Amiodarone drug interactions: Difference between revisions

Jump to navigation Jump to search
Zorkun (talk | contribs)
No edit summary
GeraldChi (talk | contribs)
 
(6 intermediate revisions by one other user not shown)
Line 1: Line 1:
{{CMG}}
#REDIRECT [[Amiodarone#Drug Interactions]]
 
Amiodarone is metabolized to desethylAmiodarone by the cytochrome P450 (CYP450) enzyme group, specifically cytochrome P450 3A4 (CYP3A4) and CYP2C8. The CYP3A4 isoenyzme is present in both the liver and intestines (see " CLINICAL PHARMACOLOGY, Pharmacokinetics"). Amiodarone is an inhibitor of CYP3A4 and p-glycoprotein. Therefore, Amiodarone has the potential for interactions with drugs or substances that may be substrates, inhibitors or inducers of CYP3A4 and substrates of p-glycoprotein. While only a limited number of in vivo drug-drug interactions with Amiodarone have been reported, the potential for other interactions should be anticipated. This is especially important for drugs associated with serious toxicity, such as other antiarrhythmics. If such drugs are needed, their dose should be reassessed and, where appropriate, plasma concentration measured. In view of the long and variable half-life of Amiodarone, potential for drug interactions exists, not only with concomitant medication, but also with drugs administered after discontinuation of Amiodarone.
 
Since Amiodarone is a substrate for CYP3A4 and CYP2C8, drugs/substances that inhibit CYP3A4 may decrease the metabolism and increase serum concentrations of Amiodarone. Reported examples include the following:
 
===Protease Inhibitors===
 
Protease inhibitors are known to inhibit CYP3A4 to varying degrees. A case report of one patient taking Amiodarone 200 mg and indinavir 800 mg three times a day resulted in increases in Amiodarone concentrations from 0.9 mg/L to 1.3 mg/L. DEA concentrations were not affected. There was no evidence of toxicity. Monitoring for Amiodarone toxicity and serial measurement of Amiodarone serum concentration during concomitant protease inhibitor therapy should be considered.
 
===Histamine H1 antagonists===
 
Loratadine, a non-sedating antihistaminic, is metabolized primarily by CYP3A4. QT interval prolongation and torsade de pointes have been reported with the co-administration of loratadine and Amiodarone.
 
==Histamine H2 antagonists====
 
Cimetidine inhibits CYP3A4 and can increase serum Amiodarone levels.
 
===Antidepressants===
 
Trazodone, an antidepressant, is metabolized primarily by CYP3A4. QT interval prolongation and torsade de pointes have been reported with the co-administration of trazodone and Amiodarone.
 
===Other substances===
 
Grapefruit juice given to healthy volunteers increased Amiodarone AUC by 50% and Cmax by 84%, and decreased DEA to unquantifiable concentrations. Grapefruit juice inhibits CYP3A4-mediated metabolism of oral Amiodarone in the intestinal mucosa, resulting in increased plasma levels of Amiodarone; therefore, grapefruit juice should not be taken during treatment with oral Amiodarone. This information should be considered when changing from intravenous Amiodarone to oral Amiodarone (see " DOSAGE AND ADMINISTRATION").
 
Amiodarone inhibits p-glycoprotein and certain CYP450 enzymes, including CYP1A2, CYP2C9, CYP2D6, and CYP3A4. This inhibition can result in unexpectedly high plasma levels of other drugs which are metabolized by those CYP450 enzymes or are substrates of p-glycoprotein. Reported examples of this interaction include the following:
 
===Immunosuppressives===
 
Cyclosporine (CYP3A4 substrate) administered in combination with oral Amiodarone has been reported to produce persistently elevated plasma concentrations of cyclosporine resulting in elevated creatinine, despite reduction in dose of cyclosporine.
 
===HMG-CoA reductase inhibitors===
 
HMG-CoA reductase inhibitors that are CYP3A4 substrates (including simvastatin and atorvastatin) in combination with Amiodarone have been associated with reports of myopathy/rhabdomyolysis.
 
===Cardiovasculars===  ====Cardiac glycosides====
 
In patients receiving digoxin therapy, administration of oral Amiodarone regularly results in an increase in the serum digoxin concentration that may reach toxic levels with resultant clinical toxicity. Amiodarone taken concomitantly with digoxin increases the serum digoxin concentration by 70% after one day. On initiation of oral Amiodarone, the need for digitalis therapy should be reviewed and the dose reduced by approximately 50% or discontinued. If digitalis treatment is continued, serum levels should be closely monitored and patients observed for clinical evidence of toxicity. These precautions probably should apply to digitoxin administration as well.
 
====Antiarrhythmics====
 
Other antiarrhythmic drugs, such as quinidine, procainamide, disopyramide, and phenytoin, have been used concurrently with oral Amiodarone. There have been case reports of increased steady-state levels of quinidine, procainamide, and phenytoin during concomitant therapy with Amiodarone. Phenytoin decreases serum Amiodarone levels. Amiodarone taken concomitantly with quinidine increases quinidine serum concentration by 33% after two days. Amiodarone taken concomitantly with procainamide for less than seven days increases plasma concentrations of procainamide and n-acetyl procainamide by 55% and 33%, respectively. Quinidine and procainamide doses should be reduced by one-third when either is administered with Amiodarone. Plasma levels of flecainide have been reported to increase in the presence of oral Amiodarone; because of this, the dosage of flecainide should be adjusted when these drugs are administered concomitantly. In general, any added antiarrhythmic drug should be initiated at a lower than usual dose with careful monitoring.
 
Combination of Amiodarone with other antiarrhythmic therapy should be reserved for patients with life-threatening ventricular arrhythmias who are incompletely responsive to a single agent or incompletely responsive to Amiodarone. During transfer to Amiodarone the dose levels of previously administered agents should be reduced by 30 to 50% several days after the addition of Amiodarone, when arrhythmia suppression should be beginning. The continued need for the other antiarrhythmic agent should be reviewed after the effects of Amiodarone have been established, and discontinuation ordinarily should be attempted. If the treatment is continued, these patients should be particularly carefully monitored for adverse effects, especially conduction disturbances and exacerbation of tachyarrhythmias, as Amiodarone is continued. In Amiodarone-treated patients who require additional antiarrhythmic therapy, the initial dose of such agents should be approximately half of the usual recommended dose.
 
