Drug Interaction Report

MONITOR: Coadministration with inhibitors of CYP450 2C9 may increase the plasma concentrations of torsemide. The interaction has not been evaluated in pharmacokinetic studies; however, torsemide has been shown to undergo metabolism by CYP450 2C9.

MANAGEMENT: Caution is advised when torsemide is prescribed with CYP450 2C9 inhibitors. Patients should be monitored for potentially increased adverse effects such as dehydration, hypotension, electrolyte imbalances, hyperglycemia, tinnitus, and hearing loss.

GENERALLY AVOID: The consumption of alcohol during therapy with leflunomide may potentiate the risk of liver injury. Leflunomide has been associated with hepatotoxicity, including elevated liver transaminases, hepatitis, jaundice/cholestasis, hepatic failure, and acute hepatic necrosis,

MANAGEMENT: Patients should be advised to avoid excessive alcohol use during leflunomide treatment.