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Drug Interaction Report

16 potential interactions and/or warnings found for the following 6 drugs:

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Interactions between your drugs

Major

spironolactone ramipril

Applies to: spironolactone, ramipril

Using ramipril together with spironolactone may increase the levels of potassium in your blood (hyperkalemia), especially if you are dehydrated or have kidney disease, diabetes, heart failure, or if you are an older adult. Hyperkalemia can cause symptoms such as weakness, confusion, numbness or tingling, and uneven heartbeats. If your doctor prescribes these medications together, you may need a dose adjustment or special tests to safely 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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Moderate

furosemide metOLazone

Applies to: furosemide, metolazone

Before taking furosemide, tell your doctor if you also use metOLazone. You may need dose adjustments or special tests in order to safely take both medications together. This combination may lower levels of certain minerals in your body such as potassium, magnesium, and sodium. You should contact your doctor if you have symptoms such as dizziness, dry mouth, thirst, tired feeling, muscle cramps, fast heart rate, urinating less than usual, or feeling like you might pass out. Blood pressure and kidney function should be monitored regularly. 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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Moderate

furosemide bisoprolol

Applies to: furosemide, bisoprolol

Using furosemide and bisoprolol together may lower your blood pressure and slow your heart rate. This can cause dizziness, or feeling like you might pass out, weakness, fainting, fast or irregular heartbeats, or loss of blood glucose control. If you take both medications together, tell your doctor if you have any of these symptoms. You may need a dose adjustment or need your blood pressure checked more often 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

metOLazone bisoprolol

Applies to: metolazone, bisoprolol

Using metOLazone and bisoprolol together may lower your blood pressure and slow your heart rate. This can cause dizziness, or feeling like you might pass out, weakness, fainting, fast or irregular heartbeats, or loss of blood glucose control. If you take both medications together, tell your doctor if you have any of these symptoms. You may need a dose adjustment or need your blood pressure checked more often 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

spironolactone bisoprolol

Applies to: spironolactone, bisoprolol

Using spironolactone and bisoprolol together may lower your blood pressure and slow your heart rate. This can cause dizziness, or feeling like you might pass out, weakness, fainting, fast or irregular heartbeats, or loss of blood glucose control. If you take both medications together, tell your doctor if you have any of these symptoms. You may need a dose adjustment or need your blood pressure checked more often 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

furosemide ramipril

Applies to: furosemide, ramipril

Although furosemide and ramipril are frequently combined together, their effects may be additive on lowering your blood pressure. You may need a dose adjustment or special tests to safely take both medications. Contact your doctor if you have a reduced heart rate, dizziness, fainting, or headaches. 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

metOLazone ramipril

Applies to: metolazone, ramipril

Although metOLazone and ramipril are frequently combined together, their effects may be additive on lowering your blood pressure. You may need a dose adjustment or special tests to safely take both medications. Contact your doctor if you have a reduced heart rate, dizziness, fainting, or headaches. 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

Moderate

ramipril food

Applies to: ramipril

It is recommended that if you are taking ramipril you should be advised to avoid moderately high or high potassium dietary intake. This can cause high levels of potassium in your blood. Do not use salt substitutes or potassium supplements while taking ramipril, unless your doctor has told you to.

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Moderate

furosemide food

Applies to: furosemide

Furosemide 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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Moderate

metOLazone food

Applies to: metolazone

MetOLazone 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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Moderate

spironolactone food

Applies to: spironolactone

Spironolactone 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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Moderate

bisoprolol food

Applies to: bisoprolol

Bisoprolol 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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Moderate

ramipril food

Applies to: ramipril

Ramipril 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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Moderate

bisoprolol food

Applies to: bisoprolol

Using bisoprolol together with multivitamin with minerals may decrease the effects of bisoprolol. Separate the administration times of bisoprolol and multivitamin with minerals by at least 2 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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Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Cardiovascular agents

Therapeutic duplication

The recommended maximum number of medicines in the 'cardiovascular agents' category to be taken concurrently is usually four. Your list includes five medicines belonging to the 'cardiovascular agents' category:

  • bisoprolol
  • furosemide
  • metolazone
  • ramipril
  • spironolactone

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

Duplication

Diuretics

Therapeutic duplication

The recommended maximum number of medicines in the 'diuretics' category to be taken concurrently is usually two. Your list includes three medicines belonging to the 'diuretics' category:

  • furosemide
  • metolazone
  • spironolactone

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.


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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.