====Antihypertensives====
 
Amiodarone should be used with caution in patients receiving β-receptor blocking agents (e.g., propranolol, a CYP3A4 inhibitor) or calcium channel antagonists (e.g., verapamil, a CYP3A4 substrate, and diltiazem, a CYP3A4 inhibitor) because of the possible potentiation of bradycardia, sinus arrest, and AV block; if necessary, Amiodarone can continue to be used after insertion of a pacemaker in patients with severe bradycardia or sinus arrest.
 
====Anticoagulants====
 
Potentiation of warfarin-type (CYP2C9 and CYP3A4 substrate) anticoagulant response is almost always seen in patients receiving Amiodarone and can result in serious or fatal bleeding. Since the concomitant administration of warfarin with Amiodarone increases the prothrombin time by 100% after 3 to 4 days, the dose of the anticoagulant should be reduced by one-third to one-half, and prothrombin times should be monitored closely.
 
Clopidogrel, an inactive thienopyridine prodrug, is metabolized in the liver by CYP3A4 to an active metabolite. A potential interaction between clopidogrel and Amiodarone resulting in ineffective inhibition of platelet aggregation has been reported.
 
Some drugs/substances are known to accelerate the metabolism of Amiodarone by stimulating the synthesis of CYP3A4 (enzyme induction). This may lead to low Amiodarone serum levels and potential decrease in efficacy. Reported examples of this interaction include the following:
 
====Antibiotics====
 
Rifampin is a potent inducer of CYP3A4. Administration of rifampin concomitantly with oral Amiodarone has been shown to result in decreases in serum concentrations of Amiodarone and desethylAmiodarone.
 
====Other substances, including herbal preparations====
 
St. John's Wort (Hypericum perforatum) induces CYP3A4. Since Amiodarone is a substrate for CYP3A4, there is the potential that the use of St. John's Wort in patients receiving Amiodarone could result in reduced Amiodarone levels.
 
====Other reported interactions with Amiodarone====
 
Fentanyl (CYP3A4 substrate) in combination with Amiodarone may cause hypotension, bradycardia, and decreased cardiac output.
 
Sinus bradycardia has been reported with oral Amiodarone in combination with lidocaine (CYP3A4 substrate) given for local anesthesia. Seizure, associated with increased lidocaine concentrations, has been reported with concomitant administration of intravenous Amiodarone.
 
Dextromethorphan is a substrate for both CYP2D6 and CYP3A4. Amiodarone inhibits CYP2D6.
 
Cholestyramine increases enterohepatic elimination of Amiodarone and may reduce its serum levels and t1/2.
 
Disopyramide increases QT prolongation which could cause arrhythmia.
 
Fluoroquinolones, macrolide antibiotics, and azoles are known to cause QTc prolongation. There have been reports of QTc prolongation, with or without TdP, in patients taking Amiodarone when fluoroquinolones, macrolide antibiotics, or azoles were administered concomitantly
 
Hemodynamic and electrophysiologic interactions have also been observed after concomitant administration with propranolol, diltiazem, and verapamil.
 
====Volatile Anesthetic Agents====
 
In addition to the interactions noted above, chronic (>2 weeks) oral Amiodarone administration impairs metabolism of phenytoin, dextromethorphan, and methotrexate.
 
