Drug Interaction Report

Methotrexate can cause impaired bone marrow function resulting in low numbers of different types of blood cells, and using it with trimethoprim can increase the risk. You may be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the interaction, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should contact your doctor if you develop paleness, fatigue, dizziness, fainting, unusual bruising or bleeding, fever, chills, diarrhea, sore throat, muscle aches, shortness of breath, blood in phlegm, weight loss, red or inflamed skin, body sores, and pain or burning during urination. 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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Using trimethoprim together with potassium chloride may increase potassium levels in the blood. High levels of potassium can develop into a condition known as hyperkalemia, which in severe cases can lead to kidney failure, muscle paralysis, irregular heart rhythm, and cardiac arrest. You may be more likely to develop hyperkalemia while using these medications if you are elderly; dehydrated; have kidney disease, diabetes, or advanced heart failure; or if you are receiving trimethoprim for long periods of time or in high dosages to treat serious infections such as Pneumocystis jiroveci pneumonia (PCP) in AIDS. Regular or long-term use of nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen (Aleve) may also increase your risk. It is important that you maintain adequate fluid intake during treatment with these medications. In addition, talk to your doctor to see if you should limit consumption of potassium-rich foods such as tomatoes, raisins, figs, potatoes, lima beans, bananas, plantains, papayas, pears, cantaloupes, mangoes, and potassium-containing salt substitutes. You should seek medical attention if you experience nausea, vomiting, weakness, confusion, tingling of the hands and feet, feelings of heaviness in the legs, a weak pulse, or a slow or irregular heartbeat, as these may be symptoms of hyperkalemia. 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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Sulfamethoxazole may increase the blood levels of methotrexate. This may increase the risk and/or severity of side effects such as nausea, vomiting, diarrhea, mouth sores, ulcers, hair loss, liver and kidney problems, and impaired bone marrow function resulting in low numbers of different types of blood cells. You may also be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts. 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. You should contact your doctor if you develop paleness, fatigue, dizziness, fainting, unusual bruising or bleeding, fever, chills, diarrhea, sore throat, muscle aches, shortness of breath, blood in phlegm, weight loss, red or inflamed skin, body sores, and pain or burning during urination. 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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Before taking methotrexate, tell your doctor if you also use indapamide. You may need dose adjustments or special tests in order to safely take both medications together. Your blood work may need to be monitored more frequently or using a different blood pressure medicine may be necessary. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using your medications without first talking to your doctor.

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Talk to your doctor before using indapamide together with any kind of medication that has a laxative effect. Combining these medications, especially over a prolonged period, may increase the risk of dehydration and electrolyte abnormalities. In severe cases, dehydration and electrolyte abnormalities can lead to irregular heart rhythm, seizures, and kidney problems. You should use magnesium citrate exactly as prescribed by your doctor or as directed on the label of the medication. Contact your doctor if you experience potential signs and symptoms of fluid and electrolyte depletion such as dizziness, lightheadedness, dry mouth, thirst, fatigue, weakness, muscle cramps, decreased urination, palpitation, and increased heart rate. 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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Dapagliflozin may add to the diuretic effects of indapamide. This may increase the risk of dehydration, kidney problems, and low blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. Use caution when getting up from a sitting or lying position, and let your doctor know if you develop these symptoms. Keep yourself hydrated by drinking plenty of fluids unless otherwise directed. You should seek medical advice immediately if you have reduced oral intake (for example, due to acute illness) or increased fluid loss (for example, due to vomiting, diarrhea, or excessive heat exposure), as it may be appropriate to interrupt one or both medications temporarily under these circumstances. In addition, indapamide may interfere with blood glucose control and reduce the effectiveness of dapagliflozin and other diabetic medications. Monitor your blood sugar levels closely. You may need a dose adjustment of your diabetic medications during and after treatment with indapamide. 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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Dapagliflozin may cause salt and water loss, which may increase the risk of dehydration and low blood pressure when used with niMODipine or similar medications. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. Use caution when getting up from a sitting or lying position, and let your doctor know if you develop these symptoms. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Keep yourself hydrated by drinking plenty of fluids unless otherwise directed. 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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Caffeine may reduce the effectiveness of methotrexate in the treatment of arthritis. If you are receiving methotrexate for arthritis, you may want to limit your intake of caffeine-containing foods and medications. Check with your doctor or pharmacist if you have concerns or are uncertain what products may contain caffeine.

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You should avoid or limit the consumption of grapefruit and grapefruit juice if you are receiving treatment with niMODipine. Grapefruit juice can significantly increase the blood levels and effects of medications like niMODipine. You may be more likely to experience side effects such as headache, low blood pressure, irregular heartbeat, swelling, and fluid retention. Talk to your doctor or pharmacist 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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Alcohol may affect blood glucose levels in patients with diabetes. Both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) may occur, depending on how much and how often you drink. You should avoid using alcohol if your diabetes is not well controlled or if you have high triglycerides, neuropathy (nerve damage), or pancreatitis. Moderate alcohol consumption generally does not affect blood glucose levels if your diabetes is under control. However, it may be best to limit alcohol intake to one drink daily for women and two drinks daily for men (1 drink = 5 oz wine, 12 oz beer, or 1.5 oz distilled spirits) in conjunction with your normal meal plan. Avoid drinking alcohol on an empty stomach or following exercise, as it may increase the risk of hypoglycemia. 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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Methotrexate may cause liver problems, and using it with other medications that can also affect the liver such as ethanol may increase that risk. You should avoid or limit the use of alcohol while being treated with these medications. Call your doctor immediately if you have fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, abdominal pain, dark urine, pale stools, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. Talk to your doctor or pharmacist 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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Ask your doctor before using sulfamethoxazole together with ethanol. Contact your doctor if you experience unpleasant side effects such as fast heartbeats, warmth or redness under your skin, tingly feeling, nausea, or vomiting. If you experience these side effects, you may need to avoid ethanol while taking sulfamethoxazole. You should check your food and medicine labels to see if these products contain ethanol. 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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Indapamide and ethanol 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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NiMODipine and ethanol 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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Using niMODipine together with multivitamin with minerals can decrease the effects of niMODipine. Talk with your doctor before using niMODipine and multivitamin with minerals together. You may need a dose adjustment or need your blood pressure checked more often if you take 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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Caffeine may reduce the effectiveness of methotrexate in the treatment of arthritis. If you are receiving methotrexate for arthritis, you may want to limit your intake of caffeine-containing foods and products. Contact your doctor if your symptoms worsen or your condition changes during treatment with these medications. Your doctor may be able to prescribe alternatives that do not interact. 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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