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Dexamethasone / ketorolac / moxifloxacin and Alcohol/Food Interactions

There are 12 alcohol/food/lifestyle interactions with dexamethasone / ketorolac / moxifloxacin which include:

Major

dexamethasone Alcohol (Ethanol)

Major Drug Interaction

Moxifloxacin and other medications in its class can cause tendinitis and tendon rupture, and the risk may be increased when combined with a steroid such as dexamethasone. Older adults over 60 years of age and those who have received a kidney, heart, and/or lung transplant may be particularly susceptible. Tendon rupture can occur during or up to several months after finishing moxifloxacin treatment and may require surgery or result in prolonged disability. Talk to your doctor if you have any questions or concerns. 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. Stop taking moxifloxacin and call your doctor immediately if you experience pain, swelling, or inflammation of a tendon area such as the back of the ankle, shoulder, biceps, hand, or thumb. You should also avoid exercise or use of the affected area until further instruction from your doctor. 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.

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Moderate

dexamethasone Alcohol (Ethanol)

Moderate Drug Interaction

Using dexamethasone together with ketorolac may increase the risk of side effects in the gastrointestinal tract such as inflammation, bleeding, ulceration, and rarely, perforation. Gastrointestinal perforation is a potentially fatal condition and medical emergency where a hole forms all the way through the stomach or intestine. You should take these medications with food to lessen the risk. Talk to your doctor if you have any questions or concerns. 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. Your doctor may also be able to recommend medications to help protect the stomach and intestine if you are at high risk for developing serious gastrointestinal complications. You should seek immediate medical attention if you experience any unusual bleeding or bruising, or have other signs and symptoms of bleeding such as dizziness; lightheadedness; red or black, tarry stools; coughing up or vomiting fresh or dried blood that looks like coffee grounds; severe headache; and weakness. 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.

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Moderate

ketorolac Alcohol (Ethanol)

Moderate Drug Interaction

Ask your doctor before using ketorolac together with ethanol. Do not drink alcohol while taking ketorolac. Alcohol can increase your risk of stomach bleeding caused by ketorolac. Call your doctor at once if you have symptoms of bleeding in your stomach or intestines. This includes black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds. 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.

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Moderate

ketorolac Alcohol (Ethanol)

Moderate Drug Interaction

Moxifloxacin may rarely cause central nervous system side effects such as tremors, involuntary muscle movements, anxiety, confusion, depression, hallucinations or seizures, and combining it with other medications that can also affect the central nervous system such as ketorolac may increase that risk. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. 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.

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Major

dexamethasone multivitamins with minerals

Major Drug Interaction

Moxifloxacin and other medications in its class can cause tendinitis and tendon rupture, and the risk may be increased when combined with a steroid such as dexamethasone. Older adults over 60 years of age and those who have received a kidney, heart, and/or lung transplant may be particularly susceptible. Tendon rupture can occur during or up to several months after finishing moxifloxacin treatment and may require surgery or result in prolonged disability. Talk to your doctor if you have any questions or concerns. 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. Stop taking moxifloxacin and call your doctor immediately if you experience pain, swelling, or inflammation of a tendon area such as the back of the ankle, shoulder, biceps, hand, or thumb. You should also avoid exercise or use of the affected area until further instruction from your doctor. 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.

Switch to professional interaction data

Moderate

dexamethasone multivitamins with minerals

Moderate Drug Interaction

Using dexamethasone together with ketorolac may increase the risk of side effects in the gastrointestinal tract such as inflammation, bleeding, ulceration, and rarely, perforation. Gastrointestinal perforation is a potentially fatal condition and medical emergency where a hole forms all the way through the stomach or intestine. You should take these medications with food to lessen the risk. Talk to your doctor if you have any questions or concerns. 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. Your doctor may also be able to recommend medications to help protect the stomach and intestine if you are at high risk for developing serious gastrointestinal complications. You should seek immediate medical attention if you experience any unusual bleeding or bruising, or have other signs and symptoms of bleeding such as dizziness; lightheadedness; red or black, tarry stools; coughing up or vomiting fresh or dried blood that looks like coffee grounds; severe headache; and weakness. 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.

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Moderate

ketorolac multivitamins with minerals

Moderate Drug Interaction

Moxifloxacin may rarely cause central nervous system side effects such as tremors, involuntary muscle movements, anxiety, confusion, depression, hallucinations or seizures, and combining it with other medications that can also affect the central nervous system such as ketorolac may increase that risk. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. 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.