==Major Interactions==
{{refbegin|3}}
* [[A-Hydrocort]]
* [[abarelix]]
* [[Abelcet]]
* [[Accuneb]]
* [[Acetazolamide]]
* [[Acetazolamide extended release]]
* [[ACTH]]
* [[ACTH Gel]]
* [[ACTH-40 HP]]
* [[ACTH-80]]
* [[Acthar]]
* [[Acthar Gel H.P.]]
* [[Actiq]]
* [[Adapin]]
* [[Adeno-jec]]
* [[Adenocard]]
* [[Adenoscan]]
* [[adenosine]]
* [[adenosine monophosphate]]
* [[adenosine triphosphate]]
* [[Adgan]]
* [[Adriamycin]]
* [[Adriamycin RDF]]
* [[agalsidase beta]]
* [[Agenerase]]
* [[Airet]]
* [[albuterol]]
* [[albuterol extended release]]
* [[alfuzosin]]
* [[alfuzosin extended release]]
* [[Alophen]]
* [[Aloxi]]
* [[Altocor]]
* [[Altoprev]]
* [[Alupent]]
* [[AmBisome]]
* [[amitriptyline]]
* [[amoxapine]]
* [[Amphocin]]
* [[Amphotec]]
* [[amphotericin B]]
* [[amphotericin B cholesteryl sulfate]]
* [[amphotericin B lipid complex]]
* [[amphotericin B liposomal]]
* [[amprenavir]]
* [[Anafranil]]
* [[Anergan 50]]
* [[anisindione]]
* [[Antinaus 50]]
* [[Anzemet]]
* [[APO-Go]]
* [[APO-Go Pen]]
* [[Apokyn]]
* [[apomorphine]]
* [[Aquacot]]
* [[Aquatensen]]
* [[Aquazide H]]
* [[Aralen Hydrochloride]]
* [[Aralen Phosphate]]
* [[arbutamine]]
* [[arsenic trioxide]]
* [[Asendin]]
* [[astemizole]]
* [[Avelox]]
* [[Avelox I.V.]]
* [[Aventyl HCl]]
* [[azithromycin]]
* [[Azithromycin 3 Day Dose Pack]]
* [[Azithromycin 5 Day Dose Pack]]
* [[azithromycin extended release]]
* [[bendroflumethiazide]]
* [[benzthiazide]]
* [[bepridil]]
* [[Betapace]]
* [[Betapace AF]]
* [[Betapace AF(obsolete)]]
* [[Biaxin]]
* [[Biaxin XL]]
* [[Biaxin XL-Pak]]
* [[Bisa-Plex]]
* [[Bisac-Evac]]
* [[bisacodyl]]
* [[Bisco-Lax]]
* [[Bisolax]]
* [[Black Draught]]
* [[Brethaire]]
* [[Brethine]]
* [[Bricanyl]]
* [[bumetanide]]
* [[Bumex]]
* [[Calan]]
* [[Calan SR]]
* [[Capastat Sulfate]]
* [[capreomycin]]
* [[Cardioquin]]
* [[Cardizem]]
* [[Cardizem CD]]
* [[Cardizem LA]]
* [[Cardizem Monovial]]
* [[Cardizem SR]]
* [[Cardoxin]]
* [[Carozide]]
* [[Carters Little Pills]]
* [[Cartia XT]]
* [[casanthranol]]
* [[cascara sagrada]]
* [[Cerubidine]]
* [[Chem Mart Tamoxifen]]
* [[chloroquine]]
* [[chloroquine hydrochloride]]
* [[chloroquine phosphate]]
* [[chlorothiazide]]
* [[Chlorpromazine]]
* [[Chlorpromazine extended release]]
* [[chlorthalidone]]
* [[Cipro]]
* [[Cipro Cystitis Pack]]
* [[Cipro I.V.]]
* [[Cipro XR]]
* [[ciprofloxacin]]
* [[ciprofloxacin extended release]]
* [[cisapride]]
* [[cisplatin]]
* [[clarithromycin]]
* [[clarithromycin extended release]]
* [[Clomipramine]]
* [[clotrimazole]]
* [[Colax]]
* [[Colocort]]
* [[Compazine]]
* [[Compazine Spansule]]
* [[Compro]]
* [[conivaptan]]
* [[Corlopam]]
* [[Correctol]]
* [[Cortef]]
* [[Cortenema]]
* [[corticotropin]]
* [[Cortifoam]]
* [[cortisone]]
* [[Cortone Acetate]]
* [[Corvert]]
* [[Coumadin]]
* [[Covera-HS]]
* [[Crixivan]]
* [[dalfopristin]]
* [[Daranide]]
* [[dasatinib]]
* [[Daunorubicin]]
* [[Daunorubicin Liposomal]]
* [[Daunoxome]]
* [[Definity]]
* [[Demadex]]
* [[Demadex I.V.]]
* [[desipramine]]
* [[Diamox]]
* [[Diamox Sequels]]
* [[Diaqua]]
* [[Diaqua-2]]
* [[dichlorphenamide]]
* [[dicumarol]]
* [[Diflucan]]
* [[Digibind]]
* [[DigiFab]]
* [[Digitek]]
* [[digitoxin]]
* [[digoxin]]
* [[digoxin capsule]]
* [[digoxin immune FAB]]
* [[Dilacor XR]]
* [[Diltia XT]]
* [[diltiazem]]
* [[diltiazem 24 hour extended release]]
* [[diltiazem extended release]]
* [[Diltiazem Hydrochloride CD]]
* [[Diltiazem Hydrochloride SR]]
* [[Diltiazem Hydrochloride XR]]
* [[Diltiazem Hydrochloride XT]]
* [[Diskets]]
* [[Diucardin]]
* [[Diurese]]
* [[Diuril]]
* [[Diuril Sodium]]
* [[dofetilide]]
* [[dolasetron]]
* [[Dolophine]]
* [[Dosaflex]]
* [[doxepin]]
* [[doxepin topical]]
* [[Doxidan Tablet]]
* [[Doxil]]
* [[Doxorubicin]]
* [[Doxorubicin Liposomal]]
* [[Dr Caldwell Laxative]]
* [[droperidol]]
