Drug Interaction Report
4 potential interactions and/or warnings found for the following 2 drugs:
- Glaucon (epinephrine ophthalmic)
- Salutensin (hydroflumethiazide / reserpine)
Interactions between your drugs
reserpine hydroflumethiazide
Applies to: Salutensin (hydroflumethiazide / reserpine), Salutensin (hydroflumethiazide / reserpine)
MONITOR: The hypotensive effects of thiazide diuretics and alpha-adrenergic blockers may be additive. Postural hypotension may occur.
MANAGEMENT: Hemodynamic responses should be monitored during coadministration, especially during the first few weeks of therapy. Patients should be advised to take the alpha-blocker at bedtime and to notify their physician if they experience dizziness or syncope while awake.
References
- Achari R, Laddu A (1992) "Terazosin: a new alpha adrenoceptor blocking drug." J Clin Pharmacol, 32, p. 520-3
- Kuokkanen K, Mattila MJ (1975) "Demonstration of an additive antihypertensive effect of prazosin and polythiazide in out-patient." Curr Ther Res Clin Exp, 17, p. 431-6
- Pool JL (1991) "Combination antihypertensive therapy with terazosin and other antihypertensive agents: results of clinical trials." Am Heart J, 122, p. 926-31
- Cohen J (1991) "Long-term efficacy and safety of terazosin alone and in combination with other antihypertensive agents." Am Heart J, 122, p. 919-25
- (2002) "Product Information. Xatral (alfuzosin)." Sanofi-Synthelabo Canada Inc
reserpine EPINEPHrine ophthalmic
Applies to: Salutensin (hydroflumethiazide / reserpine), Glaucon (epinephrine ophthalmic)
MONITOR: Postganglionic adrenergic blocking agents may potentiate the pharmacologic effects of direct-acting sympathomimetic amines, while the hypotensive effect of the former may be diminished. Postganglionic adrenergic blocking agents such as guanadrel, guanethidine, and rauwolfia alkaloids work by depleting catecholamine stores from adrenergic nerve endings, thus they may sensitize adrenergic receptors to direct-acting sympathomimetics. Clinically, hypertension and other cardiovascular adverse effects may occur.
MANAGEMENT: Due to their pressor effect, sympathomimetic amines should be used cautiously in patients with hypertension. Conversely, alternatives to postganglionic adrenergic blocking agents should be considered in patients treated with sympathomimetic amines. If the combination is used, blood pressure and heart rate should be closely monitored.
References
- Spiers AS, Calne DB (1969) "Action of dopamine on the human iris." Br Med J, 4, p. 333-5
- Muelheims GH, Entrup RW, Paiewonsky D, Mierzwiak DS (1965) "Increased sensitivity of the heart to catecholamine-induced arrhythmias following guanethidine." Clin Pharmacol Ther, 6, p. 757-62
- Limbird LE eds., Gilman AG, Hardman JG (1995) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: McGraw-Hill
Drug and food interactions
reserpine food
Applies to: Salutensin (hydroflumethiazide / reserpine)
MONITOR: Many psychotherapeutic and CNS-active agents (e.g., anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics, opioids, alcohol, muscle relaxants) exhibit hypotensive effects, especially during initiation of therapy and dose escalation. Coadministration with antihypertensives and other hypotensive agents, in particular vasodilators and alpha-blockers, may result in additive effects on blood pressure and orthostasis.
MANAGEMENT: Caution and close monitoring for development of hypotension is advised during coadministration of these agents. Some authorities recommend avoiding alcohol in patients receiving vasodilating antihypertensive drugs. Patients should be advised to avoid rising abruptly from a sitting or recumbent position and to notify their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia.
References
- Sternbach H (1991) "Fluoxetine-associated potentiation of calcium-channel blockers." J Clin Psychopharmacol, 11, p. 390-1
- Shook TL, Kirshenbaum JM, Hundley RF, Shorey JM, Lamas GA (1984) "Ethanol intoxication complicating intravenous nitroglycerin therapy." Ann Intern Med, 101, p. 498-9
- Feder R (1991) "Bradycardia and syncope induced by fluoxetine." J Clin Psychiatry, 52, p. 139
- Ellison JM, Milofsky JE, Ely E (1990) "Fluoxetine-induced bradycardia and syncope in two patients." J Clin Psychiatry, 51, p. 385-6
- Rodriguez de la Torre B, Dreher J, Malevany I, et al. (2001) "Serum levels and cardiovascular effects of tricyclic antidepressants and selective serotonin reuptake inhibitors in depressed patients." Ther Drug Monit, 23, p. 435-40
- Cerner Multum, Inc. "Australian Product Information."
- Pacher P, Kecskemeti V (2004) "Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns?" Curr Pharm Des, 10, p. 2463-75
- Andrews C, Pinner G (1998) "Postural hypotension induced by paroxetine." BMJ, 316, p. 595
hydroflumethiazide food
Applies to: Salutensin (hydroflumethiazide / reserpine)
MONITOR: Many psychotherapeutic and CNS-active agents (e.g., anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics, opioids, alcohol, muscle relaxants) exhibit hypotensive effects, especially during initiation of therapy and dose escalation. Coadministration with antihypertensives and other hypotensive agents, in particular vasodilators and alpha-blockers, may result in additive effects on blood pressure and orthostasis.
MANAGEMENT: Caution and close monitoring for development of hypotension is advised during coadministration of these agents. Some authorities recommend avoiding alcohol in patients receiving vasodilating antihypertensive drugs. Patients should be advised to avoid rising abruptly from a sitting or recumbent position and to notify their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia.
References
- Sternbach H (1991) "Fluoxetine-associated potentiation of calcium-channel blockers." J Clin Psychopharmacol, 11, p. 390-1
- Shook TL, Kirshenbaum JM, Hundley RF, Shorey JM, Lamas GA (1984) "Ethanol intoxication complicating intravenous nitroglycerin therapy." Ann Intern Med, 101, p. 498-9
- Feder R (1991) "Bradycardia and syncope induced by fluoxetine." J Clin Psychiatry, 52, p. 139
- Ellison JM, Milofsky JE, Ely E (1990) "Fluoxetine-induced bradycardia and syncope in two patients." J Clin Psychiatry, 51, p. 385-6
- Rodriguez de la Torre B, Dreher J, Malevany I, et al. (2001) "Serum levels and cardiovascular effects of tricyclic antidepressants and selective serotonin reuptake inhibitors in depressed patients." Ther Drug Monit, 23, p. 435-40
- Cerner Multum, Inc. "Australian Product Information."
- Pacher P, Kecskemeti V (2004) "Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns?" Curr Pharm Des, 10, p. 2463-75
- Andrews C, Pinner G (1998) "Postural hypotension induced by paroxetine." BMJ, 316, p. 595
Therapeutic duplication warnings
No duplication warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
No interaction information available. |
Further information
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