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Drug Interaction Report

1 drug interaction and 17 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

vasopressin midostaurin

Applies to: Pitressin (vasopressin), midostaurin

Using vasopressin together with midostaurin can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect.

You may be more susceptible if you have:

  • a heart condition called congenital long QT syndrome
  • other cardiac diseases
  • conduction abnormalities
  • electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting)

Talk to your doctor if you have any questions or concerns.

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

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

Major food/lifestyle interactions

Major:

Food/Lifestyle midostaurin

Applies to: midostaurin

Midostaurin should be taken with food to help with its absorption. Do not consume grapefruit or grapefruit juice during treatment, as it can significantly increase the blood levels of midostaurin.

You may be more likely to experience side effects such as:

  • nausea
  • vomiting
  • diarrhea
  • swelling
  • high blood sugar
  • heart rhythm abnormalities
  • impaired bone marrow function resulting in low numbers of different types of blood cells, which can increase the risk of anemia, bleeding problems, and infections

You should seek medical attention 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
  • pain and burning during urination

Talk to your healthcare provider if you have any questions or concerns.

Moderate food/lifestyle interactions

Moderate:

Food/Lifestyle vasopressin

Applies to: Pitressin (vasopressin)

You should avoid the use of alcohol while being treated with vasopressin.

Alcohol may reduce the effects of vasopressin.

Talk to your doctor if you have 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.

Disease interactions

15 potential interactionsApplies to: 14 conditions, including Migraine, Heart Failure, Asthma, Seizures, and Peripheral Arterial Disease.

Asthma

Major:

Pitressin

The vasopressin in Pitressin has a major potential interaction with Asthma.

Water intoxication and hyponatremia may occur during therapy with vasopressin or desmopressin due to their antidiuretic action. Patients are most likely to experience this problem if their fluid intake is excessive or if they do not require antidiuresis, such as when they are administered these agents for their hemostatic effects. Fluid intake should be adjusted carefully to avoid overhydration, particularly in children, elderly, and patients with conditions that may be exacerbated by fluid retention, including epilepsy, migraine, asthma, and heart failure. Patients should be monitored for signs of water intoxication (e.g., listlessness, drowsiness, and headaches), which may rarely progress to seizures and coma. The use of desmopressin is contraindicated in patients with hyponatremia or a history of hyponatremia.

Cerebral Vascular Disorder

Major:

Pitressin

The vasopressin in Pitressin has a major potential interaction with Cerebral Vascular Disorder.

Vasopressin should not be used in patients with vascular disease, especially disease of the coronary arteries, except with extreme caution. In such patients, even small doses may precipitate anginal pain, and large doses may cause myocardial infarction. If a decision is made to use the drug, ECG monitoring should be performed periodically during therapy.

Fluid Retention

Major:

Pitressin

The vasopressin in Pitressin has a major potential interaction with Fluid Retention.

Water intoxication and hyponatremia may occur during therapy with vasopressin or desmopressin due to their antidiuretic action. Patients are most likely to experience this problem if their fluid intake is excessive or if they do not require antidiuresis, such as when they are administered these agents for their hemostatic effects. Fluid intake should be adjusted carefully to avoid overhydration, particularly in children, elderly, and patients with conditions that may be exacerbated by fluid retention, including epilepsy, migraine, asthma, and heart failure. Patients should be monitored for signs of water intoxication (e.g., listlessness, drowsiness, and headaches), which may rarely progress to seizures and coma. The use of desmopressin is contraindicated in patients with hyponatremia or a history of hyponatremia.

Glomerulonephritis

Major:

Pitressin

The vasopressin in Pitressin has a major potential interaction with Glomerulonephritis.

Chronic nephritis with nitrogen retention contraindicates the use of vasopressin until reasonable nitrogen blood levels have been attained.

Heart Failure

Major:

Pitressin

The vasopressin in Pitressin has a major potential interaction with Heart Failure.

Water intoxication and hyponatremia may occur during therapy with vasopressin or desmopressin due to their antidiuretic action. Patients are most likely to experience this problem if their fluid intake is excessive or if they do not require antidiuresis, such as when they are administered these agents for their hemostatic effects. Fluid intake should be adjusted carefully to avoid overhydration, particularly in children, elderly, and patients with conditions that may be exacerbated by fluid retention, including epilepsy, migraine, asthma, and heart failure. Patients should be monitored for signs of water intoxication (e.g., listlessness, drowsiness, and headaches), which may rarely progress to seizures and coma. The use of desmopressin is contraindicated in patients with hyponatremia or a history of hyponatremia.

Hyponatremia

Major:

Pitressin

The vasopressin in Pitressin has a major potential interaction with Hyponatremia.

