6. Cerner Multum, Inc. "Australian Product Information."
  7. Pacher P, Kecskemeti V (2004) "Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns?" Curr Pharm Des, 10, p. 2463-75
  8. Andrews C, Pinner G (1998) "Postural hypotension induced by paroxetine." BMJ, 316, p. 595
View all 8 references

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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.


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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.