In experiment 2, the same regimen of GSLS was administered to chickens inoculated with inactivated AI vaccines, and an enhanced serum antibody response to AI vaccination was also observed.


Methscopolamine may interact with antidepressants (tricyclic type), MAO inhibitors (e.g., phenelzine, linezolid, tranylcypromine, isocarboxazid, selegiline, furazolidone), quinidine, amantadine, antihistamines (e.g., diphenhydramine), other anticholinergics, potassium chloride supplements, antacids, absorbent-type anti-diarrhea medicines (e.g., kaolin-pectin), phenothiazines (e.g., chlorpromazine, promethazine).


Other drugs which may enhance the neuromuscular blocking action of nondepolarizing agents such as MIVACRON include certain antibiotics (e.g., aminoglycosides, tetracyclines, bacitracin, polymyxins, lincomycin, clindamycin, colistin, and sodium colistimethate), magnesium salts, lithium, local anesthetics, procainamide, and quinidine.


TOBI should not be administered concomitantly with ethacrynic acid, furosemide, urea, or mannitol.


Moxifloxacin and Lomefloxacin reacts faster with sucralfate and gelusil in acidic media whereas with erythromycin in basic media and multi-minerals in neutral media.


Trilostane may interact with aminoglutethimide or mitotane (causing too great a decrease in adrenal function).


Co-administration of SUTENT with inducers of the CYP3A4 family (e.g., dexamethasone, phenytoin, carbamazepine, rifampin, rifabutin, rifapentin, phenobarbital, St. Johns Wort) may decrease sunitinib concentrations.


Some drug interactions are:  - birth control pills - corticosteroids - medicines for angina or high blood pressure - medicines for pain - medicines to control seizures such as phenytoin or carbamazepine - certain antibiotics given by injection - cisplatin - edrophonium - neostigmine - polymyxin B or bacitracin - local anesthetics such as procaine - general anesthetics - succinylcholine or other muscle relaxants


Cholestyramine: Cholestyramine causes a 60% reduction in the absorption and enterohepatic cycling of raloxifene and should not be coadministered with EVISTA.


When a single 100 mg dose of rimantadine HCl was administered one hour after the initiation of Cimetidine (300 mg four times a day), the apparent total rimantadine clearance of this single dose in normal healthy adults was reduced by 18% (compared to the apparent total rimantadine clearance in the same subjects in the absence of cimetidine).


Drugs such as erythromycin, diltiazem, verapamil, ketoconazole, fluconazole and itraconazole were shown to significantly increase the C max and AUC of orally administered midazolam.


Absorption of tetracyclines is impaired by antacids containing aluminum, calcium or magnesium, and iron-containing preparations.


Phenytoin, Carbamazepine, and Rifampicin: In patients treated with potent inducers of CYP3A4 (i.e., phenytoin, carbamazepine, and rifampicin), the clearance of ondansetron was significantly increased and ondansetron blood concentrations were decreased.


Use with Other Central Nervous System Depressants: The depressant effects of morphine are potentiated by the presence of other CNS depressants such as alcohol, sedatives, antihistaminics, or psychotropic drugs.


Nevertheless, during concomitant therapy with furosemide and MOBIC, patients should be observed closely for signs of declining renal function, as well as to assure diuretic efficacy.


A multiple dose drug-drug interaction study demonstrated that ketoconazole approximately doubled paricalcitol AUC0-   . Since paricalcitol is partially metabolized by CYP3A and ketoconazole le is known to be a strong inhibitor of cytochrome P450 3A enzyme, care should be taken while dosing paricalcitol with ketoconazole and other strong P450 3A inhibitors including atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin or voriconazole.


These are described in greater detail below:  Oral hypoglycemics, Coumarin-type anticoagulants, Phenytoin, Cyclosporine, Rifampin, Theophylline, Terfenadine, Cisapride, Astemizole, Rifabutin, Tacrolimus, Short-acting benzodiazepines,  Oral hypoglycemics: Clinically significant hypoglycemia may be precipitated by the use of DIFLUCAN with oral hypoglycemic agents;


Warfarin users who initiated citalopram, fluoxetine, paroxetine, amitriptyline, or mirtazapine had an increased risk of hospitalization for gastrointestinal bleeding.


It may also interact with thiazides (increased thrombocytopenia), cyclosporine (increased nephrotoxicity), sulfonylurea agents (increased hypoglycemic response), warfarin (increased anticoagulant effect), methotrexate (decreased renal excretion of methotrexate), phenytoin (decreased hepatic clearance of phenytoin).


Caution should be exercised when Methergine    (methylergonovine maleate) is used concurrently with other vasoconstrictors or ergot alkaloids.


Mequitazine can interact with CNS depressant, antichlolinergic, TCA, MAOIs, and alcohol.


It is reasonable to employ appropriate clinical monitoring when potent cytochrome P450 enzyme inducers, such as phenobarbital or rifampin, are co-administered with montelukast.


MAO Inhibitors - The pressor effect of sympathomimetic pressor amines is markedly potentiated in patients receiving monoamine oxidase inhibitors (MAOI).


Ticlopidine treatment increased the mean area under the plasma concentration-time curve extrapolated to infinity (AUC(0-   )) of oral ketamine by 2.4-fold, whereas itraconazole treatment did not increase the exposure to S-ketamine.


Interactions for Vitamin B1 (Thiamine):  Loop Diuretics, Oral Contraceptives, Stavudine, Tricyclic Antidepressants


Although this has not occurred in in vitro studies with coumarin-type anticoagulants, interactions with coumarin-type anticoagulants have been reported with FELDENE since marketing, therefore, physicians should closely monitor patients for a change in dosage requirements when administering FELDENE to patients on coumarin-type anticoagulants and other highly protein-bound drugs.


Accordingly, patients should be advised to avoid alcohol while taking REMERON SolTab. Diazepam: Concomitant administration of diazepam (15 mg) had a minimal effect on plasma levels of mirtazapine (15 mg) in 12 healthy subjects.


Ritalin may decrease the hypotensive effect of guanethidine.


Methscopolamine may interact with antidepressants (tricyclic type), MAO inhibitors (e.g., phenelzine, linezolid, tranylcypromine, isocarboxazid, selegiline, furazolidone), quinidine, amantadine, antihistamines (e.g., diphenhydramine), other anticholinergics, potassium chloride supplements, antacids, absorbent-type anti-diarrhea medicines (e.g., kaolin-pectin), phenothiazines (e.g., chlorpromazine, promethazine).


Patients receiving tacrolimus and fluconazole concomitantly should be carefully monitored.


Antacids: Absorption of a single dose of Myfortic was decreased when administered to 12 stable renal transplant patients also taking magnesium-aluminum containing antacids (30 mL): the mean Cmax and AUC(0-t) values for MPA were 25% and 37% lower, respectively, than when Myfortic was administered alone under fasting conditions.


Hyaluronidase: Hyaluronidase may increase the diffusion rate of procaine hydrochloride, resulting in a decreased time of onset, but an increase in systemic toxicity.


Patients with mild to moderate renal insufficiency should avoid taking NSAIDs with short elimination half-lives for a period of 2 days before, the day of, and 2 days following administration of ALIMTA.


Melatonin may interact with the following drugs: aspirin and other NSAIDs (may lower melatonin levels), fluvoxamine (bioavailability of oral melatonin is increased with coadministration), beta blockers (may decrease melatonin levels), fluoxetine (reports of psychotic episodes when coadministered), progestin (coadministration of melatonin with progestin can inhibit ovarian function in women), benzodiazepenes and other sedating drugs (may result in additive sedation and an increased incidence of adverse effects), and corticosteroids (coadministration of melatonin and corticosteroids may interfere with the efficacy of the corticosteroids).


The neuromuscular blocking effect of MIVACRON may be enhanced by drugs that reduce plasma cholinesterase activity (e.g., chronically administered oral contraceptives, glucocorticoids, or certain monoamine oxidase inhibitors) or by drugs that irreversibly inhibit plasma cholinesterase . Resistance to the neuromuscular blocking action of nondepolarizing neuromuscular blocking agents has been demonstrated in patients chronically administered phenytoin or carbamazepine.


Co-administration of SUTENT with strong inhibitors of the CYP3A4 family (e.g., ketoconazole, itraconazole, clarithromycin, atazanavir, indinavir, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, voriconizole) may increases sunitinib concentrations.


A multiple dose drug-drug interaction study demonstrated that ketoconazole approximately doubled paricalcitol AUC0-   . Since paricalcitol is partially metabolized by CYP3A and ketoconazole le is known to be a strong inhibitor of cytochrome P450 3A enzyme, care should be taken while dosing paricalcitol with ketoconazole and other strong P450 3A inhibitors including atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin or voriconazole.


In clinical studies, patients on opioids often needed higher serum pegvisomant concentrations to achieve appropriate IGF-I suppression compared with patients not receiving opioids.


There is usually complete cross-resistance between PURINETHOL (mercaptopurine) and TABLOID brand Thioguanine.


Some drug interactions are:  - birth control pills - corticosteroids - medicines for angina or high blood pressure - medicines for pain - medicines to control seizures such as phenytoin or carbamazepine - certain antibiotics given by injection - cisplatin - edrophonium - neostigmine - polymyxin B or bacitracin - local anesthetics such as procaine - general anesthetics - succinylcholine or other muscle relaxants


The authors report the case of an infant with confirmed congenital hypothyroidism on levothyroxine who experienced a possible drug interaction with simeticone.


Before taking this medication, tell your doctor if you are taking a tricyclic antidepressant such as amitriptyline (Elavil), amoxapine (Asendin), doxepin (Sinequan), nortriptyline (Pamelor), imipramine (Tofranil), clomipramine (Anafranil), protriptyline (Vivactil), or desipramine (Norpramin).