* [[Dulcogen]]
* [[Dulcolax Laxative]]
* [[Duragesic]]
* [[Duragesic-100]]
* [[Duragesic-12]]
* [[Duragesic-25]]
* [[Duragesic-50]]
* [[Duragesic-75]]
* [[E-Mycin]]
* [[E.E.S. Granules]]
* [[E.E.S.-200]]
* [[E.E.S.-400]]
* [[E.E.S.-400 Filmtab]]
* [[Edecrin]]
* [[Edecrin Sodium]]
* [[Elavil]]
* [[Ellence]]
* [[Emblon]]
* [[Endep]]
* [[Enduron]]
* [[epirubicin]]
* [[Ery-Tab]]
* [[Eryc]]
* [[EryPed]]
* [[EryPed 200]]
* [[EryPed 400]]
* [[Erythrocin Lactobionate]]
* [[Erythrocin Stearate Filmtab]]
* [[Erythrocot]]
* [[erythromycin]]
* [[erythromycin base]]
* [[erythromycin estolate]]
* [[erythromycin ethylsuccinate]]
* [[erythromycin lactobionate]]
* [[erythromycin stearate]]
* [[Esidrix]]
* [[Eskalith]]
* [[Eskalith-CR]]
* [[ethacrynic acid]]
* [[Evac-U-Gen]]
* [[Ex-Lax Chocolated]]
* [[Ex-Lax Gentle Nature]]
* [[Ex-Lax Maximum Relief Formula]]
* [[Ex-Lax Regular Strength Pills]]
* [[Ex-lax Ultra]]
* [[Exna]]
* [[Ezide]]
* [[Fabrazyme]]
* [[Factive]]
* [[Feen-A-Mint]]
* [[fenoldopam]]
* [[fentanyl]]
* [[fentanyl topical]]
* [[Fentora]]
* [[Fleet Bisacodyl]]
* [[Fletchers Castoria]]
* [[Florinef Acetate]]
* [[Floxin]]
* [[Floxin I.V.]]
* [[fluconazole]]
* [[fludrocortisone]]
* [[Fluothane]]
* [[fluphenazine]]
* [[fluphenazine decanoate]]
* [[fluphenazine enanthate]]
* [[fluphenazine hydrochloride]]
* [[fosamprenavir]]
* [[foscarnet]]
* [[Foscavir]]
* [[Fungizone]]
* [[Fungizone For Tissue Culture]]
* [[furosemide]]
* [[gatifloxacin]]
* [[gemifloxacin]]
* [[Gen Lax]]
* [[GenESA]]
* [[Genox]]
* [[GenRx Tamoxifen]]
* [[Gentlax]]
* [[Gentlax Tablet]]
* [[Gentle Laxative]]
* [[Geodon]]
* [[Glauctabs]]
* [[grepafloxacin]]
* [[Haldol]]
* [[Haldol Decanoate]]
* [[Halfan]]
* [[halofantrine]]
* [[haloperidol]]
* [[haloperidol decanoate]]
* [[halothane]]
* [[HCTZ]]
* [[Hismanal]]
* [[Hydro Par]]
* [[hydrochlorothiazide]]
* [[hydrocortisone]]
* [[hydrocortisone acetate]]
* [[hydrocortisone cypionate]]
* [[hydrocortisone hemisuccinate]]
* [[hydrocortisone sodium phosphate]]
* [[Hydrocortisone Sodium Succinate]]
* [[Hydrocortone]]
* [[Hydrocortone Phosphate]]
* [[Hydrodiuril]]
* [[hydroflumethiazide]]
* [[Hygroton]]
* [[ibutilide]]
* [[Idamycin PFS]]
* [[idarubicin]]
* [[Ilosone]]
* [[Ilotycin Gluceptate]]
* [[imipramine]]
* [[imipramine pamoate]]
* [[Inapsine]]
* [[indapamide]]
* [[indinavir]]
* [[Innerclean]]
* [[Invega]]
* [[Ionsys]]
* [[isoproterenol]]
* [[Isoptin]]
* [[Isoptin I.V.]]
* [[Isoptin SR]]
* [[Isuprel HCl]]
* [[Isuprel Mistometer]]
* [[itraconazole]]
* [[Jantoven]]
* [[Kayexalate]]
* [[Ketek]]
* [[Ketek Pak]]
* [[ketoconazole]]
* [[Kionex]]
* [[Lanoxicaps]]
* [[Lanoxin]]
* [[lapatinib]]
* [[Largon]]
* [[Lariam]]
* [[Lasix]]
* [[Laxative Gentle Suppositories]]
* [[Levaquin]]
* [[Levaquin Leva-Pak]]
* [[Levitra]]
* [[levofloxacin]]
* [[levomethadyl acetate]]
* [[Levoprome]]
* [[Lexiva]]
* [[lithium]]
* [[lithium carbonate]]
* [[lithium carbonate extended release]]
* [[lithium citrate]]
* [[Lithobid]]
* [[Lithonate]]
* [[Lithotabs]]
* [[Lo-Aqua]]
* [[lomefloxacin]]
* [[Loqua]]
* [[Lorelco]]
* [[lovastatin]]
* [[lovastatin extended release]]
* [[Lozol]]
* [[Ludiomil]]
* [[Magic Bullet]]
* [[maprotiline]]
* [[Maxaquin]]
* [[Medihaler-Iso]]
* [[mefloquine]]
* [[Mellaril]]
* [[Mellaril-S]]
* [[mesoridazine]]
* [[Metahydrin]]
* [[Metaprel]]
* [[metaproterenol]]
* [[methadone]]
* [[Methadose]]
* [[methazolamide]]
* [[methdilazine]]
* [[methotrimeprazine]]
* [[methyclothiazide]]
* [[metolazone]]
* [[Mevacor]]
* [[miconazole]]
* [[Microzide]]
* [[Miradon]]
* [[Modane]]
* [[Monistat I.V.]]
* [[moxifloxacin]]
* [[MY-E]]
* [[My-O-Den]]
* [[Mycelex Troche]]
* [[Mykrox]]
* [[MZM]]
* [[Naqua]]
* [[Natures Remedy]]
* [[Naturetin-10]]
* [[Naturetin-5]]
* [[Nebupent]]
* [[nelfinavir]]
