Interactions between Selfemra and Terbinafine

The FLUoxetine in Selfemra has a minor potential interaction with Anorexia/Feeding Problems.

The use of selective serotonin reuptake inhibitors (SSRIs) may occasionally cause significant weight loss, which may be undesirable in patients suffering from anorexia, malnutrition or excessive weight loss. Anorexia may occur in approximately 5% to 10% of patients. Weight change should be monitored during therapy if an SSRI is used in these patients.

The FLUoxetine in Selfemra has a moderate potential interaction with Bipolar Disorder.

Selective serotonin reuptake inhibitors (SSRIs), like other antidepressants, may occasionally cause or activate mania or hypomania. The reported incidence ranged from 0.1% to 2% in premarketing testing of several SSRIs. Patients with bipolar disorder are generally more likely to experience mania from antidepressants. Therapy with SSRIs should be administered cautiously in patients with a history of mania or bipolar disorder. Prior to initiating treatment, it is recommended to adequately screen patients for bipolar disorder, including a family history of suicide, bipolar disorder, and depression.

The FLUoxetine in Selfemra has a moderate potential interaction with Bleeding Disorder.

The use of selective serotonin reuptake inhibitors (SSRIs) has been associated with altered platelet function. Petechiae, purpura, ecchymosis, increased bleeding times, epistaxis and gastrointestinal hemorrhage have been reported. Therapy with SSRIs should be administered cautiously in patients with severe active bleeding or a hemorrhagic diathesis.

The FLUoxetine in Selfemra has a moderate potential interaction with Coagulation Defects and Disorders.

The use of selective serotonin reuptake inhibitors (SSRIs) has been associated with altered platelet function. Petechiae, purpura, ecchymosis, increased bleeding times, epistaxis and gastrointestinal hemorrhage have been reported. Therapy with SSRIs should be administered cautiously in patients with severe active bleeding or a hemorrhagic diathesis.

The FLUoxetine in Selfemra has a moderate potential interaction with Dehydration.

The use of selective serotonin reuptake inhibitors (SSRIs) has rarely been associated with hyponatremia, sometimes secondary to development of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). These events have generally been reversible following discontinuation of SSRI therapy and/or medical intervention. SSRI-related hyponatremia may be more common in elderly female patients and those who are volume-depleted or receiving concomitant diuretic therapy. Caution may be warranted when SSRI therapy is administered in these patients and patients with preexisting hyponatremia or SIADH. Serum electrolytes, especially sodium as well as BUN and plasma creatinine, should be monitored regularly.

The FLUoxetine in Selfemra has a major potential interaction with Depression.

Adult and pediatric patients with depression and other psychiatric disorders may experience worsening of their symptoms and may have the emergence of suicidal thoughts and behavior. Patients should be monitored appropriately and observed closely for worsening of their symptoms, suicidality or changes in their behavior, especially during the first few months of treatment, and at times of dose changes. Families and caregivers should be advised of the need for close observation and communication with the treating physician. Discontinuing the medication should be considered if symptoms are persistently worse, or abrupt in onset. It may be prudent to refrain from dispensing large quantities of medication to these patients.

The FLUoxetine in Selfemra has a moderate potential interaction with Depression.

Selective serotonin reuptake inhibitors (SSRIs), like other antidepressants, may occasionally cause or activate mania or hypomania. The reported incidence ranged from 0.1% to 2% in premarketing testing of several SSRIs. Patients with bipolar disorder are generally more likely to experience mania from antidepressants. Therapy with SSRIs should be administered cautiously in patients with a history of mania or bipolar disorder. Prior to initiating treatment, it is recommended to adequately screen patients for bipolar disorder, including a family history of suicide, bipolar disorder, and depression.

Terbinafine has a moderate potential interaction with Depression.

Postmarketing studies have reported depressive symptoms with the use of terbinafine tablets. Terbinafine should be used with caution in patients with depression, and prescribers should be alert to the development of depressive symptoms. Patients and caregivers should be instructed to report any depressive symptoms.

The FLUoxetine in Selfemra has a moderate potential interaction with Diabetes Mellitus.

Fluoxetine may alter blood glucose control in patients with diabetes. Hypoglycemia may occur during therapy with fluoxetine, and hyperglycemia may occur following discontinuation of the drug. Dosage adjustments in insulin and/or oral hypoglycemic medications may be necessary in patients with diabetes whenever fluoxetine therapy is initiated or discontinued.

The FLUoxetine in Selfemra has a minor potential interaction with Failure to Thrive.