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Moderate

multivitamins with minerals moxifloxacin

Moderate Drug Interaction

Moxifloxacin and multivitamin with minerals should not be taken orally at the same time. Products that contain magnesium, aluminum, calcium, iron, and/or other minerals may interfere with the absorption of moxifloxacin into the bloodstream and reduce its effectiveness. If possible, it may be best to avoid taking multivitamin with minerals while you are being treated with moxifloxacin. Otherwise, moxifloxacin should be taken 2 to 4 hours before or 4 to 6 hours after a multivitamin with minerals dose, moxifloxacin should be taken at least 2 hours before and not less than 6 hours after Suprep Bowel Prep (magnesium/potassium/sodium sulfates), or moxifloxacin and multivitamin with minerals should be taken as directed by your healthcare provider. Talk to your healthcare provider if you are unsure whether your medications contain something that could potentially interact or if you have questions on how to take this or other medications you are prescribed. 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.

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Major

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. Heerdink ER, Leufkens HG, Herings RM, Ottervanger JP, Stricker BH, Bakker A "NSAIDs associated with increased risk of congestive heart failure in elderly patients taking diuretics." Arch Intern Med 158 (1998): 1108-12
  2. Agnholt J, Andreasen F "The effect of ibuprofen therapy on water and electrolyte balance." Acta Med Scand 212 (1982): 65-9
  3. "Product Information. Lodine (etodolac)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  4. "Product Information. Celebrex (celecoxib)." Searle, Chicago, IL.
  5. Lewis RV, Toner JM, Jackson PR, Ramsay LE "Effects of indomethacin and sulindac on blood pressure of hypertensive patients." Br Med J 292 (1986): 934-5
  6. "Product Information. Daypro (oxaprozin)." Searle, Skokie, IL.
  7. Van Den Ouweland FA, Gribnau FW, Meyboom RH "Congestive heart failure due to nonsteroidal anti-inflammatory drugs in the elderly." Age Ageing 17 (1988): 8-16
  8. "Product Information. Naprosyn (naproxen)." Syntex Laboratories Inc, Palo Alto, CA.
  9. "Product Information. Mobic (meloxicam)" Boehringer-Ingelheim, Ridgefield, CT.
  10. "Product Information. Ansaid (flurbiprofen)." Pharmacia and Upjohn, Kalamazoo, MI.
  11. Heynen G "Toleration and safety of piroxicam." Eur J Rheumatol Inflamm 8 (1987): 86-93
  12. Willkens RF "Worldwide clinical safety experience with diclofenac." Semin Arthritis Rheum 2 Suppl 1 (1985): 105-10
  13. "Product Information. Clinoril (sulindac)." Merck & Co, Inc, West Point, PA.
  14. "Product Information. Indocin (indomethacin)." Merck & Co, Inc, West Point, PA.
  15. "Product Information. Orudis (ketoprofen)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  16. Johnson AG, Nguyen TV, Day RO "Do nonsteroidal anti-inflammatory drugs affect blood pressure? A meta-analysis." Ann Intern Med 121 (1994): 289-300
  17. "Product Information. Anaprox (naproxen)." Roche Laboratories, Nutley, NJ.
  18. "Product Information. Nalfon (fenoprofen)." Xspire Pharma, Ridgeland, MS.
  19. "Product Information. Feldene (piroxicam)." Pfizer US Pharmaceuticals, New York, NY.
  20. "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn, Kalamazoo, MI.
  21. Gurwitz JH, Everitt DE, Monane M, et al "The impact of ibuprofen on the efficacy of antihypertensive treatment with hydrochlorothiazide in elderly persons." J Gerontol A Biol Sci Med Sci 51 (1996): m74-9
  22. "Product Information. Vioxx (rofecoxib)." Merck & Co, Inc, West Point, PA.
  23. Easton PA, Koval A "Hypertensive reaction with sulindac." Can Med Assoc J 122 (1980): 1273-4
  24. Brooks CD, Linet OI, Schellenberg D, Turner LF, Defesche CL, Teoh KW, Johnson JH, Assenzo JR "Clinical safety of flurbiprofen." J Clin Pharmacol 30 (1990): 342-51
  25. Petersson I, Nilsson G, Hansson B-G, Hedner T "Water intoxication associated with non-steroidal anti-inflammatory drug therapy." Acta Med Scand 221 (1987): 221-3
  26. "Product Information. Bextra (valdecoxib)." Pharmacia Corporation, Peapack, NJ.
  27. "Product Information. Relafen (nabumetone)." SmithKline Beecham, Philadelphia, PA.
  28. Buckley MM, Brogden RN "Ketorolac. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential." Drugs 39 (1990): 86-109
  29. "Product Information. Tolectin (tolmetin)." McNeil Pharmaceutical, Raritan, NJ.
View all 29 references
Moderate

High Blood Pressure (Hypertension)

Moderate Potential Hazard, Moderate plausibility

corticosteroids - fluid retention

Corticosteroids may cause hypernatremia, hypokalemia, fluid retention, and elevation in blood pressure. These mineralocorticoid effects are most significant with fludrocortisone, followed by hydrocortisone and cortisone, then by prednisone and prednisolone. The remaining corticosteroids, betamethasone, dexamethasone, methylprednisolone, and triamcinolone, have little mineralocorticoid activities. However, large doses of any corticosteroid can demonstrate these effects, particularly if given for longer than brief periods. Therapy with corticosteroids should be administered cautiously in patients with preexisting fluid retention, hypertension, congestive heart failure, and/or renal dysfunction. Dietary sodium restriction and potassium supplementation may be advisable.