Coadministration with a high dose of antacid (170 mEq) results in a 28% decrease in plasma concentrations of ranitidine and may decrease plasma concentrations of bismuth from TRITEC.


Mixing SYMLIN and Insulin The pharmacokinetic parameters of SYMLIN were altered when mixed with regular, NPH, and 70/30 premixed formulations of recombinant human insulin immediately prior to injection.


Use with Other Central Nervous System Depressants: The depressant effects of morphine are potentiated by the presence of other CNS depressants such as alcohol, sedatives, antihistaminics, or psychotropic drugs.


Anticoagulants Anabolic steroids may increase sensitivity to oral anticoagulants.


Therefore, the coadministration of probenecid with meropenem is not recommended.


Due to the chemical similarity of other azole-type antifungal agents (including fluconazole, metronidazole, and miconazole) to ketoconazole, and itraconazole, concomitant use of these products with terfenadine is not recommended pending full examination of potential interactions.


Scopolamine should be used with care in patients taking other drugs that are capable of causing CNS effects such as sedatives, tranquilizers, or alcohol.


Moxifloxacin and Lomefloxacin reacts faster with sucralfate and gelusil in acidic media whereas with erythromycin in basic media and multi-minerals in neutral media.


Depending on clinical circumstances, consideration should be given to increasing the dose of DIFLUCAN when it is administered with rifampin.


Dosages of concomitantly administered opioids should be reduced by approximately half, because levomepromazine amplifies the therapeutic actions and side-effects of opioids.


Other drugs eliminated via renal secretion: Population pharmacokinetic analysis suggests that coadministration of drugs that are secreted by the cationic transport system (e.g., cimetidine, ranitidine, diltiazem, triamterene, verapamil, quinidine, and quinine) decreases the oral clearance of pramipexole by about 20%, while those secreted by the anionic transport system (e.g., cephalosporins, penicillins, indomethacin, hydrochlorothiazide, and chlorpropamide) are likely to have little effect on the oral clearance of pramipexole.


Concomitant administration of terfenadine with clarithromycin, erythromycin, or troleandomycin is contraindicated: Pending full characterization of potential interactions, concomitant administration of terfenadine with other macrolide antibiotics, including azithromycin, is not recommended.


Due to its effects on gastric emptying, SYMLIN therapy should not be considered for patients taking drugs that alter gastrointestinal motility (e.g., anticholinergic agents such as atropine) and agents that slow the intestinal absorption of nutrients (e.g., alpha glucosidase inhibitors).


It is reasonable to employ appropriate clinical monitoring when potent cytochrome P450 enzyme inducers, such as phenobarbital or rifampin, are co-administered with montelukast.


In clinical studies of TOBI, patients taking TOBI concomitantly with dornase alfa (PULMOZYME   , Genentech), (beta)-agonists, inhaled corticosteroids, other anti-pseudomonal antibiotics, or parenteral aminoglycosides demonstrated adverse experience profiles similar to the study population as a whole.


Mitotane has been reported to accelerate the metabolism of warfarin by the mechanism of hepatic microsomal enzyme induction, leading to an increase in dosage requirements for warfarin.


This is especially true if the total dose of atropine has been large and the administration of pralidoxime has been delayed.


You cannot take mazindol if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), tranylcypromine (Parnate), or phenelzine (Nardil) in the last 14 days.


HEY cells treated with dasatinib plus paclitaxel formed fewer colonies than did cells treated with either agent alone.


Although a causal relationship has not been established, there have been reports of bleeding and/or prolonged prothrombin time in patients treated with TRENTAL with and without anticoagulants or platelet aggregation inhibitors.


ProAmatine. Alpha-adrenergic blocking agents, such as prazosin, terazosin, and doxazosin, can antagonize the effects of ProAmatine. Potential for Drug Interactions: It appears possible, although there is no supporting experimental evidence, that the high renal clearance of desglymidodrine (a base) is due to active tubular secretion by the base-secreting system also responsible for the secretion of such drugs as metformin, cimetidine, ranitidine, procainamide, triamterene, flecainide, and quinidine.


MAO Inhibitors: The pressor effect of sympathomimetic pressor amines is markedly potentiated in patients receiving monoamine oxidase inhibitors (MAOI).


Co-administration of SUTENT with strong inhibitors of the CYP3A4 family (e.g., ketoconazole, itraconazole, clarithromycin, atazanavir, indinavir, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, voriconizole) may increases sunitinib concentrations.


Sunitinib as a single agent exhibits anti-proliferative effects in vitro in NSCLC cell lines with EGFR T790M and K-ras mutations but the sequential administration of docetaxel followed by sunitinib is superior to sunitinib followed by docetaxel and concurrent administration.


No significant adverse interactions with common premedications (such as atropine, scopolamine, glycopyrrolate, diazepam, hydroxyzine, and other muscle relaxants) or local anesthetics have been observed.


The use of drugs that stimulate alpha-adrenergic receptors (e.g., phenylephrine, pseudoephedrine, ephedrine, phenylpropanolamine or dihydroergotamine) may enhance or potentiate the pressor effects of ProAmatine   . Therefore, caution should be used when ProAmatine    is administered concomitantly with agents that cause vasoconstriction.


Other eye drops or medications such as acetylcholine chloride (Miochol) and carbachol (Carboptic, Isopto Carbachol) may decrease the effects of suprofen ophthalmic.


Use of Anticoagulants and Antiplatelet Agents -- Streptase, Streptokinase, alone or in combination with antiplatelet agents and anticoagulants, may cause bleeding complications.


Patients who take both ezetimibe and cyclosporine should be carefully monitored.


Other drugs which may enhance the neuromuscular blocking action of nondepolarizing agents such as MIVACRON include certain antibiotics (e.g., aminoglycosides, tetracyclines, bacitracin, polymyxins, lincomycin, clindamycin, colistin, and sodium colistimethate), magnesium salts, lithium, local anesthetics, procainamide, and quinidine.


Treatment of HEY xenograft-bearing mice with dasatinib plus paclitaxel inhibited tumor growth more than treatment with either agent alone (average tumor volume per mouse, dasatinib + paclitaxel vs paclitaxel: 0.28 vs. 0.81 cm3, difference = 0.53 cm3, 95% confidence interval [CI] = 0.44 to 0.62 cm3, P = .014);


Interactions for Vitamin B1 (Thiamine):  Loop Diuretics, Oral Contraceptives, Stavudine, Tricyclic Antidepressants


Mephenytoin may also affect the effects of other drugs, which include some steroid medications, warfarin, certain heart medicines, birth control pills, anti-infective medicines, furosemide and theophylline Please note that Mephenytoin may interact with other drugs that are not listed here.


Short-acting Benzodiazepines: Following oral administration of midazolam, fluconazole resulted in substantial increases in midazolam concentrations and psychomotor effects.


A multiple dose drug-drug interaction study demonstrated that ketoconazole approximately doubled paricalcitol AUC0-   . Since paricalcitol is partially metabolized by CYP3A and ketoconazole le is known to be a strong inhibitor of cytochrome P450 3A enzyme, care should be taken while dosing paricalcitol with ketoconazole and other strong P450 3A inhibitors including atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin or voriconazole.


Anticoagulants (such as heparin and vitamin K antagonists) and drugs that alter platelet function (such as acetylsalicylic acid, dipyridamole, and GP IIb/IIIa inhibitors) may increase the risk of bleeding if administered prior to, during, or after TNKase therapy.


ARAMINE should be used with caution in digitalized patients, since the combination of digitalis and sympathomimetic amines may cause ectopic arrhythmias.


Salicylate competes with a number of drugs for protein binding sites, notably penicillin, thiopental, thyroxine, triiodothyronine, phenytoin, sulfinpyrazone, naproxen, warfarin, methotrexate, and possibly corticosteroids.


Drug Interactions: Inhibitors of CYP3A4 Isozymes: Caution is advised when midazolam is administered concomitantly with drugs that are known to inhibit the cytochrome P450 3A4 enzyme system (ie, some drugs in the drug classes of azole antimycotics, protease inhibitors, calcium channel antagonists, and macrolide antibiotics).


We also found that Bcl-2 was overexpressed in DZNep insensitive cells, and cotreatment with DZNep and ABT-737, a Bcl-2 family inhibitor, synergistically inhibited growth and induced apoptosis of DZNep insensitive MM cells.


Cholestyramine: Cholestyramine causes a 60% reduction in the absorption and enterohepatic cycling of raloxifene and should not be coadministered with EVISTA.


Ticagrelor (Brilinta)--better than clopidogrel (Plavix)


In a formal, single-dose interaction study (n = 6 males) the clearance of mexiletine was decreased by 38% following the coadministration of fluvoxamine, an inhibitor of CYP1A2.


AAV2-mediated retinal transduction is improved by co-injection of heparinase III or chondroitin ABC lyase.


Astemizole: The use of fluconazole in patients concurrently taking astemizole or other drugs metabolized by the cytochrome P450 system may be associated with elevations in serum levels of these drugs.


Barbiturates may decrease the effectiveness of oral contraceptives, certain antibiotics, quinidine, theophylline, corticosteroids, anticoagulants, and beta blockers.


The concurrent administration of potent inhalational agents (eg, isoflurane, enflurane, and halothane) during maintenance with DIPRIVAN Injectable Emulsion has not been extensively evaluated.


There is usually complete cross-resistance between PURINETHOL (mercaptopurine) and TABLOID brand Thioguanine.


