Drug Interaction Report

MONITOR: Coadministration of dopamine and intravenous hydantoin derivatives may result in sudden and profound hypotension and bradycardia. The mechanism may be a combination of catecholamine depletion and hydantoin-induced myocardial depression, and the effect may be dose-rate dependent. Fatalities have been reported, but causality is unknown. Data are available for intravenous phenytoin only.

MANAGEMENT: Extreme caution and frequent blood pressure monitoring are recommended if concomitant use is necessary. Alternative anticonvulsants may be considered.

MONITOR: Coadministration of two or more sympathomimetic agents may increase the risk of adverse effects such as nervousness, irritability, and increased heart rate. Central nervous system (CNS) stimulants, particularly amphetamines, can potentiate the adrenergic response to vasopressors and other sympathomimetic agents. Additive increases in blood pressure and heart rate may occur due to enhanced peripheral sympathetic activity.

MANAGEMENT: Caution is advised if two or more sympathomimetic agents are coadministered. Pulse and blood pressure should be closely monitored.