References

  1. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb, Princeton, NJ.
  2. Lieberman P, Patterson R, Kunske R "Complications of long-term steroid therapy for asthma." J Allergy Clin Immunol 49 (1972): 329-36
  3. Pang S, Clark AT, Freeman LC, Dolan LM, Immken L, Mueller OT, Stiff D, Shulman DI "Maternal side effects of prenatal dexamethasone therapy for fetal congenital adrenal hyperplasia." J Clin Endocrinol Metab 75 (1992): 249-53
  4. Jackson SH, Beevers DG, Myers K "Does long-term low-dose corticosteroid therapy cause hypertension?" Clin Sci 61 (1981): s381-3
  5. "Product Information. Hydeltrasol (prednisolone)." Merck & Co, Inc, West Point, PA.
  6. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co, Inc, West Point, PA.
  7. "Product Information. Cortone Acetate (cortisone)." Merck & Co, Inc, West Point, PA.
  8. Seale JP, Compton MR "Side-effects of corticosteroid agents." Med J Aust 144 (1986): 139-42
  9. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn, Kalamazoo, MI.
  10. Baethge BA, Lidsky MD, Goldberg JW "A study of adverse effects of high-dose intravenous (pulse) methylprednisolone therapy in patients with rheumatic disease." Ann Pharmacother 26 (1992): 316-20
  11. Klepikov PV, Kutyrina IM, Tareyeva IE "Steroid-induced hypertension in patients with nephrotic syndrome." Nephron 48 (1988): 286-90
  12. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb, Princeton, NJ.
  13. Thomas TP "The complications of systemic corticosteroid therapy in the elderly." Gerontology 30 (1984): 60-5
  14. Swartz SL, Dluhy RG "Corticosteroids: clinical pharmacology and therapeutic use." Drugs 16 (1978): 238-55
  15. "Product Information. Decadron (dexamethasone)." Merck & Co, Inc, West Point, PA.
  16. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn, Kalamazoo, MI.
  17. "Product Information. Celestone (betamethasone)." Schering Corporation, Kenilworth, NJ.
  18. Ramsahoye BH, Davies SV, el-Gaylani N, Sandeman D, Scanlon MF "The mineralocorticoid effects of high dose hydrocortisone." BMJ 310 (1995): 656-7
View all 18 references
Moderate

High Cholesterol (Hyperlipoproteinemia, Hypertriglyceridemia, Sitosterolemia)

Moderate Potential Hazard, Moderate plausibility

corticosteroids - hyperlipidemia

Corticosteroids may elevate serum triglyceride and LDL cholesterol levels if used for longer than brief periods. Patients with preexisting hyperlipidemia may require closer monitoring during prolonged corticosteroid therapy, and adjustments made accordingly in their lipid-lowering regimen.

References

  1. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb, Princeton, NJ.
  2. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb, Princeton, NJ.
  3. "Product Information. Hydeltrasol (prednisolone)." Merck & Co, Inc, West Point, PA.
  4. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co, Inc, West Point, PA.
  5. "Product Information. Cortone Acetate (cortisone)." Merck & Co, Inc, West Point, PA.
  6. "Product Information. Decadron (dexamethasone)." Merck & Co, Inc, West Point, PA.
  7. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn, Kalamazoo, MI.
  8. "Product Information. Celestone (betamethasone)." Schering Corporation, Kenilworth, NJ.
  9. Seale JP, Compton MR "Side-effects of corticosteroid agents." Med J Aust 144 (1986): 139-42
  10. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn, Kalamazoo, MI.
View all 10 references
Moderate

High Blood Pressure (Hypertension)

Moderate Potential Hazard, Moderate plausibility

NSAIDs - hypertension

NSAIDs including topicals can lead to the onset of new hypertension or worsening of preexisting hypertension, either of which can contribute to the increased incidence of cardiovascular events. Blood pressure should be monitored closely during NSAID therapy and throughout the course of therapy.

Dexamethasone / ketorolac / moxifloxacin drug interactions

There are 1036 drug interactions with dexamethasone / ketorolac / moxifloxacin

Dexamethasone / ketorolac / moxifloxacin disease interactions

There are 45 disease interactions with dexamethasone / ketorolac / moxifloxacin which include:

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.