Therefore, physicians should closely monitor patients for a change in anticoagulant dosage requirements when administering Mitotane to patients on coumarin-type anticoagulants.


When phenytoin or other hepatic enzyme inducers such as rifampin and phenobarbital have been taken concurrently with Mexitil   , lowered Mexitil    plasma levels have been reported.


Synergistic interaction between sunitinib and docetaxel is sequence dependent in human non-small lung cancer with EGFR TKIs-resistant mutation.


Caution should be used when administering MOBIC with warfarin since patients on warfarin may experience changes in INR and an increased risk of bleeding complications when a new medication is introduced.


however, as with other NSAIDs, concomitant administration of meloxicam and aspirin is not generally recommended because of the potential for increased adverse effects.


The bioavailability of SKELID is decreased 80% by calcium, when calcium and SKELID are administered at the same time, and 60% by some aluminum- or magnesium-containing antacids, when administered 1 hour before SKELID.


The following agents may increase certain actions or side effects of anticholinergic drugs: amantadine, antiarrhythmic agents of class I (e.g., quinidine), antihistamines, antipsychotic agents (e.g., phenothiazines), benzodiazepines, MAO inhibitors, narcotic analgesics (e.g., meperidine), nitrates and nitrites, sympathomimetic agents, tricyclic antidepressants, and other drugs having anticholinergic activity.


In addition, DZNep insensitivity might be associated with overexpression of Bcl-2, and the combination of ABT-737 and DZNep could synergistically induced apoptosis.


Sulfoxone may increase the effects of barbiturates, tolbutamide, and uricosurics.


While no formal drug interaction studies have been performed, the following concomitant drugs were used in at least 10% of patients in either or both Sj   grens efficacy studies: acetylsalicylic acid, artificial tears, calcium, conjugated estrogens, hydroxychloroquine sulfate, ibuprofen, levothyroxine sodium, medroxyprogesterone acetate, methotrexate, multivitamins, naproxen, omeprazole, paracetamol, and prednisone.


The sedative effect of VERSED Syrup is accentuated by any concomitantly administered medication which depresses the central nervous system, particularly narcotics (eg, morphine, meperidine and fentanyl), propofol, ketamine, nitrous oxide, secobarbital and droperidol.


Concurrent administration of bacteriostatic antibiotics (e.g., erythromycin, tetracycline) may diminish the bactericidal effects of penicillins by slowing the rate of bacterial growth.


Before taking this medication, tell your doctor if you are taking a tricyclic antidepressant such as amitriptyline (Elavil), amoxapine (Asendin), doxepin (Sinequan), nortriptyline (Pamelor), imipramine (Tofranil), clomipramine (Anafranil), protriptyline (Vivactil), or desipramine (Norpramin).


Inhibition of Src family and Abl kinases with either siRNAs or dasatinib enhances paclitaxel sensitivity of ovarian cancer cells through p27(Kip1)-mediated suppression of Bcl-2 and Cdk1 expression.


The molecular basis of this synergism is that the signaling pathways that were initially activated by docetaxel exposure were efficiently suppressed by the subsequent exposure to sunitinib.


It is recommended that Myfortic and antacids not be administered simultaneously.


Cisapride: There have been reports of cardiac events, including torsade de pointes in patients to whom fluconazole and cisapride were coadministered.


Use of Anticoagulants and Antiplatelet Agents -- Streptase, Streptokinase, alone or in combination with antiplatelet agents and anticoagulants, may cause bleeding complications.


Other drugs eliminated via renal secretion: Population pharmacokinetic analysis suggests that coadministration of drugs that are secreted by the cationic transport system (e.g., cimetidine, ranitidine, diltiazem, triamterene, verapamil, quinidine, and quinine) decreases the oral clearance of pramipexole by about 20%, while those secreted by the anionic transport system (e.g., cephalosporins, penicillins, indomethacin, hydrochlorothiazide, and chlorpropamide) are likely to have little effect on the oral clearance of pramipexole.


Methscopolamine may interact with antidepressants (tricyclic type), MAO inhibitors (e.g., phenelzine, linezolid, tranylcypromine, isocarboxazid, selegiline, furazolidone), quinidine, amantadine, antihistamines (e.g., diphenhydramine), other anticholinergics, potassium chloride supplements, antacids, absorbent-type anti-diarrhea medicines (e.g., kaolin-pectin), phenothiazines (e.g., chlorpromazine, promethazine).


Additionally, in one controlled study in five normal subjects and seven patients, the clearance of caffeine was decreased 50% following the administration of Mexitil   .


Sympathomimetics may reduce the antihypertensive effects of methyldopa, mecamylamine, reserpine and veratrum alkaloids.


Important Non-Thalidomide Drug Interactions Drugs That Interfere with Hormonal Contraceptives: Concomitant use of HIV-protease inhibitors, griseofulvin, modafinil, penicillins, rifampin, rifabutin, phenytoin, carbamazepine, or certain herbal supplements such as St.


Drugs Eliminated by Active Tubular Secretion: Although studies to assess drug-drug interactions with Sanctura have not been conducted, Sanctura has the potential for pharmacokinetic interactions with other drugs that are eliminated by active tubular secretion (e.g. digoxin, procainamide, pancuronium, morphine, vancomycin, metformin and tenofovir).


Interaction with Other Central Nervous System Depressants: MEPERIDINE SHOULD BE USED WITH GREAT CAUTION AND IN REDUCED DOSAGE IN PATIENTS WHO ARE CONCURRENTLY RECEIVING OTHER NARCOTIC ANALGESICS, GENERAL ANESTHETICS, PHENOTHIAZINES, OTHER TRANQUILIZERS, SEDATIVE-HYPNOTICS (INCLUDING BARBITURATES), TRICYCLIC ANTIDEPRESSANTS AND OTHER CNS DEPRESSANTS (INCLUDING ALCOHOL).


Other drugs which may enhance the neuromuscular blocking action of nondepolarizing agents such as MIVACRON include certain antibiotics (e.g., aminoglycosides, tetracyclines, bacitracin, polymyxins, lincomycin, clindamycin, colistin, and sodium colistimethate), magnesium salts, lithium, local anesthetics, procainamide, and quinidine.


Mequitazine can interact with CNS depressant, antichlolinergic, TCA, MAOIs, and alcohol.


However, ketoconazole, a potent inhibitor of cytochrome P450 3A4, may increase plasma levels of mometasone furoate during concomitant dosing.


Additive sedative effects can occur when metoclopramide is given with alcohol, sedatives, hypnotics, narcotics, or tranquilizers.


dasatinib + paclitaxel vs.


Additive sedative effects and confusional states may emerge if levomepromazine is given with benzodiazepines or barbiturates.


The finding that metoclopramide releases catecholamines in patients with essential hypertension suggests that it should be used cautiously, if at all, in patients receiving monoamine oxi-dase inhibitors.


In drug-interaction studies, the recommended clinical dose of montelukast did not have clinically important effects on the pharmacokinetics of the following drugs: theophylline, prednisone, prednisolone, oral contraceptives (norethindrone 1 mg/ethinyl estradiol 35 mcg), terfenadine, digoxin, and warfarin.


This implies that in vivo hepatic and first-pass CYP3A activities are significantly lower in patients receiving cyclosporine than in those receiving tacrolimus, indicating that, at the doses generally used in clinical practice, cyclosporine is the stronger of the two with respect to CYP3A inhibition.


The incremental LDL-C reduction due to adding ezetimibe to cholestyramine may be reduced by this interaction.


When cells were exposed to docetaxel followed by sunitinib, synergism was observed.


Based on studies evaluating possible interactions of pantoprazole with other drugs, no dosage adjustment is needed with concomitant use of the following: theophylline, cisapride, antipyrine, caffeine, carbamazepine, diazepam (and its active metabolite, desmethyldiazepam), diclofenac, naproxen, piroxicam, digoxin, ethanol, glyburide, an oral contraceptive (levonorgestrel/ethinyl estradiol), metoprolol, nifedipine, phenytoin, warfarin, midazolam, clarithromycin, metronidazole, or amoxicillin.


Caution is advised for patients receiving high-dose aspirin and methazolamide concomitantly, as anorexia, tachypnea, lethargy, coma and death have been reported with concomitant use of high-dose aspirin and carbonic anhydrase inhibitors.


Barbiturates may decrease the effectiveness of oral contraceptives, certain antibiotics, quinidine, theophylline, corticosteroids, anticoagulants, and beta blockers.


An inhibitor of CYP2C8 (such as gemfibrozil) may increase the AUC of rosiglitazone and an inducer of CYP2C8 (such as rifampin) may decrease the AUC of rosiglitazone.


For patients receiving ketoconazole or other potent CYP3A4 inhibitors such as other azole antifungals (eg, itraconazole, miconazole) or macrolide antibiotics (eg, erythromycin, clarithromycin) or cyclosporine or vinblastine, the recommended dose of DETROL LA is 2 mg daily.


Therefore, the use of sumatriptan succinate tablets in patients receiving MAO-A inhibitors is contraindicated . Selective serotonin reuptake inhibitors (SSRIs) (e.g., fluoxetine, fluvoxamine, paroxetine, sertraline) have been reported, rarely, to cause weakness, hyperreflexia, and incoordination when coadministered with sumatriptan.


In post-marketing experience, as with other azole antifungals, bleeding events (bruising, epistaxis, gastrointestinal bleeding, hematuria, and melena) have been reported in association with increases in prothrombin time in patients receiving fluconazole concurrently with warfarin.


