Drug Interactions between olodaterol / tiotropium and Tagamet HB
This report displays the potential drug interactions for the following 2 drugs:
- olodaterol/tiotropium
- Tagamet HB (cimetidine)
Interactions between your drugs
cimetidine tiotropium
Applies to: Tagamet HB (cimetidine) and olodaterol / tiotropium
Coadministration with cimetidine is not expected to significantly alter the pharmacokinetics of orally inhaled tiotropium. In one study, concomitant administration of cimetidine (400 mg three times daily) and tiotropium (14.4 mcg intravenously over 15 minutes) resulted in a 20% increase in the 4-hour area under the plasma concentration-time curve (AUC) and a 28% decrease in the renal clearance of tiotropium. Tiotropium peak plasma concentration (Cmax) and total amount excreted in urine over 96 hours were not affected. These changes are unlikely to be of clinical significance.
References
- "Product Information. Spiriva (tiotropium)." Boehringer Ingelheim (2002):
Drug and food interactions
cimetidine food
Applies to: Tagamet HB (cimetidine)
Concurrent use of cimetidine and ethanol may result in increased ethanol concentrations. The mechanism appears to be due to inhibition of gastric alcohol dehydrogenase by cimetidine, leading to increased bioavailability of the alcohol and inhibition of hepatic metabolism of alcohol. The clinical significance of this interaction is limited. More importantly, patients requiring cimetidine for gastrointestinal disease should be counseled to avoid alcohol to prevent worsening of their disease. The other H-2 receptor antagonists appear to have minimal effects on the concentrations of alcohol.
References
- Feely J, Wood AJ "Effects of cimetidine on the elimination and actions of ethanol." JAMA 247 (1982): 2819-21
- Hansten PD "Effects of H2-receptor antagonists on blood alcohol levels." JAMA 267 (1992): 2469
cimetidine food
Applies to: Tagamet HB (cimetidine)
Caffeine effects may be increased in patients also taking cimetidine. The mechanism may be due to decreased caffeine metabolism induced by cimetidine. Although adequate clinical data are lacking, a reduction in dose or elimination of caffeine may be needed if excess CNS stimulation is observed.
References
- "Product Information. Tagamet (cimetidine)." SmithKline Beecham PROD (2001):
- Broughton LJ, Rodgers HJ "Decreased systenuc clearance of caffeine due to cimetidine." Br J Clin Pharmacol 12 (1981): 155-9
cimetidine food
Applies to: Tagamet HB (cimetidine)
H2 antagonists may reduce the clearance of nicotine. Cimetidine, 600 mg given twice a day for two days, reduced clearance of an intravenous nicotine dose by 30%. Ranitidine, 300 mg given twice a day for two days, reduced clearance by 10%. The clinical significance of this interaction is not known. Patients should be monitored for increased nicotine effects when using the patches or gum for smoking cessation and dosage adjustments should be made as appropriate.
References
- Bendayan R, Sullivan JT, Shaw C, Frecker RC, Sellers EM "Effect of cimetidine and ranitidine on the hepatic and renal elimination of nicotine in humans." Eur J Clin Pharmacol 38 (1990): 165-9
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.
See also
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.
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