* [[Neptazane]]
* [[nilotinib]]
* [[Nizoral]]
* [[Nolvadex]]
* [[Nolvadex D]]
* [[norfloxacin]]
* [[Noroxin]]
* [[Norpramin]]
* [[nortriptyline]]
* [[Norvir]]
* [[Norvir Soft Gelatin]]
* [[Noxafil]]
* [[ofloxacin]]
* [[ondansetron]]
* [[Optison]]
* [[Orap]]
* [[Oretic]]
* [[Orlaam]]
* [[Ormazine]]
* [[oxygen]]
* [[paliperidone]]
* [[palonosetron]]
* [[Pamelor]]
* [[panitumumab]]
* [[PCE Dispertab]]
* [[Pedia-Lax]]
* [[Pentam 300]]
* [[pentamidine]]
* [[Pentazine]]
* [[Perdiem Overnight]]
* [[perflutren]]
* [[Permitil]]
* [[perphenazine]]
* [[Pharmorubicin PFS]]
* [[Pharmorubicin RDF]]
* [[Phenadoz]]
* [[Phenazine 50]]
* [[Phenergan]]
* [[Phenergan Fortis]]
* [[Phenoject-50]]
* [[pimozide]]
* [[Pitressin]]
* [[Platinol-AQ]]
* [[Plenaxis]]
* [[polythiazide]]
* [[posaconazole]]
* [[Pro-Med]]
* [[ProAir HFA]]
* [[probucol]]
* [[prochlorperazine]]
* [[prochlorperazine extended release]]
* [[Procot]]
* [[Prolixin]]
* [[Prolixin Decanoate]]
* [[Prolixin Enanthate]]
* [[Promacot]]
* [[promazine]]
* [[promethazine]]
* [[Promethegan]]
* [[propafenone]]
* [[propafenone extended release]]
* [[propiomazine]]
* [[Propulsid]]
* [[Proquin XR]]
* [[Prorex]]
* [[protriptyline]]
* [[Proventil]]
* [[Proventil HFA]]
* [[Proventil Repetabs]]
* [[Prudoxin]]
* [[QM-260]]
* [[Qualaquin]]
* [[Quin-G]]
* [[Quin-Release]]
* [[Quinaglute Dura-Tabs]]
* [[Quinidex Extentabs]]
* [[quinidine]]
* [[quinidine extended release]]
* [[quinine]]
* [[Quinora]]
* [[Ranexa]]
* [[ranolazine]]
* [[Raxar]]
* [[Renese]]
* [[Respirol]]
* [[Risperdal]]
* [[Risperdal Consta]]
* [[Risperdal M-Tab]]
* [[risperidone]]
* [[ritodrine]]
* [[ritonavir]]
* [[Robimycin]]
* [[Rythmol]]
* [[Rythmol SR]]
* [[Saluron]]
* [[Senexon]]
* [[Senna]]
* [[Senna Concentrate]]
* [[Senna Lax]]
* [[Senna Smooth]]
* [[Senna-gen]]
* [[Sennalax]]
* [[Senokot]]
* [[Senokot Child]]
* [[Senokot Extra]]
* [[SenokotXTRA]]
* [[Senolax]]
* [[SenoSol]]
* [[SenoSol-X]]
* [[Serentil]]
* [[simvastatin]]
* [[Sinequan]]
* [[sodium biphosphate]]
* [[sodium polystyrene sulfonate]]
* [[Soltamox]]
* [[Solu-Cortef]]
* [[Sorine]]
* [[sotalol]]
* [[Sotalol Hydrochloride AF]]
* [[Sotalol Hydrochloride AF(obsolete)]]
* [[sparfloxacin]]
* [[Sparine]]
* [[Sporanox]]
* [[Sprycel]]
* [[Stelazine]]
* [[Sublimaze]]
* [[Surmontil]]
* [[Tacaryl]]
* [[Tamofen]]
* [[Tamofen(obsolete)]]
* [[Tamone]]
* [[Tamosin]]
* [[Tamoxen]]
* [[tamoxifen]]
* [[Tamoxifen Hexal]]
* [[Tao]]
* [[Tasigna]]
* [[Taztia XT]]
* [[telithromycin]]
* [[Telzir]]
* [[Temaril]]
* [[Tequin]]
* [[Tequin Teqpaq]]
* [[terbutaline]]
* [[terfenadine]]
* [[Terry White Chemists Tamoxifen]]
* [[Thalitone]]
* [[thiethylperazine]]
* [[thioridazine]]
* [[Thorazine]]
* [[Tiazac]]
* [[Tikosyn]]
* [[tizanidine]]
* [[Tofranil]]
* [[Tofranil-PM]]
* [[Torecan]]
* [[torsemide]]
* [[trichlormethiazide]]
* [[trifluoperazine]]
* [[triflupromazine]]
* [[Trilafon]]
* [[trimeprazine]]
* [[trimipramine]]
* [[Trisenox]]
* [[troleandomycin]]
* [[Tykerb]]
* [[Uni-Cenna]]
* [[Uprima]]
* [[Uroxatral]]
* [[V-Gan-25]]
* [[V-Gan-50]]
* [[Vanatrip]]
* [[Vaprisol]]
* [[vardenafil]]
* [[Vascor]]
* [[vasopressin]]
* [[Vectibix]]
* [[Ventolin]]
* [[Ventolin HFA]]
* [[Ventolin Nebules]]
* [[Ventolin Rotacaps]]
* [[Veracolate]]
* [[verapamil]]
* [[verapamil 24 hour extended release]]
* [[verapamil extended release]]
* [[Verelan]]
* [[Verelan PM]]
* [[Vfend]]
* [[Viracept]]
* [[Vivactil]]
* [[Volmax]]
* [[voriconazole]]
* [[vorinostat]]
* [[VoSpire ER]]
* [[warfarin]]
* [[X-Prep]]
* [[Yutopar]]
* [[Z-Pak]]
* [[Zagam]]
* [[Zagam Respipac]]
* [[Zanaflex]]
* [[Zaroxolyn]]
* [[ziprasidone]]
* [[Zithromax]]
* [[Zithromax IV]]
* [[Zithromax TRI-PAK]]
* [[Zithromax Z-Pak]]
* [[Zmax]]
* [[Zocor]]
* [[Zofran]]
* [[Zofran ODT]]
* [[Zolinza]]
* [[Zonalon]]
{{refend}}
 