Examples of some of the more potent CYP 3A4 inhibitors include macrolide antibiotics (e.g., erythromycin, troleandomycin, clarithromycin), HIV protease or reverse transcriptase inhibitors (e.g., ritonavir, indinavir, nelfinavir, delavirdine) or azole antifungals (e.g., ketoconazole, itraconazole, voriconazole).


Other drugs which may enhance the neuromuscular blocking action of nondepolarizing agents such as MIVACRON include certain antibiotics (e.g., aminoglycosides, tetracyclines, bacitracin, polymyxins, lincomycin, clindamycin, colistin, and sodium colistimethate), magnesium salts, lithium, local anesthetics, procainamide, and quinidine.


Melatonin may interact with the following drugs: aspirin and other NSAIDs (may lower melatonin levels), fluvoxamine (bioavailability of oral melatonin is increased with coadministration), beta blockers (may decrease melatonin levels), fluoxetine (reports of psychotic episodes when coadministered), progestin (coadministration of melatonin with progestin can inhibit ovarian function in women), benzodiazepenes and other sedating drugs (may result in additive sedation and an increased incidence of adverse effects), and corticosteroids (coadministration of melatonin and corticosteroids may interfere with the efficacy of the corticosteroids).


Human pharmacologic studies have shown that Ritalin may inhibit the metabolism of coumarin anticoagulants, anticonvulsants (phenobarbital, diphenylhydantoin, primidone), phenylbutazone, and tricyclic drugs (imipramine, clomipramine, desipramine).


The following agents may increase certain actions or side effects of anticholinergic drugs: amantadine, antiarrhythmic agents of class I (e.g., quinidine), antihistamines, antipsychotic agents (e.g., phenothiazines), benzodiazepines, MAO inhibitors, narcotic analgesics (e.g., meperidine), nitrates and nitrites, sympathomimetic agents, tricyclic antidepressants, and other drugs having anticholinergic activity.


Therefore, caution should be exercised with concomitant administration of warfarin and FLOMAX capsules.


Concomitant administration of terfenadine with clarithromycin, erythromycin, or troleandomycin is contraindicated: Pending full characterization of potential interactions, concomitant administration of terfenadine with other macrolide antibiotics, including azithromycin, is not recommended.


Phenytoin, Carbamazepine, and Rifampicin: In patients treated with potent inducers of CYP3A4 (i.e., phenytoin, carbamazepine, and rifampicin), the clearance of ondansetron was significantly increased and ondansetron blood concentrations were decreased.


Usage with Alcohol: Due to the potential for increased CNS depressants effects, alcohol should be used with caution in patients who are currently receiving pentazocine.


Therefore, do not administer Myfortic with cholestyramine or other agents that may interfere with enterohepatic recirculation or drugs that may bind bile acids, for example bile acid sequestrates or oral activated charcoal, because of the potential to reduce the efficacy of Myfortic.


Interaction with Mixed Agonist/Antagonist Opioid Analgesics: Agonist/antagonist analgesics (i.e., pentazocine, nalbuphine, butorphanol, or buprenorphine) should NOT be administered to patients who have received or are receiving a course of therapy with a proof opioid agonist analgesic.


Co-administration of SUTENT with inducers of the CYP3A4 family (e.g., dexamethasone, phenytoin, carbamazepine, rifampin, rifabutin, rifapentin, phenobarbital, St. Johns Wort) may decrease sunitinib concentrations.


Patients treated with proton pump inhibitors and warfarin concomitantly should be monitored for increases in INR and prothrombin time.


Changes in insulin and other diabetes drug therapies may be necessary during treatment with mazindol.


Before taking this medication, tell your doctor if you are taking a tricyclic antidepressant such as amitriptyline (Elavil), amoxapine (Asendin), doxepin (Sinequan), nortriptyline (Pamelor), imipramine (Tofranil), clomipramine (Anafranil), protriptyline (Vivactil), or desipramine (Norpramin).


Anticoagulants (such as heparin and vitamin K antagonists) and drugs that alter platelet function (such as acetylsalicylic acid, dipyridamole, and GP IIb/IIIa inhibitors) may increase the risk of bleeding if administered prior to, during, or after TNKase therapy.


Dopamine antagonists: Since pramipexole is a dopamine agonist, it is possible that dopamine antagonists, such as the neuroleptics (phenothiazines, butyrophenones, thioxanthenes) or metoclopramide, may diminish the effectiveness of MIRAPEX.


The concomitant use of oxybutynin with other anticholinergic drugs or with other agents which produce dry mouth, constipation, somnolence (drowsiness), and/or other anticholinergic-like effects may increase the frequency and/or severity of such effects.


However, the impairment of cognitive and motor skills produced by REMERON    were shown to be additive with those produced by alcohol.


We found antagonism between celecoxib and the four drugs in the breast cancer cells MCF7 following all incubation schedules and between celecoxib and doxorubicin in all cell lines except for two combinations in HCT116 cells.


Use of potassium-sparing diuretics (spironolactone, amiloride, triamterene and others), potassium supplements or other drugs capable of increasing serum potassium (indomethacin, heparin, cyclosporine and others) can increase the risk of hyperkalemia.


Plasma levels of piroxicam are depressed to approximately 80% of their normal values when FELDENE is administered in conjunction with aspirin (3900 mg/day), but concomitant administration of antacids has no effect on piroxicam plasma levels . Nonsteroidal anti-inflammatory agents, including FELDENE, have been reported to increase steady state plasma lithium levels.


Drugs such as erythromycin, diltiazem, verapamil, ketoconazole, fluconazole and itraconazole were shown to significantly increase the C max and AUC of orally administered midazolam.


The occurrence of stupor, muscular rigidity, severe agitation, and elevated temperature has been reported in some patients receiving the combination of selegiline and meperidine.


Melatonin may interact with the following drugs: aspirin and other NSAIDs (may lower melatonin levels), fluvoxamine (bioavailability of oral melatonin is increased with coadministration), beta blockers (may decrease melatonin levels), fluoxetine (reports of psychotic episodes when coadministered), progestin (coadministration of melatonin with progestin can inhibit ovarian function in women), benzodiazepenes and other sedating drugs (may result in additive sedation and an increased incidence of adverse effects), and corticosteroids (coadministration of melatonin and corticosteroids may interfere with the efficacy of the corticosteroids).


- Cisapride, pimozide: Other drugs such as cisapride or pimozide, which are metabolised by hepatic CYP3A isozymes have been associated with QT interval prolongation and/or cardiac arrythmias (typically torsades de pointe) as a result of increase in their serum level subsequent to interaction with significant inhibitors of the isozyme, including some macrolide antibacterials.


Sulfamethizole may increase the effects of barbiturates, tolbutamide, and uricosurics.


The sedative effect of VERSED Syrup is accentuated by any concomitantly administered medication which depresses the central nervous system, particularly narcotics (eg, morphine, meperidine and fentanyl), propofol, ketamine, nitrous oxide, secobarbital and droperidol.


Although this has not occurred in in vitro studies with coumarin-type anticoagulants, interactions with coumarin-type anticoagulants have been reported with FELDENE since marketing, therefore, physicians should closely monitor patients for a change in dosage requirements when administering FELDENE to patients on coumarin-type anticoagulants and other highly protein-bound drugs.


Posicor inhibits some of the liver's ability to metabolize some other drugs - terfenadine, astemizole, cisapride, cyclosporine, and tricyclic antidepressants.


Salicylates and Other Non-Steroidal Anti-Inflammatory Drugs: May decrease the antihypertensive effects of MYKROX Tablets.


Other drugs eliminated via renal secretion: Population pharmacokinetic analysis suggests that coadministration of drugs that are secreted by the cationic transport system (e.g., cimetidine, ranitidine, diltiazem, triamterene, verapamil, quinidine, and quinine) decreases the oral clearance of pramipexole by about 20%, while those secreted by the anionic transport system (e.g., cephalosporins, penicillins, indomethacin, hydrochlorothiazide, and chlorpropamide) are likely to have little effect on the oral clearance of pramipexole.


Calcium doses   1000 mg diminished nonheme iron absorption by an average of 49.6%.


Other inhibitors of the cytochrome P450 3A4 enzyme system, such as antimycotic agents (e.g., itraconazole and miconazole) or macrolide antibiotics (e.g., erythromycin and clarithromycin), may alter oxybutynin mean pharmacokinetic parameters (i.e., Cmax and AUC).


Curariform Drugs: Diuretic-induced hypokalemia may enhance neuromuscular blocking effects of curariform drugs (such as tubocurarine) the most serious effect would be respiratory depression which could proceed to apnea.


Montelukast at Doses of    100 mg Daily Dosed to Pharmacokinetic Steady State:  - did not significantly alter the plasma concentrations of either component of an oral contraceptive containing norethindrone 1 mg/ethinyl estradiol 35 mcg.


Calcium is the only known component in the diet that may affect absorption of both nonheme and heme iron.


Barbiturates may decrease the effectiveness of oral contraceptives, certain antibiotics, quinidine, theophylline, corticosteroids, anticoagulants, and beta blockers.


Oral Contraceptives: In 10 healthy women, the pharmacokinetic profiles of norethindrone and ethinyl estradiol following administration of a single dose containing 1.0 mg of norethindrone acetate and 75    g of ethinyl estradiol were studied.


Methscopolamine may interact with antidepressants (tricyclic type), MAO inhibitors (e.g., phenelzine, linezolid, tranylcypromine, isocarboxazid, selegiline, furazolidone), quinidine, amantadine, antihistamines (e.g., diphenhydramine), other anticholinergics, potassium chloride supplements, antacids, absorbent-type anti-diarrhea medicines (e.g., kaolin-pectin), phenothiazines (e.g., chlorpromazine, promethazine).