The use of selective serotonin reuptake inhibitors (SSRIs) may occasionally cause significant weight loss, which may be undesirable in patients suffering from anorexia, malnutrition or excessive weight loss. Anorexia may occur in approximately 5% to 10% of patients. Weight change should be monitored during therapy if an SSRI is used in these patients.

The FLUoxetine in Selfemra has a moderate potential interaction with Glaucoma, Narrow Angle.

Some SSRI antidepressants such as fluoxetine, paroxetine and sertraline may have an effect on pupil size causing dilation. This effect can potentially narrow the eye angle resulting in increased intraocular pressure and angle closure glaucoma, especially in predisposed patients. These drugs should be used with caution in patients with angle-closure glaucoma or history of glaucoma.

The FLUoxetine in Selfemra has a moderate potential interaction with Hyponatremia.

Treatment with SSRI antidepressants can cause hyponatremia. Caution should be used when treating patients with hyponatremia or at greater risk of hyponatremia such as the elderly, patients taking diuretics or who are volume depleted.

The FLUoxetine in Selfemra has a moderate potential interaction with Hyponatremia.

The use of selective serotonin reuptake inhibitors (SSRIs) has rarely been associated with hyponatremia, sometimes secondary to development of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). These events have generally been reversible following discontinuation of SSRI therapy and/or medical intervention. SSRI-related hyponatremia may be more common in elderly female patients and those who are volume-depleted or receiving concomitant diuretic therapy. Caution may be warranted when SSRI therapy is administered in these patients and patients with preexisting hyponatremia or SIADH. Serum electrolytes, especially sodium as well as BUN and plasma creatinine, should be monitored regularly.

Terbinafine has a moderate potential interaction with Immunodeficiency.

Transient decreases in absolute lymphocyte counts have been reported with oral terbinafine during clinical trials. The clinical significance of these decreases is unknown. Monitoring of complete blood counts may be appropriate in patients with known or suspected immunodeficiency receiving terbinafine for greater than six weeks.

Terbinafine has a major potential interaction with Liver Disease.

Oral terbinafine is not recommended for use in patients with chronic or active liver disease. Terbinafine may be hepatotoxic. Rare cases of cholestatic hepatitis and liver failure, some resulting in liver transplant or death, have been reported during treatment of various dermatologic conditions in patients with and without preexisting liver disease. Although a causal relationship has not been established, the severity of hepatic events and/or their outcome may be worse in patients with active or chronic liver disease.

The FLUoxetine in Selfemra has a moderate potential interaction with Liver Disease.

Selective serotonin reuptake inhibitors (SSRIs) are primarily metabolized by the liver. The plasma concentrations of SSRIs and their metabolites may be increased and the half-lives prolonged in patients with impaired hepatic function. Dosage adjustments may be necessary in accordance with the individual product package labeling.

The FLUoxetine in Selfemra has a moderate potential interaction with Long QT Syndrome.

Some SSRI antidepressants such as fluoxetine and citalopram have shown to cause QT interval prolongation and ventricular arrhythmias including Torsade de Pointes. These drugs should be used with caution in patients with congenital QT syndrome, a previous personal or family history of QT prolongation, and ventricular arrhythmia. Consider periodic EKG assessment on these patients. Treatment should be discontinued and a cardiac evaluation should be considered if a patient develops signs or symptoms of ventricular arrhythmia.

Terbinafine has a moderate potential interaction with Lupus Erythematosus.

Precipitation and exacerbation of cutaneous and systemic lupus erythematosus has been reported postmarketing in patients taking terbinafine tablets. Terbinafine should be discontinued in patients with any clinical signs and symptoms suggestive of lupus erythematosus.

The FLUoxetine in Selfemra has a minor potential interaction with Malnourishment.

The use of selective serotonin reuptake inhibitors (SSRIs) may occasionally cause significant weight loss, which may be undesirable in patients suffering from anorexia, malnutrition or excessive weight loss. Anorexia may occur in approximately 5% to 10% of patients. Weight change should be monitored during therapy if an SSRI is used in these patients.

The FLUoxetine in Selfemra has a moderate potential interaction with Mania.

Selective serotonin reuptake inhibitors (SSRIs), like other antidepressants, may occasionally cause or activate mania or hypomania. The reported incidence ranged from 0.1% to 2% in premarketing testing of several SSRIs. Patients with bipolar disorder are generally more likely to experience mania from antidepressants. Therapy with SSRIs should be administered cautiously in patients with a history of mania or bipolar disorder. Prior to initiating treatment, it is recommended to adequately screen patients for bipolar disorder, including a family history of suicide, bipolar disorder, and depression.

Terbinafine has a major potential interaction with Neutropenia.

