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Drug Interaction Report

1 drug interaction and 24 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

polyethylene glycol 3350 with electrolytes tetrabenazine

Applies to: Plenvu (polyethylene glycol 3350 with electrolytes), tetrabenazine

Tetrabenazine can cause an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect.

The risk is increased if you have low blood levels of magnesium or potassium, which can occur with bowel cleansing preparations or excessive use of medications that have a laxative effect.

You should use polyethylene glycol 3350 with electrolytes exactly as prescribed by your doctor, and drink plenty of clear liquids before, during, and after the cleansing process to avoid becoming dehydrated.

Your doctor may be able to recommend specific fluids you can drink before starting polyethylene glycol 3350 with electrolytes to help maintain your electrolyte levels. He/she may also want to monitor your electrolyte levels and/or heart rhythm.

You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications.

In addition, you should let your doctor know if you experience signs and symptoms of low electrolyte levels such as:

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.

Food/lifestyle interactions

Moderate food/lifestyle interactions

Moderate:

Food/Lifestyle polyethylene glycol 3350 with electrolytes

Applies to: Plenvu (polyethylene glycol 3350 with electrolytes)

Mixing polyethylene glycol 3350 with electrolytes and starch-based food thickeners can reduce the thickening effect, which could increase the chance of the liquid going down the wrong way (aspiration), especially if you have trouble swallowing.

Also, taking oral medications within one hour of starting polyethylene glycol 3350 with electrolytes may speed up movement through your digestive system, potentially reducing the absorption and effectiveness of those medications.

Try to avoid taking other oral medications during and within one hour after starting polyethylene glycol 3350 with electrolytes.

It's important to inform your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor

Moderate:

Food/Lifestyle tetrabenazine

Applies to: tetrabenazine

Alcohol can increase the nervous system side effects of tetrabenazine such as:

  • dizziness
  • drowsiness
  • 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 tetrabenazine.

Do not use more than the recommended dose of tetrabenazine, 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.

Disease interactions

22 potential interactionsApplies to: 20 conditions, including Depression, Osteoporosis, Seizures, Arrhythmia, and Breast Cancer.

Arrhythmia

Major:

tetrabenazine

Tetrabenazine has a major potential interaction with Arrhythmia.

Tetrabenazine can cause an increase in the corrected QT interval. QT prolongation can lead to the development of ventricular arrhythmias. The use of tetrabenazine should be avoided in patients with congenital long QT syndrome and in patients with a history of arrhythmias.

Breast Cancer

Moderate:

tetrabenazine

Tetrabenazine has a moderate potential interaction with Breast Cancer.

Tetrabenazine can elevate serum prolactin concentrations. This should be considered when therapy will be prescribed in patients with previously detected breast cancer. Additionally, chronic increase in serum prolactin has been associated with low levels of estrogen and increase risk of osteoporosis. If there is suspicion of hyperprolactinemia, appropriate laboratory testing is advised and treatment discontinuation should be considered.

Dehydration

Moderate:

Plenvu

The polyethylene glycol 3350 with electrolytes in Plenvu has a moderate potential interaction with Dehydration.

Use caution when prescribing PEG electrolyte solutions to patients with impaired renal function or patients taking concomitant medications that may affect renal function. Ensure adequate hydration and consider performing baseline and post-colonoscopy laboratory tests (electrolytes, creatinine, and BUN) in these patients.

Depression

Major:

tetrabenazine

Tetrabenazine has a major potential interaction with Depression.

The use of tetrabenazine is contraindicated in patients with untreated or uncontrolled depression. Tetrabenazine can increase the risk of depression and suicidal thoughts and behavior.

Dysphagia

Moderate:

tetrabenazine

Tetrabenazine has a moderate potential interaction with Dysphagia.

Tetrabenazine reduces dopaminergic transmission and can be associated with esophageal dysmotility and dysphagia. Caution should be exercised when used in patients with conditions that predispose to dysphagia. Special caution is advised in patients with Huntington's disease as dysphagia is a common symptom and it could lead to aspiration pneumonia.

Esophageal Obstruction

Moderate:

Plenvu

The polyethylene glycol 3350 with electrolytes in Plenvu has a moderate potential interaction with Esophageal Obstruction.

Patients with impaired gag reflex, unconscious or semi-conscious patients, and patients prone to regurgitation or aspiration should be administered polyethylene glycol (PEG) electrolyte solutions cautiously. Patients experiencing severe bloating, distention or abdominal pain may need to receive PEG electrolyte solutions at a slower rate.

Gastrointestinal Obstruction

Major:

Plenvu

The polyethylene glycol 3350 with electrolytes in Plenvu has a major potential interaction with Gastrointestinal Obstruction.

The use of polyethylene glycol (PEG) solutions is contraindicated in patients with gastrointestinal obstruction, perforation, or toxic megacolon. If gastrointestinal obstruction or perforation is suspected, appropriate studies should be performed prior to administration of these agents. Use with caution in patients with severe active ulcerative colitis. Increased activity of the gut caused by these agents could worsen these conditions.

Major:

Plenvu

The polyethylene glycol 3350 with electrolytes in Plenvu has a major potential interaction with Gastrointestinal Obstruction.

The use of laxatives is contraindicated in patients with intestinal obstruction disorders. Patients with intestinal obstruction disorders may need their underlying condition treated to correct the constipation. Some laxatives require reduction in the colon to their active form to be effective which may be a problem in patients with intestinal obstruction.

Gastrointestinal Perforation

Major:

Plenvu

The polyethylene glycol 3350 with electrolytes in Plenvu has a major potential interaction with Gastrointestinal Perforation.