Although specific drug or food interactions with mifepristone have not been studied, on the basis of this drug   s metabolism by CYP 3A4, it is possible that ketoconazole, itraconazole, erythromycin, and grapefruit juice may inhibit its metabolism (increasing serum levels of mifepristone).


Several studies demonstrate a decrease in the bioavailability of methyldopa when it is ingested with ferrous sulfate or ferrous gluconate.


Concomitant treatment with NEXAVAR resulted in a 21% increase in the AUC of doxorubicin.


Drugs that impair intestinal absorption of fat-soluble vitamins, such as cholestyramine, may interfere with the absorption of Zemplar Capsules.


norepinephrine and dobutamine are incompatible with sodium bicarbonate solution.


Based on studies evaluating possible interactions of pantoprazole with other drugs, no dosage adjustment is needed with concomitant use of the following: theophylline, cisapride, antipyrine, caffeine, carbamazepine, diazepam (and its active metabolite, desmethyldiazepam), diclofenac, naproxen, piroxicam, digoxin, ethanol, glyburide, an oral contraceptive (levonorgestrel/ethinyl estradiol), metoprolol, nifedipine, phenytoin, warfarin, midazolam, clarithromycin, metronidazole, or amoxicillin.


Since Celontin (methsuximide) may interact with concurrently administered antiepileptic drugs, periodic serum level determinations of these drugs may be necessary (eg methsuximide may increase the plasma concentrations of phenytoin and phenobarbital).


The following agents may increase certain actions or side effects of anticholinergic drugs: amantadine, antiarrhythmic agents of class I (e.g., quinidine), antihistamines, antipsychotic agents (e.g., phenothiazines), benzodiazepines, MAO inhibitors, narcotic analgesics (e.g., meperidine), nitrates and nitrites, sympathomimetic agents, tricyclic antidepressants, and other drugs having anticholinergic activity.


Evidence of spontaneous recovery from succinylcholine should be observed before the administration of MIVACRON.


One case of hypertensive crisis has been reported in a patient taking the recommended doses of selegiline and a sympathomimetic medication (ephedrine).


Phenothiazines are capable of potentiating CNS depressants (e.g., barbiturates, anesthetics, opiates, alcohol, etc.)


Lithium: In clinical trials, NSAIDs have produced an elevation of plasma lithium levels and a reduction in renal lithium clearance.


Salicylate competes with a number of drugs for protein binding sites, notably penicillin, thiopental, thyroxine, triiodothyronine, phenytoin, sulfinpyrazone, naproxen, warfarin, methotrexate, and possibly corticosteroids.


In a study in which 34 different drugs were tested, therapeutically relevant concentrations of tolbutamide, sodium salicylate and sulfamethizole displaced protein-bound teniposide in fresh human serum to a small but significant extent.


An increase in intracellular levels of methotrexate was observed in vitro in the presence of teniposide.


Drugs that induce hepatic enzymes such as phenobarbital, phenytoin and rifampin may increase the clearance of corticosteroids and may require increases in corticosteroid dose to achieve the desired response.


While the effects of chronic phenytoin or carbamazepine therapy on the action of MIVACRON are unknown, slightly shorter durations of neuromuscular block may be anticipated and infusion rate requirements may be higher.


Methscopolamine may interact with antidepressants (tricyclic type), MAO inhibitors (e.g., phenelzine, linezolid, tranylcypromine, isocarboxazid, selegiline, furazolidone), quinidine, amantadine, antihistamines (e.g., diphenhydramine), other anticholinergics, potassium chloride supplements, antacids, absorbent-type anti-diarrhea medicines (e.g., kaolin-pectin), phenothiazines (e.g., chlorpromazine, promethazine).


Some drug interactions are:  - birth control pills - corticosteroids - medicines for angina or high blood pressure - medicines for pain - medicines to control seizures such as phenytoin or carbamazepine - certain antibiotics given by injection - cisplatin - edrophonium - neostigmine - polymyxin B or bacitracin - local anesthetics such as procaine - general anesthetics - succinylcholine or other muscle relaxants


Acute administration of hemantane or doxycycline failed to influence locomotion in mice, while their combination normalized motor activity.


Other drugs which may enhance the neuromuscular blocking action of nondepolarizing agents such as MIVACRON include certain antibiotics (e.g., aminoglycosides, tetracyclines, bacitracin, polymyxins, lincomycin, clindamycin, colistin, and sodium colistimethate), magnesium salts, lithium, local anesthetics, procainamide, and quinidine.


Do not exceed a 5 mg daily dose of VESIcare when administered with therapeutic doses of ketoconazole or other potent CYP3A4 inhibitors.


Several studies demonstrate a decrease in the bioavailability of methyldopa when it is ingested with ferrous sulfate or ferrous gluconate.


In vitro studies with human liver microsomes showed that terbinafine does not inhibit the metabolism of tolbutamide, ethinylestradiol, ethoxycoumarin, and cyclosporine.


ProAmatine. Alpha-adrenergic blocking agents, such as prazosin, terazosin, and doxazosin, can antagonize the effects of ProAmatine. Potential for Drug Interactions: It appears possible, although there is no supporting experimental evidence, that the high renal clearance of desglymidodrine (a base) is due to active tubular secretion by the base-secreting system also responsible for the secretion of such drugs as metformin, cimetidine, ranitidine, procainamide, triamterene, flecainide, and quinidine.


If at all possible guanethidine should be discontinued well before minoxidil is begun.


In the absence of data regarding potential interaction between ALIMTA and NSAIDs with longer half-lives, all patients taking these NSAIDs should interrupt dosing for at least 5 days before, the day of, and 2 days following ALIMTA administration.


If a diuretic is also used, the risk of lithium toxicity may be increased.


Interactions for Vitamin B1 (Thiamine):  Loop Diuretics, Oral Contraceptives, Stavudine, Tricyclic Antidepressants


Rats treated with neonatal quinpirole enhanced time spent in the amphetamine-paired context compared with quinpirole-free controls conditioned with amphetamine, but only female controls conditioned with amphetamine spent more time in the drug-paired context compared with saline-treated controls.


These are described in greater detail below:  Oral hypoglycemics, Coumarin-type anticoagulants, Phenytoin, Cyclosporine, Rifampin, Theophylline, Terfenadine, Cisapride, Astemizole, Rifabutin, Tacrolimus, Short-acting benzodiazepines,  Oral hypoglycemics: Clinically significant hypoglycemia may be precipitated by the use of DIFLUCAN with oral hypoglycemic agents;


Plasma levels of piroxicam are depressed to approximately 80% of their normal values when FELDENE is administered in conjunction with aspirin (3900 mg/day), but concomitant administration of antacids has no effect on piroxicam plasma levels . Nonsteroidal anti-inflammatory agents, including FELDENE, have been reported to increase steady state plasma lithium levels.


Warfarin users who initiated citalopram, fluoxetine, paroxetine, amitriptyline, or mirtazapine had an increased risk of hospitalization for gastrointestinal bleeding.


These data suggest that GH administration may alter the clearance of compounds known to be metabolized by CP450 liver enzymes (e.g., corticosteroids, sex steroids, anticonvulsants, cyclosporin).


A controlled study found that concomitant fluconazole 200 mg once daily and cisapride 20 mg four times a day yielded a significant increase in cisapride plasma levels and prolongation of QTc interval.


For patients receiving ketoconazole or other potent CYP3A4 inhibitors such as other azole antifungals (eg, itraconazole, miconazole) or macrolide antibiotics (eg, erythromycin, clarithromycin) or cyclosporine or vinblastine, the recommended dose of DETROL LA is 2 mg daily.


Drugs which may potentiate the myeloproliferative effects of Leukine, such as lithium and corticosteroids, should be used with caution.


Due to its effects on gastric emptying, SYMLIN therapy should not be considered for patients taking drugs that alter gastrointestinal motility (e.g., anticholinergic agents such as atropine) and agents that slow the intestinal absorption of nutrients (e.g., alpha glucosidase inhibitors).


Methscopolamine may interact with antidepressants (tricyclic type), MAO inhibitors (e.g., phenelzine, linezolid, tranylcypromine, isocarboxazid, selegiline, furazolidone), quinidine, amantadine, antihistamines (e.g., diphenhydramine), other anticholinergics, potassium chloride supplements, antacids, absorbent-type anti-diarrhea medicines (e.g., kaolin-pectin), phenothiazines (e.g., chlorpromazine, promethazine).


Posicor inhibits some of the liver's ability to metabolize some other drugs - terfenadine, astemizole, cisapride, cyclosporine, and tricyclic antidepressants.


Thus strong inhibitors of cytochrome P4501A2, such as fluvoxamine, given concomitantly during administration of Ropivacaine, can interact with Ropivacaine leading to increased ropivacaine plasma levels.


e.g., other belladonna alkaloids, antihistamines (including meclizine), tricyclic antidepressants, and muscle relaxants.


The use of drugs that stimulate alpha-adrenergic receptors (e.g., phenylephrine, pseudoephedrine, ephedrine, phenylpropanolamine or dihydroergotamine) may enhance or potentiate the pressor effects of ProAmatine   . Therefore, caution should be used when ProAmatine    is administered concomitantly with agents that cause vasoconstriction.


Patients receiving antibiotics and sulfonamides generally should not be treated with ganglion blockers.


Salicylate competes with a number of drugs for protein binding sites, notably penicillin, thiopental, thyroxine, triiodothyronine, phenytoin, sulfinpyrazone, naproxen, warfarin, methotrexate, and possibly corticosteroids.


The incubations were performed in the absence and presence of the non-specific CYP inhibitor, 1-aminobenzotriazole (ABT) and isoform-specific inhibitors.