Isolated cases of severe neutropenia have been reported in patients administered oral terbinafine. A causal relationship has not been established, although the neutropenia resolved following discontinuation of terbinafine with or without supportive care. Therapy with terbinafine should be administered cautiously in patients with preexisting neutropenia. It may be appropriate to monitor blood counts more frequently during terbinafine therapy. If secondary infection occurs and the neutrophil count is <= 1000 cells/mm3, terbinafine should be discontinued and supportive management initiated.

The FLUoxetine in Selfemra has a major potential interaction with Psychosis.

Adult and pediatric patients with depression and other psychiatric disorders may experience worsening of their symptoms and may have the emergence of suicidal thoughts and behavior. Patients should be monitored appropriately and observed closely for worsening of their symptoms, suicidality or changes in their behavior, especially during the first few months of treatment, and at times of dose changes. Families and caregivers should be advised of the need for close observation and communication with the treating physician. Discontinuing the medication should be considered if symptoms are persistently worse, or abrupt in onset. It may be prudent to refrain from dispensing large quantities of medication to these patients.

Terbinafine has a moderate potential interaction with Renal Dysfunction.

The use of oral terbinafine in patients with renal impairment (CrCl <= 50 mL/min) has not been adequately studied and is, therefore, not recommended. Terbinafine metabolites are primarily eliminated by the kidney. The clinical significance of possible metabolite accumulation due to decreased clearance is unknown.

The FLUoxetine in Selfemra has a minor potential interaction with Renal Dysfunction.

Fluoxetine is primarily metabolized by the liver. All but one metabolites are inactive, and they are excreted by the kidney. The clearance of norfluoxetine, the active metabolite, is not dependent on renal function. Dosage adjustments are generally not deemed necessary in patients with impaired renal function, although the clinical significance of possible metabolite accumulation is unknown. Caution may be warranted when fluoxetine therapy is administered in patients with severe renal dysfunction.

The FLUoxetine in Selfemra has a moderate potential interaction with Seizures.

Selective serotonin reuptake inhibitors (SSRIs) may trigger seizures in approximately 0.2% of patients, and some of them are not recommended in patients with unstable epilepsy. Therapy with SSRIs should be administered cautiously in patients with seizure disorders.

The FLUoxetine in Selfemra has a moderate potential interaction with SIADH.

The use of selective serotonin reuptake inhibitors (SSRIs) has rarely been associated with hyponatremia, sometimes secondary to development of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). These events have generally been reversible following discontinuation of SSRI therapy and/or medical intervention. SSRI-related hyponatremia may be more common in elderly female patients and those who are volume-depleted or receiving concomitant diuretic therapy. Caution may be warranted when SSRI therapy is administered in these patients and patients with preexisting hyponatremia or SIADH. Serum electrolytes, especially sodium as well as BUN and plasma creatinine, should be monitored regularly.

The FLUoxetine in Selfemra has a moderate potential interaction with Thrombocytopathy.

The use of selective serotonin reuptake inhibitors (SSRIs) has been associated with altered platelet function. Petechiae, purpura, ecchymosis, increased bleeding times, epistaxis and gastrointestinal hemorrhage have been reported. Therapy with SSRIs should be administered cautiously in patients with severe active bleeding or a hemorrhagic diathesis.

The FLUoxetine in Selfemra has a moderate potential interaction with Thrombocytopenia.

The use of selective serotonin reuptake inhibitors (SSRIs) has been associated with altered platelet function. Petechiae, purpura, ecchymosis, increased bleeding times, epistaxis and gastrointestinal hemorrhage have been reported. Therapy with SSRIs should be administered cautiously in patients with severe active bleeding or a hemorrhagic diathesis.

The FLUoxetine in Selfemra has a moderate potential interaction with Ventricular Arrhythmia.

Some SSRI antidepressants such as fluoxetine and citalopram have shown to cause QT interval prolongation and ventricular arrhythmias including Torsade de Pointes. These drugs should be used with caution in patients with congenital QT syndrome, a previous personal or family history of QT prolongation, and ventricular arrhythmia. Consider periodic EKG assessment on these patients. Treatment should be discontinued and a cardiac evaluation should be considered if a patient develops signs or symptoms of ventricular arrhythmia.

The FLUoxetine in Selfemra has a moderate potential interaction with Vitamin K Deficiency.

The use of selective serotonin reuptake inhibitors (SSRIs) has been associated with altered platelet function. Petechiae, purpura, ecchymosis, increased bleeding times, epistaxis and gastrointestinal hemorrhage have been reported. Therapy with SSRIs should be administered cautiously in patients with severe active bleeding or a hemorrhagic diathesis.