==Moderate Interactions==
{{refbegin|3}}
* [[8-Mop]]
* [[Abilify]]
* [[Abilify Discmelt]]
* [[Abraxane]]
* [[acebutolol]]
* [[Aerolate III]]
* [[Aerolate JR]]
* [[Aerolate SR]]
* [[Akbeta]]
* [[Alavert]]
* [[Alfenta]]
* [[alfentanil]]
* [[aliskiren]]
* [[Amidate]]
* [[aminolevulinic acid topical]]
* [[aminophylline]]
* [[aminophylline extended release]]
* [[Anestacaine]]
* [[Angiografin]]
* [[aprepitant]]
* [[Aquaphyllin]]
* [[Arava]]
* [[arformoterol]]
* [[ARI Sodium Iodide (I123) 1-12 MBq]]
* [[ARI Sodium Iodide (I123) 100-750 MBq]]
* [[aripiprazole]]
* [[articaine]]
* [[Asmalix]]
* [[atazanavir]]
* [[atenolol]]
* [[atomoxetine]]
* [[atorvastatin]]
* [[Azilect]]
* [[Baycol]]
* [[bendamustine]]
* [[Betagan]]
* [[Betagan C-Cap]]
* [[Betaseron]]
* [[betaxolol]]
* [[betaxolol ophthalmic]]
* [[Betimol]]
* [[Betoptic]]
* [[Betoptic S]]
* [[Bextra]]
* [[bisoprolol]]
* [[bitolterol]]
* [[Blocadren]]
* [[bortezomib]]
* [[bosentan]]
* [[Brevibloc]]
* [[Brevital Sodium]]
* [[Bronkodyl]]
* [[Bronkometer]]
* [[Brovana]]
* [[budesonide]]
* [[bupivacaine]]
* [[Bystolic]]
* [[Carbocaine]]
* [[Carbocaine HCl]]
* [[Cardiografin]]
* [[carteolol]]
* [[carteolol ophthalmic]]
* [[Cartrol]]
* [[carvedilol]]
* [[carvedilol extended release]]
* [[Celebrex]]
* [[celecoxib]]
* [[Cerebyx]]
* [[cerivastatin]]
* [[cevimeline]]
* [[Chirocaine]]
* [[Choledyl]]
* [[Choledyl SA]]
* [[Cholestin (obsolete)]]
* [[Cholografin Meglumine]]
* [[Cialis]]
* [[cilostazol]]
* [[cimetidine]]
* [[Citanest HCl Plain]]
* [[Claritin]]
* [[Claritin 24 Hour Allergy]]
* [[Claritin Hives Relief]]
* [[Claritin Reditab]]
* [[Clear-Atadine]]
* [[Clear-Atadine Children's]]
* [[clofarabine]]
* [[Clolar]]
* [[codeine]]
* [[codeine phosphate]]
* [[codeine sulfate]]
* [[colesevelam]]
* [[Compound 374]]
* [[Conray]]
* [[Conray-30]]
* [[Conray-400]]
* [[Conray-43]]
* [[Coreg]]
* [[Coreg CR]]
* [[Corgard]]
* [[cyclophosphamide]]
* [[cyclophosphamide lyophilized]]
* [[Cyclosporine]]
* [[Cymbalta]]
* [[Cysto-Conray]]
* [[Cysto-Conray II]]
* [[Cystografin]]
* [[Cystografin-Dilute]]
* [[Cytoxan]]
* [[Cytoxan Lyophilized]]
* [[darifenacin]]
* [[darunavir]]
* [[ddC]]
* [[delavirdine]]
* [[desflurane]]
* [[Desyrel]]
* [[Desyrel Dividose]]
* [[Detrol]]
* [[Detrol LA]]
* [[Di-Phen]]
* [[diatrizoate]]
* [[Diatrizoate Meglumine]]
* [[diatrizoate meglumine-diatrizoate sodium]]
* [[diatrizoate sodium]]
* [[Dilantin]]
* [[Dilantin Infatabs]]
* [[Dilantin Kapseals]]
* [[Dilantin-125]]
* [[Dilocaine]]
* [[Dimetapp ND]]
* [[Diprivan]]
* [[disopyramide]]
* [[disopyramide extended release]]
* [[duloxetine]]
* [[Duranest-MPF]]
* [[echinacea]]
* [[efavirenz]]
* [[eletriptan]]
* [[Elixophyllin]]
* [[Emend]]
* [[Emend 3-Day]]
* [[Emend for Injection]]
* [[Enablex]]
* [[enflurane]]
* [[Entocort]]
* [[Entocort EC]]
* [[eplerenone]]
* [[esmolol]]
* [[ethotoin]]
* [[Ethrane]]
* [[etidocaine]]
* [[etomidate]]
* [[etravirine]]
* [[Evoxac]]
* [[FK506]]
* [[Flagyl]]
* [[Flagyl 375]]
* [[Flagyl ER]]
* [[Flagyl I.V.]]
* [[Flagyl I.V. RTU]]
* [[flecainide]]
* [[fluvoxamine]]
* [[fluvoxamine extended release]]
* [[Folex PFS]]
* [[Foradil Aerolizer]]
* [[Forane]]
* [[formoterol]]
* [[Fortovase]]
* [[fosaprepitant]]
* [[fosphenytoin]]
* [[galantamine]]
* [[galantamine extended release]]
* [[Gantanol]]
* [[Gastrografin]]
* [[gefitinib]]
* [[Gengraf]]
* [[Gleevec]]
* [[Hexabrix]]
* [[Hivid]]
* [[Hypaque]]
* [[Hypaque Cysto]]
* [[Hypaque Meglumine]]
* [[Hypaque Sodium]]
* [[Hypaque-76]]
* [[Hypaque-M]]
* [[imatinib]]
* [[Inderal]]
* [[Inderal LA]]
* [[InnoPran XL]]
* [[Inspra]]
* [[Intelence]]
* [[interferon beta-1b]]
* [[Invirase]]
* [[iodamide]]
* [[iodipamide]]
* [[iodixanol]]
* [[Iodotope]]
* [[iohexol]]
* [[iopamidol]]
* [[Iopamidol-370]]
* [[iopromide]]
* [[iothalamate]]
* [[ioversol]]
* [[ioxaglate]]
* [[ioxilan]]
* [[Iressa]]
* [[isoetharine]]
* [[isoflurane]]
* [[Isovue-128]]
* [[Isovue-200]]
* [[Isovue-250]]
* [[Isovue-300]]
* [[Isovue-370]]
* [[Isovue-M-200]]
* [[Isovue-M-300]]
* [[Istalol]]
* [[ixabepilone]]
* [[Ixempra]]
* [[Kerlone]]
* [[Ketalar]]
* [[ketamine]]
* [[L-Caine]]
* [[labetalol]]
* [[leflunomide]]
* [[levalbuterol]]
* [[Levatol]]
* [[levobetaxolol ophthalmic]]
* [[Levobunolol]]
* [[levobunolol ophthalmic]]
* [[levobupivacaine]]
* [[Levulan Kerastick]]
* [[lidocaine]]
* [[Lidoject 1]]
* [[Lidoject 2]]
* [[Lipitor]]
* [[Lopressor]]
* [[loratadine]]
* [[Loratadine Reditab]]
* [[Luvox]]
* [[Luvox CR]]
* [[maraviroc]]
* [[Marcaine HCl]]
* [[Marcaine Spinal]]
* [[Maxair]]
* [[Maxair Autohaler]]
* [[MD-76]]
* [[MD-76 R]]
* [[MD-Gastroview]]
* [[mepivacaine]]
* [[methohexital]]
* [[methotrexate]]
* [[Methotrexate Sodium Preservative Free]]
* [[methoxsalen]]
* [[methoxyflurane]]
* [[metipranolol ophthalmic]]
* [[metoprolol]]
* [[metoprolol extended release]]
* [[metoprolol succinate]]
* [[Metoprolol Succinate ER]]