However, the co   administration of SPIRIVA with other anticholinergic   containing drugs (e.g., ipratropium) has not been studied and is therefore not recommended.


Other drugs which may enhance the neuromuscular blocking action of nondepolarizing agents such as MIVACRON include certain antibiotics (e.g., aminoglycosides, tetracyclines, bacitracin, polymyxins, lincomycin, clindamycin, colistin, and sodium colistimethate), magnesium salts, lithium, local anesthetics, procainamide, and quinidine.


Other drugs eliminated via renal secretion: Population pharmacokinetic analysis suggests that coadministration of drugs that are secreted by the cationic transport system (e.g., cimetidine, ranitidine, diltiazem, triamterene, verapamil, quinidine, and quinine) decreases the oral clearance of pramipexole by about 20%, while those secreted by the anionic transport system (e.g., cephalosporins, penicillins, indomethacin, hydrochlorothiazide, and chlorpropamide) are likely to have little effect on the oral clearance of pramipexole.


After 21 weeks of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine treatment, all 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine/vehicle-treated animals displayed parkinsonian symptoms, whereas none of the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine/3-[(2-methyl-1,3-thiazol-4-yl) ethynyl] pyridine-treated monkeys were significantly affected.


The following agents may increase certain actions or side effects of anticholinergic drugs: amantadine, antiarrhythmic agents of class I (e.g., quinidine), antihistamines, antipsychotic agents (e.g., phenothiazines), benzodiazepines, MAO inhibitors, narcotic analgesics (e.g., meperidine), nitrates and nitrites, sympathomimetic agents, tricyclic antidepressants, and other drugs having anticholinergic activity.


The metabolism of Metopirone is accelerated by phenytoin;


Furthermore, we present a case report in which a second Herceptin treatment following lapatinib resulted in the marked shrinkage of multiple metastatic tumors in HER2-positive breast cancer.


Interaction with Other Central Nervous System Depressants: MEPERIDINE SHOULD BE USED WITH GREAT CAUTION AND IN REDUCED DOSAGE IN PATIENTS WHO ARE CONCURRENTLY RECEIVING OTHER NARCOTIC ANALGESICS, GENERAL ANESTHETICS, PHENOTHIAZINES, OTHER TRANQUILIZERS, SEDATIVE-HYPNOTICS (INCLUDING BARBITURATES), TRICYCLIC ANTIDEPRESSANTS AND OTHER CNS DEPRESSANTS (INCLUDING ALCOHOL).


Drugs that induce hepatic enzymes such as phenobarbital, phenytoin and rifampin may increase the clearance of corticosteroids and may require increases in corticosteroid dose to achieve the desired response.


Although it was previously reported that lapatinib combined with Herceptin improved the progression-free survival rate compared with lapatinib alone for patients with Herceptin-refractory HER2-positive metastatic breast cancer, the mechanism is purported to be an antiproliferative effect relating to the synergism of these two agents.


Drugs that induce hepatic enzymes such as phenobarbital, phenytoin, and rifampin may increase the clearance of methylprednisolone and may require increased in methylprednisolone dose to achieve the desired response.


The FDA has approved ticagrelor (Brilinta-AstraZeneca), an oral antiplatelet drug, for use with low-dose aspirin to reduce the rate of thrombotic cardiovascular events in patients with acute coronary syndrome (ACS).


No cross-resistance with other chemotherapeutic agents, radiotherapy or steroids has been demonstrated.


These are described in greater detail below:  Oral hypoglycemics, Coumarin-type anticoagulants, Phenytoin, Cyclosporine, Rifampin, Theophylline, Terfenadine, Cisapride, Astemizole, Rifabutin, Tacrolimus, Short-acting benzodiazepines,  Oral hypoglycemics: Clinically significant hypoglycemia may be precipitated by the use of DIFLUCAN with oral hypoglycemic agents;


Interactions for Vitamin B1 (Thiamine):  Loop Diuretics, Oral Contraceptives, Stavudine, Tricyclic Antidepressants


Concurrent use of DEMSER with alcohol or other CNS depressants can increase their sedative effects.


Other eye drops or medications such as acetylcholine chloride (Miochol) and carbachol (Carboptic, Isopto Carbachol) may decrease the effects of suprofen ophthalmic.


Probenecid competes with meropenem for active tubular secretion and thus inhibits the renal excretion of meropenem.


Furosemide: Clinical studies, as well as post-marketing observations, have shown that NSAIDs can reduce the natriuretic effect of furosemide and thiazide diuretics in some patients.


Thiazides may decrease arterial responsiveness to norepinephrine.


Other drugs eliminated via renal secretion: Population pharmacokinetic analysis suggests that coadministration of drugs that are secreted by the cationic transport system (e.g., cimetidine, ranitidine, diltiazem, triamterene, verapamil, quinidine, and quinine) decreases the oral clearance of pramipexole by about 20%, while those secreted by the anionic transport system (e.g., cephalosporins, penicillins, indomethacin, hydrochlorothiazide, and chlorpropamide) are likely to have little effect on the oral clearance of pramipexole.


The neuromuscular blocking effect of MIVACRON may be enhanced by drugs that reduce plasma cholinesterase activity (e.g., chronically administered oral contraceptives, glucocorticoids, or certain monoamine oxidase inhibitors) or by drugs that irreversibly inhibit plasma cholinesterase . Resistance to the neuromuscular blocking action of nondepolarizing neuromuscular blocking agents has been demonstrated in patients chronically administered phenytoin or carbamazepine.


Distinct and statistically significant synergism was observed between methylglyoxal and piperacillin by disc diffusion tests when compared with their individual effects.


ProAmatine. Alpha-adrenergic blocking agents, such as prazosin, terazosin, and doxazosin, can antagonize the effects of ProAmatine. Potential for Drug Interactions: It appears possible, although there is no supporting experimental evidence, that the high renal clearance of desglymidodrine (a base) is due to active tubular secretion by the base-secreting system also responsible for the secretion of such drugs as metformin, cimetidine, ranitidine, procainamide, triamterene, flecainide, and quinidine.


Oral hypoglycemic agents Oxandrolone may inhibit the metabolism of oral hypoglycemic agents.


Use of Anticoagulants and Antiplatelet Agents -- Streptase, Streptokinase, alone or in combination with antiplatelet agents and anticoagulants, may cause bleeding complications.


SKELAXIN may enhance the effects of alcohol, barbiturates and other CNS depressants.


While no formal drug interaction studies have been performed, the following concomitant drugs were used in at least 10% of patients in either or both Sj   grens efficacy studies: acetylsalicylic acid, artificial tears, calcium, conjugated estrogens, hydroxychloroquine sulfate, ibuprofen, levothyroxine sodium, medroxyprogesterone acetate, methotrexate, multivitamins, naproxen, omeprazole, paracetamol, and prednisone.


The CNS-depressant effect of propoxyphene is additive with that of other CNS depressants, including alcohol.


The use of drugs that stimulate alpha-adrenergic receptors (e.g., phenylephrine, pseudoephedrine, ephedrine, phenylpropanolamine or dihydroergotamine) may enhance or potentiate the pressor effects of ProAmatine   . Therefore, caution should be used when ProAmatine    is administered concomitantly with agents that cause vasoconstriction.


Before taking this medication, tell your doctor if you are taking a tricyclic antidepressant such as amitriptyline (Elavil), amoxapine (Asendin), doxepin (Sinequan), nortriptyline (Pamelor), imipramine (Tofranil), clomipramine (Anafranil), protriptyline (Vivactil), or desipramine (Norpramin).


In addition to bleeding associated with heparin and vitamin K antagonists, drugs that alter platelet function (such as aspirin, dipyridamole, and abciximab) may increase the risk of bleeding if administered prior to or after Retavase    therapy.


Paroxetine and fluoxetine reduce the plasma concentration of endoxifen by about 50%.


Co-administration of SUTENT with inducers of the CYP3A4 family (e.g., dexamethasone, phenytoin, carbamazepine, rifampin, rifabutin, rifapentin, phenobarbital, St. Johns Wort) may decrease sunitinib concentrations.


Sulfamethizole may increase the effects of barbiturates, tolbutamide, and uricosurics.


Melatonin may interact with the following drugs: aspirin and other NSAIDs (may lower melatonin levels), fluvoxamine (bioavailability of oral melatonin is increased with coadministration), beta blockers (may decrease melatonin levels), fluoxetine (reports of psychotic episodes when coadministered), progestin (coadministration of melatonin with progestin can inhibit ovarian function in women), benzodiazepenes and other sedating drugs (may result in additive sedation and an increased incidence of adverse effects), and corticosteroids (coadministration of melatonin and corticosteroids may interfere with the efficacy of the corticosteroids).


Posicor inhibits some of the liver's ability to metabolize some other drugs - terfenadine, astemizole, cisapride, cyclosporine, and tricyclic antidepressants.


If concomitant treatment with sumatriptan and an SSRI is clinically warranted, appropriate observation of the patient is advised.


Pindolol has been shown to increase serum thioridazine levels when both drugs are co-administered.


Co-administration of SUTENT with strong inhibitors of the CYP3A4 family (e.g., ketoconazole, itraconazole, clarithromycin, atazanavir, indinavir, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, voriconizole) may increases sunitinib concentrations.


In clinical studies of TOBI, patients taking TOBI concomitantly with dornase alfa (PULMOZYME   , Genentech), (beta)-agonists, inhaled corticosteroids, other anti-pseudomonal antibiotics, or parenteral aminoglycosides demonstrated adverse experience profiles similar to the study population as a whole.


