Drug Interaction Report

GENERALLY AVOID: The hypotensive and bradycardic effects of lofexidine may be increased if it is used concurrently with other medications capable of these effects. Clinical trials reported orthostatic hypotension (29% and 42%), bradycardia (24% and 32%), and hypotension (30% and 30%) more frequently in patients on lofexidine 2.16 mg and 2.88 mg, respectively, compared to placebo (5%, 5%, and 1%, respectively).

MANAGEMENT: Concomitant use of lofexidine with medications that can decrease pulse rate or blood pressure should generally be avoided. If patients are using lofexidine in an outpatient setting, they should be capable of and counseled on self-monitoring for hypotension, orthostasis, and bradycardia. Patients should also be instructed to remain hydrated, rise carefully from a sitting or lying down position, and to contact their healthcare provider for guidance on dosing if hypotension or bradycardia occur.

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.