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Clonidine/ketorolac/ropivacaine and Alcohol/Food Interactions

There are 5 alcohol/food/lifestyle interactions with clonidine / ketorolac / ropivacaine.

Minor

Caffeine Ropivacaine

Minor Drug Interaction

Ropivacaine serum concentrations may increase when given with drugs metabolized by the CYP450 isoenzyme 1A2. The theorized mechanism is via competitive inhibition. Information is only available from in-vitro studies. The clinical significance is unknown. Consider monitoring the patient more closely for prolonged or excessive ropivacaine effects if these agents are coadministered.

References

  1. (2001) "Product Information. Naropin (ropivacaine)." Astra-Zeneca Pharmaceuticals

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Moderate

Clonidine Alcohol (Ethanol)

Moderate Drug Interaction

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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Moderate

Ketorolac Alcohol (Ethanol)

Moderate Drug Interaction

GENERALLY AVOID: The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.

MANAGEMENT: Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.

References

  1. (2002) "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn

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Major

Ketorolac High Blood Pressure (Hypertension)

Major Potential Hazard, Moderate plausibility

NSAIDs - fluid retention

Fluid retention and edema have been reported in association with the use of nonsteroidal anti-inflammatory drugs (NSAIDs). Therapy with NSAIDs should be administered cautiously in patients with preexisting fluid retention, hypertension, or a history of heart failure. Blood pressure and cardiovascular status should be monitored closely during the initiation of NSAID treatment and throughout the course of therapy.

References

  1. (2002) "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn
  2. (2002) "Product Information. Nalfon (fenoprofen)." Xspire Pharma
  3. (2002) "Product Information. Indocin (indomethacin)." Merck & Co., Inc
  4. (2002) "Product Information. Orudis (ketoprofen)." Wyeth-Ayerst Laboratories
  5. (2002) "Product Information. Naprosyn (naproxen)." Syntex Laboratories Inc
  6. (2006) "Product Information. Anaprox (naproxen)." Roche Laboratories
  7. (2001) "Product Information. Clinoril (sulindac)." Merck & Co., Inc
  8. (2001) "Product Information. Tolectin (tolmetin)." McNeil Pharmaceutical
  9. (2001) "Product Information. Relafen (nabumetone)." SmithKline Beecham
  10. (2001) "Product Information. Feldene (piroxicam)." Pfizer U.S. Pharmaceuticals
  11. (2001) "Product Information. Ansaid (flurbiprofen)." Pharmacia and Upjohn
  12. (2001) "Product Information. Lodine (etodolac)." Wyeth-Ayerst Laboratories
  13. (2001) "Product Information. Daypro (oxaprozin)." Searle
  14. (2001) "Product Information. Mobic (meloxicam)." Boehringer-Ingelheim
View all 14 references
Moderate

Ketorolac High Blood Pressure (Hypertension)

Moderate Potential Hazard, Moderate plausibility

NSAIDs - hypertension

Nonsteroidal anti-inflammatory drugs (NSAIDs), including topicals, can lead to new onset of hypertension or worsening of preexisting hypertension, either of which can contribute to the increased incidence of cardiovascular events. NSAIDs should be used with caution in patients with hypertension. Blood pressure should be monitored closely during the initiation of NSAID therapy and throughout the course of therapy.

References

  1. (2002) "Product Information. Indocin (indomethacin)." Merck & Co., Inc
  2. (2002) "Product Information. Naprosyn (naproxen)." Syntex Laboratories Inc
  3. (2001) "Product Information. Voltaren (diclofenac)." Novartis Pharmaceuticals
  4. (2001) "Product Information. Relafen (nabumetone)." SmithKline Beecham
  5. (2001) "Product Information. Feldene (piroxicam)." Pfizer U.S. Pharmaceuticals
  6. (2001) "Product Information. Dolobid (diflunisal)." Merck & Co., Inc
  7. (2001) "Product Information. Ansaid (flurbiprofen)." Pharmacia and Upjohn
  8. (2001) "Product Information. Lodine (etodolac)." Wyeth-Ayerst Laboratories
  9. (2001) "Product Information. Daypro (oxaprozin)." Searle
  10. (2001) "Product Information. Celebrex (celecoxib)." Searle
  11. (2012) "Product Information. Meclofenamate Sodium (meclofenamate)." Mylan Pharmaceuticals Inc
  12. (2016) "Product Information. Flector Patch (diclofenac topical)." Actavis U.S. (Alpharma USPD)
View all 12 references

Clonidine/ketorolac/ropivacaine drug interactions

There are 845 drug interactions with clonidine / ketorolac / ropivacaine.

Clonidine/ketorolac/ropivacaine disease interactions

There are 18 disease interactions with clonidine / ketorolac / ropivacaine which include:

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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.

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