Because Matulane exhibits some monoamine oxidase inhibitory activity, sympathomimetic drugs, tricyclic antidepressant drugs (e.g., amitriptyline HCl, imipramine HCl) and other drugs and foods with known high tyramine content, such as wine, yogurt, ripe cheese and bananas, should be avoided.


In a study in which 34 different drugs were tested, therapeutically relevant concentrations of tolbutamide, sodium salicylate and sulfamethizole displaced protein-bound teniposide in fresh human serum to a small but significant extent.


Terbinafine increases the clearance of cyclosporine by 15%.


While co-administration of ZAVESCA    appeared to increase the clearance of Cerezyme by 70%, these results are not conclusive because of the small number of subjects studied and because patients took variable doses of Cerezyme.


Other Antihypertensives: When MYKROX Tablets are used with other antihypertensive drugs, care must be taken, especially during initial therapy.


Paliperidone may antagonize the effect of levodopa and other dopamine agonists.


Methscopolamine may interact with antidepressants (tricyclic type), MAO inhibitors (e.g., phenelzine, linezolid, tranylcypromine, isocarboxazid, selegiline, furazolidone), quinidine, amantadine, antihistamines (e.g., diphenhydramine), other anticholinergics, potassium chloride supplements, antacids, absorbent-type anti-diarrhea medicines (e.g., kaolin-pectin), phenothiazines (e.g., chlorpromazine, promethazine).


Terbinafine clearance is increased 100% by rifampin, a CyP450 enzyme inducer, and decreased 33% by cimetidine, a CyP450 enzyme inhibitor.


Other drugs eliminated via renal secretion: Population pharmacokinetic analysis suggests that coadministration of drugs that are secreted by the cationic transport system (e.g., cimetidine, ranitidine, diltiazem, triamterene, verapamil, quinidine, and quinine) decreases the oral clearance of pramipexole by about 20%, while those secreted by the anionic transport system (e.g., cephalosporins, penicillins, indomethacin, hydrochlorothiazide, and chlorpropamide) are likely to have little effect on the oral clearance of pramipexole.


The effects of anticholinergic drugs, such as atropine and tricyclic antidepressants may be enhanced by the concomitant administration of triprolidine.


Caution should be used when EVISTA is coadministered with other highly protein-bound drugs, such as clofibrate, indomethacin, naproxen, ibuprofen, diazepam, and diazoxide.


Digoxin: A controlled pharmacokinetic study has shown no effect on plasma digoxin concentrations when coadministered with ACEON    Tablets, but an effect of digoxin on the plasma concentration of perindopril/perindoprilat has not been excluded.


Other HDAC Inhibitors Severe thrombocytopenia and gastrointestinal bleeding have been reported with concomitant use of ZOLINZA and other HDAC inhibitors (e.g., valproic acid).


Caution should be observed in administering DEMSER to patients receiving phenothiazines or haloperidol because the extrapyramidal effects of these drugs can be expected to be potentiated by inhibition of catecholamine synthesis.


Phenothiazines are capable of potentiating CNS depressants (e.g., barbiturates, anesthetics, opiates, alcohol, etc.)


Warfarin users had an increased odds ratio of gastrointestinal bleeding upon initiation of citalopram (OR   =   1.73 [95% CI, 1.25-2.38]), fluoxetine (OR   =   1.63 [95% CI, 1.11-2.38]), paroxetine (OR   =   1.64 [95% CI, 1.27-2.12]), amitriptyline (OR   =   1.47 [95% CI, 1.02-2.11]).


Human pharmacologic studies have shown that Ritalin may inhibit the metabolism of coumarin anticoagulants, anticonvulsants (phenobarbital, diphenylhydantoin, primidone), phenylbutazone, and tricyclic drugs (imipramine, clomipramine, desipramine).


We found antagonism between celecoxib and the four drugs in the breast cancer cells MCF7 following all incubation schedules and between celecoxib and doxorubicin in all cell lines except for two combinations in HCT116 cells.


Inducers of CYP3A4 Isozymes: Cytochrome P450 inducers, such as rifampin, carbamazepine, and phenytoin, induce metabolism and caused a markedly decreased C max and AUC of oral midazolam in adult studies.


Single dose pharmacokinetic studies demonstrated that the metabolism of rivastigmine is not significantly affected by concurrent administration of digoxin, warfarin, diazepam, or fluoxetine.


Concomitant administration of CHEMET with other chelation therapy, such as CaNa 2 EDTA is not recommended.


Macrolides: Clinical drug interaction studies indicate that erythromycin and clarithromycin can exert an effect on terfenadine metabolism by a mechanism which may be similar to that of ketoconazole, but to a lesser extent.


HMG-CoA reductase inhibitors: No clinically significant pharmacokinetic interactions were seen when ezetimibe was co-administered with atorvastatin, simvastatin, pravastatin, lovastatin, or fluvastatin.


Therefore, when concomitant use of thiabendazole and xanthine derivatives is anticipated, it may be necessary to monitor blood levels and/or reduce the dosage of such compounds.


Furthermore, in patients receiving both drugs, careful monitoring of the INR or PT, and adjustment of the warfarin dosage if indicated are recommended when the oxandrolone dose is changed or discontinued.


Dopamine antagonists: Since pramipexole is a dopamine agonist, it is possible that dopamine antagonists, such as the neuroleptics (phenothiazines, butyrophenones, thioxanthenes) or metoclopramide, may diminish the effectiveness of MIRAPEX.


It has been reported that sulfamethoxazole may prolong the prothrombin time in patients who are receiving the anticoagulant warfarin.


When the rapid onset of a concomitant orally administered agent is a critical determinant of effectiveness (such as analgesics), the agent should be administered at least 1 hour prior to or 2 hours after SYMLIN injection.


Methscopolamine may interact with antidepressants (tricyclic type), MAO inhibitors (e.g., phenelzine, linezolid, tranylcypromine, isocarboxazid, selegiline, furazolidone), quinidine, amantadine, antihistamines (e.g., diphenhydramine), other anticholinergics, potassium chloride supplements, antacids, absorbent-type anti-diarrhea medicines (e.g., kaolin-pectin), phenothiazines (e.g., chlorpromazine, promethazine).


But the use of fixed combination amlodipine/valsartan compared with traditional therapy was associated with lower clinical and self measured BP, quicker achievement of target BP (5.8+/-2.3 and 9.2+/-1.8 days, respectively, 0.05), lesser number of antihypertensive drugs (2.5+/-0.6 and 3.0+/-0.9 days, respectively), lower rate of concealed inefficacy of treatment (12 and 31%, respectively, 0.05).


Barbiturates may decrease the effectiveness of oral contraceptives, certain antibiotics, quinidine, theophylline, corticosteroids, anticoagulants, and beta blockers.


Mequitazine can interact with CNS depressant, antichlolinergic, TCA, MAOIs, and alcohol.


Digoxin: There was a slight increase in the area under the curve (AUC, 11%) and mean peak drug concentration (Cmax, 18%) of digoxin with the co-administration of 100 mg sitagliptin for 10 days.


Anticoagulants (oral): The activity of oral anticoagulants may be potentiated by anti-vitamin-K activity attributed to methimazole.


Examples of some of the more potent CYP 3A4 inhibitors include macrolide antibiotics (e.g., erythromycin, troleandomycin, clarithromycin), HIV protease or reverse transcriptase inhibitors (e.g., ritonavir, indinavir, nelfinavir, delavirdine) or azole antifungals (e.g., ketoconazole, itraconazole, voriconazole).


Thus strong inhibitors of cytochrome P4501A2, such as fluvoxamine, given concomitantly during administration of Ropivacaine, can interact with Ropivacaine leading to increased ropivacaine plasma levels.


Based on studies evaluating possible interactions of pantoprazole with other drugs, no dosage adjustment is needed with concomitant use of the following: theophylline, cisapride, antipyrine, caffeine, carbamazepine, diazepam (and its active metabolite, desmethyldiazepam), diclofenac, naproxen, piroxicam, digoxin, ethanol, glyburide, an oral contraceptive (levonorgestrel/ethinyl estradiol), metoprolol, nifedipine, phenytoin, warfarin, midazolam, clarithromycin, metronidazole, or amoxicillin.


Furthermore, rifampin, dexamethasone, St.


John   s Wort, and certain anticonvulsants (phenytoin, phenobarbital, carbamazepine) may induce mifepristone metabolism (lowering serum levels of mifepristone).


Interaction with Guanethidine: Although minoxidil does not itself cause orthostatic hypotension, its administration to patients already receiving guanethidine can result in profound orthostatic effects.


Although specific drug or food interactions with mifepristone have not been studied, on the basis of this drug   s metabolism by CYP 3A4, it is possible that ketoconazole, itraconazole, erythromycin, and grapefruit juice may inhibit its metabolism (increasing serum levels of mifepristone).


Interaction with Other Central Nervous System Depressants: MEPERIDINE SHOULD BE USED WITH GREAT CAUTION AND IN REDUCED DOSAGE IN PATIENTS WHO ARE CONCURRENTLY RECEIVING OTHER NARCOTIC ANALGESICS, GENERAL ANESTHETICS, PHENOTHIAZINES, OTHER TRANQUILIZERS, SEDATIVE-HYPNOTICS (INCLUDING BARBITURATES), TRICYCLIC ANTIDEPRESSANTS AND OTHER CNS DEPRESSANTS (INCLUDING ALCOHOL).


Drugs Eliminated by Active Tubular Secretion: Although studies to assess drug-drug interactions with Sanctura have not been conducted, Sanctura has the potential for pharmacokinetic interactions with other drugs that are eliminated by active tubular secretion (e.g. digoxin, procainamide, pancuronium, morphine, vancomycin, metformin and tenofovir).