Water intoxication and hyponatremia may occur during therapy with vasopressin or desmopressin due to their antidiuretic action. Patients are most likely to experience this problem if their fluid intake is excessive or if they do not require antidiuresis, such as when they are administered these agents for their hemostatic effects. Fluid intake should be adjusted carefully to avoid overhydration, particularly in children, elderly, and patients with conditions that may be exacerbated by fluid retention, including epilepsy, migraine, asthma, and heart failure. Patients should be monitored for signs of water intoxication (e.g., listlessness, drowsiness, and headaches), which may rarely progress to seizures and coma. The use of desmopressin is contraindicated in patients with hyponatremia or a history of hyponatremia.

Interstitial Lung Disease

Moderate:

midostaurin

Midostaurin has a moderate potential interaction with Interstitial Lung Disease.

The use of certain multikinase inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, these agents should be permanently discontinued and appropriate measures should be instituted. Treatment should be immediately withheld in patients diagnosed with ILD/pneumonitis and permanently discontinued if no other potential causes of ILD/pneumonitis have been identified.

Ischemic Heart Disease

Major:

Pitressin

The vasopressin in Pitressin has a major potential interaction with Ischemic Heart Disease.

Vasopressin should not be used in patients with vascular disease, especially disease of the coronary arteries, except with extreme caution. In such patients, even small doses may precipitate anginal pain, and large doses may cause myocardial infarction. If a decision is made to use the drug, ECG monitoring should be performed periodically during therapy.

Liver Disease

Moderate:

midostaurin

Midostaurin has a moderate potential interaction with Liver Disease.

Midostaurin and quizartinib should be used with caution in patients with severe hepatic or severe renal dysfunction as the pharmacokinetics of these agents have not been studied in these patients. No dosage adjustments are recommended in patients with mild or moderate hepatic or renal dysfunction.

Migraine

Major:

Pitressin

The vasopressin in Pitressin has a major potential interaction with Migraine.

Water intoxication and hyponatremia may occur during therapy with vasopressin or desmopressin due to their antidiuretic action. Patients are most likely to experience this problem if their fluid intake is excessive or if they do not require antidiuresis, such as when they are administered these agents for their hemostatic effects. Fluid intake should be adjusted carefully to avoid overhydration, particularly in children, elderly, and patients with conditions that may be exacerbated by fluid retention, including epilepsy, migraine, asthma, and heart failure. Patients should be monitored for signs of water intoxication (e.g., listlessness, drowsiness, and headaches), which may rarely progress to seizures and coma. The use of desmopressin is contraindicated in patients with hyponatremia or a history of hyponatremia.

Peripheral Arterial Disease

Major:

Pitressin

The vasopressin in Pitressin has a major potential interaction with Peripheral Arterial Disease.

Vasopressin should not be used in patients with vascular disease, especially disease of the coronary arteries, except with extreme caution. In such patients, even small doses may precipitate anginal pain, and large doses may cause myocardial infarction. If a decision is made to use the drug, ECG monitoring should be performed periodically during therapy.

Pulmonary Impairment

Moderate:

midostaurin

Midostaurin has a moderate potential interaction with Pulmonary Impairment.

The use of certain multikinase inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, these agents should be permanently discontinued and appropriate measures should be instituted. Treatment should be immediately withheld in patients diagnosed with ILD/pneumonitis and permanently discontinued if no other potential causes of ILD/pneumonitis have been identified.

Renal Dysfunction

Major:

Pitressin

The vasopressin in Pitressin has a major potential interaction with Renal Dysfunction.

Vasopressin is contraindicated in patients with chronic nephritis with nitrogen retention. This until reasonable nitrogen blood levels have been attained.

Moderate:

midostaurin

Midostaurin has a moderate potential interaction with Renal Dysfunction.

Midostaurin and quizartinib should be used with caution in patients with severe hepatic or severe renal dysfunction as the pharmacokinetics of these agents have not been studied in these patients. No dosage adjustments are recommended in patients with mild or moderate hepatic or renal dysfunction.

Seizures

Major:

Pitressin

The vasopressin in Pitressin has a major potential interaction with Seizures.

Water intoxication and hyponatremia may occur during therapy with vasopressin or desmopressin due to their antidiuretic action. Patients are most likely to experience this problem if their fluid intake is excessive or if they do not require antidiuresis, such as when they are administered these agents for their hemostatic effects. Fluid intake should be adjusted carefully to avoid overhydration, particularly in children, elderly, and patients with conditions that may be exacerbated by fluid retention, including epilepsy, migraine, asthma, and heart failure. Patients should be monitored for signs of water intoxication (e.g., listlessness, drowsiness, and headaches), which may rarely progress to seizures and coma. The use of desmopressin is contraindicated in patients with hyponatremia or a history of hyponatremia.

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.