Drug Interaction Report

The donepezil in Namzaric has a major potential interaction with Arrhythmia.

Due to their pharmacological action, cholinesterase inhibitors can have a vagotonic effect on the sinoatrial and atrioventricular nodes producing bradycardia or heart block. Therapy with cholinesterase inhibitors should be administered cautiously in patients with preexisting bradycardia or underlying cardiac conduction abnormalities. Syncopal episodes have been reported. Atropine may be used to reverse bradycardia produced by cholinesterase inhibitors.

The donepezil in Namzaric has a major potential interaction with Asthma.

Cholinesterase inhibitors inhibit the hydrolysis of acetylcholine. The enhanced effect of acetylcholine produces constriction of the bronchi, increased bronchial secretions, and bronchospasm. Therapy with cholinesterase inhibitors should be administered cautiously in patients with respiratory dysfunction, history of asthma, or obstructive pulmonary disease. Respiratory function should be closely monitored for the occurrence of respiratory adverse reactions. Use of atropine along with discontinuation of the cholinesterase inhibitor may be required for serious respiratory distress.

The donepezil in Namzaric has a major potential interaction with COPD.

Cholinesterase inhibitors inhibit the hydrolysis of acetylcholine. The enhanced effect of acetylcholine produces constriction of the bronchi, increased bronchial secretions, and bronchospasm. Therapy with cholinesterase inhibitors should be administered cautiously in patients with respiratory dysfunction, history of asthma, or obstructive pulmonary disease. Respiratory function should be closely monitored for the occurrence of respiratory adverse reactions. Use of atropine along with discontinuation of the cholinesterase inhibitor may be required for serious respiratory distress.

Omeprazole has a major potential interaction with Diarrhea.

Published observational studies suggest that proton pump inhibitor (PPI) use may be associated with an increased risk of Clostridium difficile-associated diarrhea (CDAD), especially in hospitalized patients. This diagnosis should be considered for diarrhea that does not improve. It is recommended that patients should use the lowest dose and shortest duration of PPI therapy appropriate to the condition being treated. Close monitoring is recommended in patients with diarrhea and in those taking antibacterial agents as CDAD has been reported with the use of nearly all these agents. Treatment with antibacterial agents alters the normal flora of the colon, leading to overgrowth of C. difficile. C. difficile produces toxins A and B, which contribute to the development of CDAD. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation should be instituted as clinically indicated.

The donepezil in Namzaric has a moderate potential interaction with Hyperthyroidism.

Many of the manifestations of hyperthyroidism may be exacerbated by increased levels of acetylcholine produced by cholinesterase inhibitors. Therapy with cholinesterase inhibitors should be administered cautiously to patients with hyperthyroidism. Monitoring of thyroid levels is recommended.

The donepezil in Namzaric has a major potential interaction with Ischemic Heart Disease.

The use of cholinesterase inhibitors has been associated with a constriction of coronary arteries. Therapy with cholinesterase inhibitors should be administered cautiously in patients with coronary artery disease.

The donepezil in Namzaric has a moderate potential interaction with Liver Disease.

Donepezil is extensively metabolized by the liver (CYP450-2D6/3A4) to two active and various minor forms. The clearance of donepezil was decreased 20% in patients with stable alcoholic cirrhosis compared to healthy patients. Care should be exercised when using donepezil in patients with liver disease.

The memantine in Namzaric has a moderate potential interaction with Liver Disease.

Memantine should be used with caution in patients with severe hepatic impairment and a dosage reduction is recommended. No dosage adjustment is needed in patients with mild or moderate hepatic impairment.

Omeprazole has a moderate potential interaction with Magnesium Imbalance.

Symptomatic and asymptomatic hypomagnesemia has been reported rarely in patients treated with PPIs for at least 3 months, in most cases after a year of therapy. Serious adverse events can include tetany, seizures, and arrhythmias. Caution should be used in patients prone to magnesium imbalances such as patients taking other medications that can cause hypomagnesemia (e.g., diuretics). Regular monitoring is recommended.

Omeprazole has a moderate potential interaction with Osteoporosis.

Various published observational studies have reported that PPI therapy may be associated with an increased risk for osteoporosis related fractures of the hip, wrist or spine. The risk was increased in patients who received high doses (multiple daily doses), and long term treatment (a year or longer). Patients should use the lowest dose and shortest duration of PPI therapy appropriate to the condition being treated. Caution should be used in patients at risk for osteoporosis related fractures and should be managed according to established treatment guidelines.

The donepezil in Namzaric has a major potential interaction with Parkinsonism.

Cholinesterase inhibitors should be used with caution in patients with parkinsonism. Some of these drugs might be contraindicated in these patients (refer to specific prescribing information). Symptoms of Parkinson's disease may be exacerbated with the increase in cholinergic activity. Caregivers and patients should be advised.

The donepezil in Namzaric has a moderate potential interaction with Peptic Ulcer.

The use of cholinesterase inhibitors is associated with an increase in gastric acid secretion and gastric contractions. Monitor for symptoms of active or occult gastrointestinal bleeding, especially in patients at increased risk for developing ulcers (e.g., history of ulcer disease or concurrent use of nonsteroidal anti-inflammatory drugs).

Omeprazole has a major potential interaction with Pseudomembranous Colitis.

Published observational studies suggest that proton pump inhibitor (PPI) use may be associated with an increased risk of Clostridium difficile-associated diarrhea (CDAD), especially in hospitalized patients. This diagnosis should be considered for diarrhea that does not improve. It is recommended that patients should use the lowest dose and shortest duration of PPI therapy appropriate to the condition being treated. Close monitoring is recommended in patients with diarrhea and in those taking antibacterial agents as CDAD has been reported with the use of nearly all these agents. Treatment with antibacterial agents alters the normal flora of the colon, leading to overgrowth of C. difficile. C. difficile produces toxins A and B, which contribute to the development of CDAD. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation should be instituted as clinically indicated.

The memantine in Namzaric has a moderate potential interaction with Renal Dysfunction.

Memantine renal clearance involves active tubular secretion moderated by pH dependent tubular reabsorption and conditions that raise urine pH may increase the plasma levels of memantine. Therapy with memantine should be used cautiously in patients with conditions that raise urine pH, such as renal tubular acidosis or severe infections of the urinary tract. Additionally, memantine should be used with caution in patients with severe renal impairment and a dosage reduction is recommended. No dosage adjustment is needed in patients with mild or moderate renal impairment.

The donepezil in Namzaric has a moderate potential interaction with Seizures.

Cholinesterase inhibitors have been associated with convulsions and tremor. Therapy with cholinesterase inhibitors should be administered cautiously in patients with seizure disorders. Patients with Alzheimer's disease should be closely monitored for seizures.

The memantine in Namzaric has a moderate potential interaction with Urinary Tract Infection.

Memantine renal clearance involves active tubular secretion moderated by pH dependent tubular reabsorption and conditions that raise urine pH may increase the plasma levels of memantine. Therapy with memantine should be used cautiously in patients with conditions that raise urine pH, such as renal tubular acidosis or severe infections of the urinary tract. Additionally, memantine should be used with caution in patients with severe renal impairment and a dosage reduction is recommended. No dosage adjustment is needed in patients with mild or moderate renal impairment.