The use of polyethylene glycol (PEG) solutions is contraindicated in patients with gastrointestinal obstruction, perforation, or toxic megacolon. If gastrointestinal obstruction or perforation is suspected, appropriate studies should be performed prior to administration of these agents. Use with caution in patients with severe active ulcerative colitis. Increased activity of the gut caused by these agents could worsen these conditions.

Heart Disease

Moderate:

Plenvu

The polyethylene glycol 3350 with electrolytes in Plenvu has a moderate potential interaction with Heart Disease.

The use of ionic osmotic laxative products for bowel preparation has been associated with rare reports of serious arrhythmias. Use caution when prescribing PEG electrolyte solutions in patients at increased risk of arrhythmias (e.g., patients with a history of prolonged QT, uncontrolled arrhythmias, recent myocardial infarction, unstable angina, congestive heart failure, or cardiomyopathy). Clinical monitoring of cardiovascular status is recommended prior to, during, and after therapy.

Huntington's Disease

Major:

tetrabenazine

Tetrabenazine has a major potential interaction with Huntington's Disease.

Patients with Huntington disease are prone to depression. Tetrabenazine can increase the risk of depression and suicidal thoughts and should be used with caution in patients with Huntington's disease. The benefits and risks of treatment should be considered before starting therapy, and patients should be under close observation for emergence or worsening of depression symptoms. The family and caregivers should also be informed of this risk and should be instructed to report any changes in behavior or any concerns to the treating physician.

Moderate:

tetrabenazine

Tetrabenazine has a moderate potential interaction with Huntington's Disease.

Tetrabenazine reduces dopaminergic transmission and can be associated with esophageal dysmotility and dysphagia. Caution should be exercised when used in patients with conditions that predispose to dysphagia. Special caution is advised in patients with Huntington's disease as dysphagia is a common symptom and it could lead to aspiration pneumonia.

Hyperprolactinemia

Moderate:

tetrabenazine

Tetrabenazine has a moderate potential interaction with Hyperprolactinemia.

Tetrabenazine can elevate serum prolactin concentrations. This should be considered when therapy will be prescribed in patients with previously detected breast cancer. Additionally, chronic increase in serum prolactin has been associated with low levels of estrogen and increase risk of osteoporosis. If there is suspicion of hyperprolactinemia, appropriate laboratory testing is advised and treatment discontinuation should be considered.

Hyponatremia

Moderate:

Plenvu

The polyethylene glycol 3350 with electrolytes in Plenvu has a moderate potential interaction with Hyponatremia.

PEG electrolyte solutions have been associated with seizure activity, and/or loss of consciousness. The seizure cases were associated with electrolyte abnormalities and low serum osmolality. Therapy with these agents should be administered cautiously in patients with a history of or predisposition to seizures or in patients with known or suspected hyponatremia.

Hypotension

Moderate:

tetrabenazine

Tetrabenazine has a moderate potential interaction with Hypotension.

Tetrabenazine can induce postural dizziness and syncope and should be used with caution in patients who are vulnerable to hypotension.

Inflammatory Bowel Disease

Major:

Plenvu

The polyethylene glycol 3350 with electrolytes in Plenvu has a major potential interaction with Inflammatory Bowel Disease.

The use of laxatives is contraindicated in patients with inflammatory bowel disease. Patients with inflammatory bowel disease may experience colonic perforation with use of stimulant laxatives.

Liver Disease

Major:

tetrabenazine

Tetrabenazine has a major potential interaction with Liver Disease.

The use of tetrabenazine is contraindicated in patients with hepatic impairment. The safety and efficacy of exposure to the drug and other metabolites are unknown and it is not possible to adjust the dosage in hepatic impairment to ensure safe use.

Osteoporosis

Moderate:

tetrabenazine

Tetrabenazine has a moderate potential interaction with Osteoporosis.

Tetrabenazine can elevate serum prolactin concentrations. This should be considered when therapy will be prescribed in patients with previously detected breast cancer. Additionally, chronic increase in serum prolactin has been associated with low levels of estrogen and increase risk of osteoporosis. If there is suspicion of hyperprolactinemia, appropriate laboratory testing is advised and treatment discontinuation should be considered.

Renal Dysfunction

Moderate:

Plenvu

The polyethylene glycol 3350 with electrolytes in Plenvu has a moderate potential interaction with Renal Dysfunction.

Use caution when prescribing PEG electrolyte solutions to patients with impaired renal function or patients taking concomitant medications that may affect renal function. Ensure adequate hydration and consider performing baseline and post-colonoscopy laboratory tests (electrolytes, creatinine, and BUN) in these patients.

Seizures

Moderate:

Plenvu

The polyethylene glycol 3350 with electrolytes in Plenvu has a moderate potential interaction with Seizures.

PEG electrolyte solutions have been associated with seizure activity, and/or loss of consciousness. The seizure cases were associated with electrolyte abnormalities and low serum osmolality. Therapy with these agents should be administered cautiously in patients with a history of or predisposition to seizures or in patients with known or suspected hyponatremia.

Syncope

Moderate:

tetrabenazine

Tetrabenazine has a moderate potential interaction with Syncope.

Tetrabenazine can induce postural dizziness and syncope and should be used with caution in patients who are vulnerable to hypotension.

Ulcerative Colitis

Major:

Plenvu

The polyethylene glycol 3350 with electrolytes in Plenvu has a major potential interaction with Ulcerative Colitis.

The use of polyethylene glycol (PEG) solutions is contraindicated in patients with gastrointestinal obstruction, perforation, or toxic megacolon. If gastrointestinal obstruction or perforation is suspected, appropriate studies should be performed prior to administration of these agents. Use with caution in patients with severe active ulcerative colitis. Increased activity of the gut caused by these agents could worsen these conditions.

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.