* [[metoprolol tartrate]]
* [[metrizamide]]
* [[Metro I.V.]]
* [[metronidazole]]
* [[metronidazole extended release]]
* [[Metryl]]
* [[mexiletine]]
* [[Mexitil]]
* [[mibefradil]]
* [[Mifeprex]]
* [[mifepristone]]
* [[monascus]]
* [[Mycobutin]]
* [[Myelo-Kit]]
* [[nadolol]]
* [[naltrexone]]
* [[Naropin]]
* [[Naropin Novaplus]]
* [[Naropin Polyamp]]
* [[Naropin SDV]]
* [[Navelbine]]
* [[nebivolol]]
* [[nefazodone]]
* [[Neoral]]
* [[Neosar]]
* [[Nervocaine]]
* [[Nexavar]]
* [[nitrous oxide]]
* [[Normodyne]]
* [[Norpace]]
* [[Norpace CR]]
* [[Ocupress]]
* [[Omnipaque 140]]
* [[Omnipaque 180]]
* [[Omnipaque 180 Redi-Unit]]
* [[Omnipaque 210]]
* [[Omnipaque 240]]
* [[Omnipaque 240 Redi-Unit]]
* [[Omnipaque 300]]
* [[Omnipaque 350]]
* [[Omnipaque Flexipak]]
* [[Onxol]]
* [[OptiPranolol]]
* [[Optiray 160]]
* [[Optiray 240]]
* [[Optiray 300]]
* [[Optiray 320]]
* [[Optiray 350]]
* [[oxcarbazepine]]
* [[Oxilan]]
* [[Oxsoralen-Ultra]]
* [[oxtriphylline]]
* [[oxtriphylline extended release]]
* [[paclitaxel]]
* [[paclitaxel protein-bound]]
* [[Peganone]]
* [[penbutolol]]
* [[Penthrane]]
* [[Pentothal]]
* [[Perforomist]]
* [[Phenytek]]
* [[phenytoin]]
* [[phenytoin extended release]]
* [[Phenytoin Sodium]]
* [[Prompt]]
* [[pindolol]]
* [[pirbuterol]]
* [[Pletal]]
* [[Polocaine]]
* [[Polocaine-MPF]]
* [[Posicor]]
* [[Prandin]]
* [[Prezista]]
* [[Priftin]]
* [[prilocaine]]
* [[procainamide]]
* [[procainamide 12 hour extended release]]
* [[procainamide extended release]]
* [[Procan SR]]
* [[Procanbid]]
* [[Prograf]]
* [[Pronestyl]]
* [[Pronestyl-SR]]
* [[propofol]]
* [[propranolol]]
* [[propranolol extended release]]
* [[Protostat]]
* [[Pulmicort Flexhaler]]
* [[Pulmicort Nebuamp]]
* [[Pulmicort Respules]]
* [[Pulmicort Turbuhaler]]
* [[quetiapine]]
* [[quetiapine extended release]]
* [[Quibron-T]]
* [[Quibron-T/SR]]
* [[ramelteon]]
* [[Rapamune]]
* [[rasagiline]]
* [[Razadyne]]
* [[Razadyne ER]]
* [[red yeast rice]]
* [[Relpax]]
* [[Reminyl]]
* [[Reno-30]]
* [[Reno-60]]
* [[Reno-Dip]]
* [[Reno-M-30]]
* [[Reno-M-60]]
* [[Reno-M-DIP]]
* [[Renocal-76]]
* [[Renografin-60]]
* [[Renografin-76]]
* [[Renovist]]
* [[Renovist II]]
* [[Renovue-65]]
* [[Renovue-Dip]]
* [[repaglinide]]
* [[Repreve]]
* [[Requip]]
* [[ReQuip Follow on Pack]]
* [[Requip Starter Kit]]
* [[ReQuip Starter Pack]]
* [[Rescriptor]]
* [[Respbid]]
* [[Revatio]]
* [[ReVia]]
* [[Reyataz]]
* [[Rezulin]]
* [[Rheumatrex Dose Pack]]
* [[rifabutin]]
* [[Rifadin]]
* [[Rifadin IV]]
* [[rifampin]]
* [[rifapentine]]
* [[Rimactane]]
* [[ropinirole]]
* [[ropivacaine]]
* [[Rozerem]]
* [[RU-486]]
* [[salmeterol]]
* [[Sandimmune]]
* [[saquinavir]]
* [[saquinavir mesylate]]
* [[Sectral]]
* [[Selzentry]]
* [[Sensorcaine]]
* [[Sensorcaine-MPF]]
* [[Sensorcaine-MPF Spinal]]
* [[Serevent]]
* [[Serevent Diskus]]
* [[Seroquel]]
* [[Seroquel XR]]
* [[Serzone]]
* [[sevoflurane]]
* [[sildenafil]]
* [[sirolimus]]
* [[Slo-Bid Gyrocaps]]
* [[Slo-Phyllin]]
* [[Slo-Phyllin 125]]
* [[Slo-Phyllin 80]]
* [[sodium iodide I-123]]
* [[sodium iodide-I-131]]
* [[Sojourn]]
* [[solifenacin]]
* [[sorafenib]]
* [[Strattera]]
* [[sulfamethoxazole]]
* [[Suprane]]
* [[Sustiva]]
* [[T-Phyl]]
* [[tacrolimus]]
* [[tadalafil]]
* [[Tagamet]]
* [[Tagamet HB]]
* [[Tambocor]]
* [[Tavist ND]]
* [[Taxol]]
* [[Tekturna]]
* [[temsirolimus]]
* [[Tenormin]]
* [[Terrell]]
* [[thalidomide]]
* [[Thalomid]]
* [[Theo-24]]
* [[Theo-Dur]]
* [[Theo-Dur Sprinkles]]
* [[Theo-Time]]
* [[Theo-X]]
* [[Theobid]]
* [[TheoCap]]
* [[Theochron]]
* [[Theoclear L.A.-130]]
* [[Theoclear L.A.-260]]
* [[Theoclear-80]]
* [[Theolair]]
* [[Theolair-SR]]
* [[theophylline]]
* [[theophylline 24 hr extended release]]
* [[theophylline extended release]]
* [[Theovent]]
* [[thioguanine]]
* [[thiopental]]
* [[timolol]]
* [[timolol hemihydrate ophthalmic]]
* [[timolol ophthalmic]]
* [[timolol ophthalmic long-acting]]
* [[Timoptic Ocudose]]
* [[Timoptic Ocumeter]]
* [[Timoptic Ocumeter Plus]]
* [[Timoptic-XE]]
* [[tolterodine]]
* [[tolterodine extended release]]
* [[Toprol-XL]]
* [[Torisel]]
* [[Tornalate]]
* [[Tracleer]]
* [[Trandate]]
* [[Trazodone]]
* [[Treanda]]
* [[Trexall]]
* [[Trileptal]]
* [[troglitazone]]
* [[Truphylline]]
* [[Truxacaine]]
* [[Truxophyllin]]
* [[UAD Caine]]
* [[Ultane]]
* [[Ultane P.E.N.]]
* [[Ultravist]]
* [[Uni-Dur]]
* [[Uniphyl]]
* [[Urografin 150]]
* [[Urografin 325]]
* [[Urografin 370]]
* [[Urovison]]
* [[Uvadex]]
* [[valdecoxib]]
* [[Velcade]]
* [[verteporfin]]
* [[Vesicare]]
* [[Viagra]]
* [[vinorelbine]]
* [[Visipaque]]
* [[Visken]]
* [[Visudyne]]
* [[Vivitrol]]
* [[Wal-itin]]
* [[Welchol]]
* [[Xopenex]]
* [[Xopenex Concentrate]]
* [[Xopenex HFA]]
* [[Xylocaine Dental Cartridges]]
* [[Xylocaine Duo-Trach Kit]]
* [[Xylocaine HCl]]
* [[Xylocaine HCl For Spinal]]
* [[Xylocaine-MPF]]
* [[zalcitabine]]
* [[Zebeta]]
{{refend}}
 
