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Can you take Ranitidine with Tolterodine?

1 drug interaction and 16 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

raNITIdine tolterodine

Applies to: ranitidine and tolterodine

RaNITIdine may increase the blood levels and effects of tolterodine.

High levels of tolterodine can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect.

You may be more susceptible if you have:

  • a heart condition called congenital long QT syndrome
  • other cardiac diseases
  • conduction abnormalities
  • electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting)

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. Talk to your doctor if you have any questions or concerns.

You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone.

Contact your doctor if you experience heart palpitations, difficulty urinating, dry mouth, constipation, blurred vision, headache, drowsiness, dizziness, and/or abdominal pain.

Do not drive or operate heavy machinery until the effects of tolterodine have been determined.

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

Minor food/lifestyle interactions

Minor:

raNITIdine Nicotine

Applies to: ranitidine

Information for this minor interaction is available on the professional version.

Disease interactions

15 potential interactions Applies to: 13 conditions, including Myasthenia Gravis, Dementia, Urinary Retention, Hemodialysis, and Liver Disease.

Central Nervous System Disorders

Moderate:

tolterodine

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.

Dementia

Moderate:

tolterodine

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.

Gastrointestinal Hemorrhage

Major:

ranitidine

raNITIdine has a major potential interaction with Gastrointestinal Hemorrhage.

Histamine H2 receptor antagonists should not be used in the presence of vomit with blood, or bloody or black stools. These might be serious conditions and the diagnosis needs to be ruled out.

Gastrointestinal Obstruction

Major:

tolterodine

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.

Glaucoma/Intraocular Hypertension

Major:

tolterodine

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.

Hemodialysis

Moderate:

ranitidine

raNITIdine has a moderate potential interaction with Hemodialysis.

Ranitidine is partially removed by hemodialysis and should be administered after dialysis.

Liver Disease

Moderate:

ranitidine

raNITIdine has a moderate potential interaction with Liver Disease.

Ranitidine is partially metabolized by the liver. Although dosage reductions are generally not necessary, therapy with ranitidine should be administered cautiously in patients with liver disease. Elevated ALT (SGPT) has been observed in patients receiving ranitidine intravenously at dosages greater than those normally recommended for 5 days or more.

Moderate:

tolterodine

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.

Long QT Syndrome

Moderate:

tolterodine

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.

Myasthenia Gravis

Moderate:

tolterodine

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.

Phenylketonuria

Moderate:

ranitidine

raNITIdine has a moderate potential interaction with Phenylketonuria.

Zantac (brand of ranitidine) 150 EFFERdose tablets and granules both contain 16.84 mg of phenylalanine per each 150 mg of ranitidine. The phenylalanine content should be considered when these products are used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics).

Porphyria

Major:

ranitidine

raNITIdine has a major potential interaction with Porphyria.

Ranitidine may rarely precipitate acute porphyria attacks and should be avoided in patients with a history of acute porphyria.

Renal Dysfunction

Moderate:

ranitidine

raNITIdine has a moderate potential interaction with Renal Dysfunction.

Ranitidine is primarily eliminated by the kidney. Although the drug is generally well-tolerated, the daily dosage should initially be reduced in patients with moderate to severe renal impairment (CrCl < 50 mL/min). If necessary, the daily dosage may be increased with caution.

Moderate:

tolterodine

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.

Urinary Retention

Major:

tolterodine

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.

More resources

ranitidine

A total of 256 drugs are known to interact with ranitidine.

tolterodine

A total of 670 drugs are known to interact with tolterodine.

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.