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Drug Interaction Report

13 potential interactions and/or warnings found for the following 5 drugs:

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Interactions between your drugs

Moderate

ethinyl estradiol levothyroxine

Applies to: Sprintec (ethinyl estradiol / norgestimate), levothyroxine

Before taking ethinyl estradiol, tell your doctor if you also use levothyroxine. You may need dose adjustments or special tests in order to safely take both medications together. If you are already taking ethinyl estradiol and levothyroxine, your thyroid levels may need to be measured if your dose of ethinyl estradiol is changed or stopped. You should notify your doctor if you have symptoms of low thyroid such as tiredness, feeling cold, constipation, unexplained weight gain, depression, joint or muscle pain, thinning hair or hair loss, dry skin, hoarseness, and abnormal menstrual periods. 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

lithium guanFACINE

Applies to: Lithium Carbonate ER (lithium), Intuniv (guanfacine)

GuanFACINE and lithium may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. 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

lithium lurasidone

Applies to: Lithium Carbonate ER (lithium), Latuda (lurasidone)

Using lithium together with lurasidone may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Rarely, a syndrome consisting of weakness, lethargy, fever, tremors, confusion, abnormal muscle movements, and increased white blood cells and other lab values has also been reported during combined use of these medications. Talk to your doctor if you have any questions or concerns. 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

guanFACINE lurasidone

Applies to: Intuniv (guanfacine), Latuda (lurasidone)

Lurasidone and guanFACINE may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. 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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No other interactions were found between your selected drugs. However, this does not necessarily mean no other interactions exist. Always consult your healthcare provider.

Drug and food interactions

Major

guanFACINE food

Applies to: Intuniv (guanfacine)

Avoid consuming grapefruit or grapefruit juice during treatment with guanFACINE, as it may increase blood levels and effects of the medication. This may cause blood pressure to fall excessively, especially when you rise from a sitting or lying position. The risk of other side effects such as drowsiness, dizziness, lightheadedness, fainting, headache, palpitations, and heart rate changes may also increase. Additionally, you should avoid or limit the use of alcohol while being treated with guanFACINE. Combining the medication with alcohol can intensify sedative and blood pressure lowering effects, which may increase the risk of falls and injury. Avoid driving or operating hazardous machinery until you know how the medication affects you, and use caution when getting up from a sitting or lying position. If you are using a long-acting or extended-release formulation of the medication, make sure you do not take it with a high-fat meal. Doing so results in increased absorption and elevated blood levels of the medication. Talk to your doctor or pharmacist if you have any questions or concerns.

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Major

lurasidone food

Applies to: Latuda (lurasidone)

Avoid consuming grapefruit or grapefruit juice during treatment with lurasidone, as it may increase blood levels of the medication. This can increase the risk of side effects such as Parkinson-like symptoms, abnormal muscle movements, seizures, high blood sugar, diabetes, high cholesterol, weight gain, sex hormone irregularities, and heat-related disorders such as heat intolerance or heat stroke. In addition, you may be more likely to experience side effects associated with low blood pressure such as dizziness, lightheadedness, headache, flushing, fainting, and heart palpitations. You should also avoid the use of alcohol while being treated with lurasidone. Alcohol can increase the nervous system and blood-pressure lowering effects of lurasidone. You may experience increased drowsiness, dizziness, difficulty concentrating, and impairment in thinking and judgment. Talk to your doctor or pharmacist if you have any questions or concerns. Lurasidone should be taken with food consisting of at least 350 calories. Avoid driving or operating hazardous machinery until you know how the medication affects you, and use caution when getting up from a sitting or lying position.

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Moderate

lithium food

Applies to: Lithium Carbonate ER (lithium)

Alcohol can increase the nervous system side effects of lithium such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with lithium. Do not use more than the recommended dose of lithium, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

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Moderate

levothyroxine food

Applies to: levothyroxine

The timing of meals relative to your oral levothyroxine dose can affect the absorption of the medication. Therefore, levothyroxine should be taken on a consistent schedule with regard to time of day and relation to meals to avoid large fluctuations in blood levels, which may alter its effects. In addition, absorption of levothyroxine may be decreased and/or delayed by foods such as soybean flour, cotton seed meal, walnuts, dietary fiber, calcium, calcium fortified juices and grapefruit or grapefruit juice. These foods should be avoided within several hours of dosing if possible. 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

norgestimate food

Applies to: Sprintec (ethinyl estradiol / norgestimate)

Grapefruit juice may increase the blood levels of certain medications such as norgestimate. You may want to limit your consumption of grapefruit and grapefruit juice during treatment with norgestimate. However, if you have been regularly consuming grapefruit or grapefruit juice with the medication, then it is advisable for you to talk with your doctor before changing the amounts of these products in your diet, as this may alter the effects of your medication. Contact your doctor if your condition changes or you experience increased side effects. Orange juice is not expected to interact.

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Moderate

levothyroxine food

Applies to: levothyroxine

Using multivitamin with minerals together with levothyroxine may decrease the effects of levothyroxine. You should separate the administration of levothyroxine and multivitamin with minerals by at least 4 hours. If your doctor does prescribe these medications together, you may need a dose adjustment or special test 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

lithium food

Applies to: Lithium Carbonate ER (lithium)

Using caffeine together with lithium may increase the effects of caffeine. Contact your doctor if you experience nausea, vomiting, diarrhea, drowsiness, muscle weakness, tremor, lack of coordination, blurred vision, or ringing in your ears. If your doctor does prescribe these medications together, you may need a dose adjustment or special test 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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Minor

ethinyl estradiol food

Applies to: Sprintec (ethinyl estradiol / norgestimate)

Information for this minor interaction is available on the professional version.

Minor

ethinyl estradiol food

Applies to: Sprintec (ethinyl estradiol / norgestimate)

Information for this minor interaction is available on the professional version.

Therapeutic duplication warnings

No duplication warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.


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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.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.