==Minor Interactions==
{{refbegin|3}}
* [[alli]]
* [[alprazolam]]
* [[alprazolam extended release]]
* [[Altabax]]
* [[Aricept]]
* [[Aricept ODT]]
* [[armodafinil]]
* [[Ativan]]
* [[Babee Cof]]
* [[Balminil DM]]
* [[Balminil DM Pour Enfants]]
* [[Balminil DM Sans Sucrose]]
* [[Benadryl for the Family Dry Forte]]
* [[Benylin]]
* [[Benylin Adult Formula]]
* [[Benylin DM]]
* [[Benylin DM Pediatric]]
* [[Benylin Dry Coughs]]
* [[Benylin Pediatric]]
* [[Bisolvon Dry]]
* [[Bisolvon Dry Junior]]
* [[Buckley's Mixture Cough Suppressant]]
* [[Buckleys Mixture]]
* [[Calmylin]]
* [[chlordiazepoxide]]
* [[clonazepam]]
* [[clorazepate]]
* [[clorazepate extended release]]
* [[Contac Cough]]
* [[Cough Syrup DM]]
* [[Covonia Bronchial Balsam]]
* [[Creo-Terpin]]
* [[Creomulsion]]
* [[Creomulsion Children]]
* [[Dalmane]]
* [[Delsym]]
* [[Delsym 12 Hour Cough Relief]]
* [[Delsym 12 Hour Cough Relief for Children & Adults]]
* [[DexAlone]]
* [[Dexi-Tuss]]
* [[dextromethorphan]]
* [[dextromethorphan extended release]]
* [[Dextromethorphan HBr Adult Formula]]
* [[Diastat]]
* [[Diastat AcuDial]]
* [[Diastat Pediatric]]
* [[diazepam]]
* [[Dimetapp Cold Cough & Flu Day & Night Liquid Caps]]
* [[Dizac]]
* [[donepezil]]
* [[Doral]]
* [[Dristan DM]]
* [[Dry Cough]]
* [[Elixsure Cough]]
* [[estazolam]]
* [[flurazepam]]
* [[halazepam]]
* [[Halcion]]
* [[Hold DM]]
* [[Jack & Jill Thin Strips Cough]]
* [[Klonopin]]
* [[Klonopin Wafer]]
* [[Librium]]
* [[Lloydspharmacy Dry Adult Cough]]
* [[lopinavir]]
* [[lorazepam]]
* [[midazolam]]
* [[Mitran]]
* [[modafinil]]
* [[montelukast]]
* [[Neocitran Thin Strips Cough]]
* [[Niravam]]
* [[Novahistine DM]]
* [[Nucosef DM]]
* [[Nuvigil]]
* [[orlistat]]
* [[oxazepam]]
* [[Pedia Relief]]
* [[Pediacare]]
* [[Pertussin CS Childrens]]
* [[Pertussin DM]]
* [[Pertussin ES]]
* [[Prosom]]
* [[Provigil]]
* [[quazepam]]
* [[Restoril]]
* [[retapamulin topical]]
* [[Robafen Cough Liquidgels]]
* [[Robafen Pediatric Cough & Cold]]
* [[Robitussin Cough Calmers]]
* [[Robitussin CoughGels]]
* [[Robitussin Dry Cough]]
* [[Robitussin DX Cough Control]]
* [[Robitussin DX Cough Control Forte]]
* [[Robitussin DX Dry Cough Forte]]
* [[Robitussin Honey Cough]]
* [[Robitussin Junior Persistent Cough]]
* [[Robitussin Maximum Strength]]
* [[Robitussin Pediatric Cough Suppressant]]
* [[Robitussin Soft Pastilles]]
* [[Scot-Tussin Diabetic]]
* [[Scot-Tussin DM Cough Chasers]]
* [[Serax]]
* [[Silphen DM]]
* [[Singulair]]
* [[St. Joseph Cough Suppressant]]
* [[Strepsils Cough]]
* [[Strepsils Cough Relief]]
* [[Sucrets DM Cough]]
* [[temazepam]]
* [[Theraflu Thin Strips Cough]]
* [[Tranxene SD]]
* [[Tranxene T-Tab]]
* [[Triaminic DM]]
* [[Triaminic Long Acting Cough]]
* [[Triaminic Long Acting Cough(obs)]]
* [[Triaminic Softchew]]
* [[Triaminic Thin Strips Cough]]
* [[Triaminic Thin Strips Nasal Congestion(obsolete)]]
* [[Triaminic Toddler Congestion Thin Strips(obsolete)]]
* [[triazolam]]
* [[Tussin Pediatric]]
* [[Tussinol for Dry Coughs]]
* [[Tylenol Simply Cough]]
* [[Valium]]
* [[Valrelease]]
* [[Versed]]
* [[Vicks 44 Cough Medicine]]
* [[Vicks 44 Cough Relief]]
* [[Vicks Formula 44]]
* [[Vicks Formula 44 for Dry Coughs]]
* [[Xanax]]
* [[Xanax XR]]
* [[Xenical]]
* [[Zetran]]
{{refend}}
 
 
 
 
 
{{FDA}}
 
 
 
[[Category:Drugs]]

Latest revision as of 00:42, 22 July 2014