You cannot take mazindol if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), tranylcypromine (Parnate), or phenelzine (Nardil) in the last 14 days.


Triprolidine may enhance the sedative effects of central nervous system depressants including alcohol, barbiturates, hypnotics, narcotic analgesics, sedatives, and tranquillisers.


Trimethoprim, given at a common clinical dosage, increased the phenytoin half-life by 51% and decreased the phenytoin metabolic clearance rate by 30%.


During maintenance of anesthesia or sedation, the rate of DIPRIVAN Injectable Emulsion administration should be adjusted according to the desired level of anesthesia or sedation and may be reduced in the presence of supplemental analgesic agents (eg, nitrous oxide or opioids).


Warfarin users who initiated citalopram, fluoxetine, paroxetine, amitriptyline, or mirtazapine had an increased risk of hospitalization for gastrointestinal bleeding.


For patients receiving ketoconazole or other potent CYP3A4 inhibitors such as other azole antifungals (eg, itraconazole, miconazole) or macrolide antibiotics (eg, erythromycin, clarithromycin) or cyclosporine or vinblastine, the recommended dose of DETROL LA is 2 mg daily.


Methscopolamine may interact with antidepressants (tricyclic type), MAO inhibitors (e.g., phenelzine, linezolid, tranylcypromine, isocarboxazid, selegiline, furazolidone), quinidine, amantadine, antihistamines (e.g., diphenhydramine), other anticholinergics, potassium chloride supplements, antacids, absorbent-type anti-diarrhea medicines (e.g., kaolin-pectin), phenothiazines (e.g., chlorpromazine, promethazine).


Inducers of CYP3A4 Isozymes: Cytochrome P450 inducers, such as rifampin, carbamazepine, and phenytoin, induce metabolism and caused a markedly decreased C max and AUC of oral midazolam in adult studies.


Some drug interactions are:  - birth control pills - corticosteroids - medicines for angina or high blood pressure - medicines for pain - medicines to control seizures such as phenytoin or carbamazepine - certain antibiotics given by injection - cisplatin - edrophonium - neostigmine - polymyxin B or bacitracin - local anesthetics such as procaine - general anesthetics - succinylcholine or other muscle relaxants


Important Non-Thalidomide Drug Interactions Drugs That Interfere with Hormonal Contraceptives: Concomitant use of HIV-protease inhibitors, griseofulvin, modafinil, penicillins, rifampin, rifabutin, phenytoin, carbamazepine, or certain herbal supplements such as St.


MAO Inhibitors: The pressor effect of sympathomimetic pressor amines is markedly potentiated in patients receiving monoamine oxidase inhibitors (MAOI).


Melatonin may interact with the following drugs: aspirin and other NSAIDs (may lower melatonin levels), fluvoxamine (bioavailability of oral melatonin is increased with coadministration), beta blockers (may decrease melatonin levels), fluoxetine (reports of psychotic episodes when coadministered), progestin (coadministration of melatonin with progestin can inhibit ovarian function in women), benzodiazepenes and other sedating drugs (may result in additive sedation and an increased incidence of adverse effects), and corticosteroids (coadministration of melatonin and corticosteroids may interfere with the efficacy of the corticosteroids).


There have been postmarketing reports of increased INR and prothrombin time in patients receiving proton pump inhibitors, including pantoprazole, and warfarin concomitantly.


These data suggest that GH administration may alter the clearance of compounds known to be metabolized by CP450 liver enzymes (e.g., corticosteroids, sex steroids, anticonvulsants, cyclosporin).


Co-administration of SUTENT with strong inhibitors of the CYP3A4 family (e.g., ketoconazole, itraconazole, clarithromycin, atazanavir, indinavir, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, voriconizole) may increases sunitinib concentrations.


Use with Cholinomimetics and Other Cholinesterase Inhibitors: A synergistic effect may be expected when cholinesterase inhibitors are given concurrently with succinylcholine, similar neuromuscular blocking agents or cholinergic agonists such as bethanechol.


Therefore, FLOMAX capsules should be used with caution in combination with cimetidine, particularly at doses higher than 0.4 mg.


(ii) acetyl-l-carnitine elicits a significant protective effect on DEB induced toxicity, which was potentiated by  alpha-lipoic acid.


Use of potassium-sparing diuretics (spironolactone, triamterene, amiloride) or potassium supplements concomitantly with ACE inhibitors can increase the risk of hyperkalemia.


Carbidopa/Levodopa: Carbidopa/Levodopa does not influence the pharmacokinetics of pramipexole in healthy volunteers (N= 10).


Co-administration of SUTENT with inducers of the CYP3A4 family (e.g., dexamethasone, phenytoin, carbamazepine, rifampin, rifabutin, rifapentin, phenobarbital, St. Johns Wort) may decrease sunitinib concentrations.


Ticlopidine treatment increased the mean area under the plasma concentration-time curve extrapolated to infinity (AUC(0-   )) of oral ketamine by 2.4-fold, whereas itraconazole treatment did not increase the exposure to S-ketamine.


Anticholinesterases: Concurrent use of procaine hydrochloride and anticholinesterase agents may result in increased systemic toxicity since anticholinesterases inhibit the breakdown of procaine hydrochloride.


You cannot take mazindol if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), tranylcypromine (Parnate), or phenelzine (Nardil) in the last 14 days.


Other inhibitors of the cytochrome P450 3A4 enzyme system, such as antimycotic agents (e.g., itraconazole and miconazole) or macrolide antibiotics (e.g., erythromycin and clarithromycin), may alter oxybutynin mean pharmacokinetic parameters (i.e., Cmax and AUC).


Probenecid: Probenecid, a known inhibitor of renal tubular secretion of organic acids via the aruonic transporter, did not noticeably influence pramipexole pharmacokinetics (N= 12).


Dopamine antagonists, such as the neuroleptics (phenothiazines, butyrophenones, thioxanthines ) or metoclopramide, ordinarily should not be administered concurrently with Permax (a dopamine agonist);


The following agents may increase certain actions or side effects of anticholinergic drugs: amantadine, antiarrhythmic agents of class I (e.g., quinidine), antihistamines, antipsychotic agents (e.g., phenothiazines), benzodiazepines, MAO inhibitors, narcotic analgesics (e.g., meperidine), nitrates and nitrites, sympathomimetic agents, tricyclic antidepressants, and other drugs having anticholinergic activity.


Synergism was also noted when methylglyoxal was combined with carbenicillin and amikacin.


For patients receiving ketoconazole or other potent CYP3A4 inhibitors such as other azole antifungals (eg, itraconazole, miconazole) or macrolide antibiotics (eg, erythromycin, clarithromycin) or cyclosporine or vinblastine, the recommended dose of DETROL LA is 2 mg daily.


DIFLUCAN reduces the metabolism of tolbutamide, glyburide, and glipizide and increases the plasma concentration of these agents.


Cyclosporine: DIFLUCAN may significantly increase cyclosporine levels in renal transplant patients with or without renal impairment.


If diuretics cannot be interrupted, close medical supervision should be provided with the first dose of ACEON    Tablets, for at least two hours and until blood pressure has stabilized for another hour.


Lithium: Increased serum lithium levels and symptoms of lithium toxicity have been reported in patients receiving ACE inhibitors during therapy with lithium.


Treatment of HEY xenograft-bearing mice with dasatinib plus paclitaxel inhibited tumor growth more than treatment with either agent alone (average tumor volume per mouse, dasatinib + paclitaxel vs paclitaxel: 0.28 vs. 0.81 cm3, difference = 0.53 cm3, 95% confidence interval [CI] = 0.44 to 0.62 cm3, P = .014);


Methscopolamine may interact with antidepressants (tricyclic type), MAO inhibitors (e.g., phenelzine, linezolid, tranylcypromine, isocarboxazid, selegiline, furazolidone), quinidine, amantadine, antihistamines (e.g., diphenhydramine), other anticholinergics, potassium chloride supplements, antacids, absorbent-type anti-diarrhea medicines (e.g., kaolin-pectin), phenothiazines (e.g., chlorpromazine, promethazine).


The pressor response of adrenergic agents may also be potentiated by tricyclic antidepressants.


Other eye drops or medications such as acetylcholine chloride (Miochol) and carbachol (Carboptic, Isopto Carbachol) may decrease the effects of suprofen ophthalmic.


Other drugs which may enhance the neuromuscular blocking action of nondepolarizing agents such as MIVACRON include certain antibiotics (e.g., aminoglycosides, tetracyclines, bacitracin, polymyxins, lincomycin, clindamycin, colistin, and sodium colistimethate), magnesium salts, lithium, local anesthetics, procainamide, and quinidine.


As there is in vitro evidence that aminosalicylate derivatives (e.g., olsalazine, mesalazine, or sulphasalazine) inhibit the TPMT enzyme, they should be administered with caution to patients receiving concurrent thioguanine therapy.


Salicylate competes with a number of drugs for protein binding sites, notably penicillin, thiopental, thyroxine, triiodothyronine, phenytoin, sulfinpyrazone, naproxen, warfarin, methotrexate, and possibly corticosteroids.


Mequitazine can interact with CNS depressant, antichlolinergic, TCA, MAOIs, and alcohol.


Pilocarpine should be administered with caution to patients taking beta adrenergic antagonists because of the possibility of conduction disturbances.


Concomitant administration of terfenadine with clarithromycin, erythromycin, or troleandomycin is contraindicated: Pending full characterization of potential interactions, concomitant administration of terfenadine with other macrolide antibiotics, including azithromycin, is not recommended.


The concomitant use of Sanctura with other anticholinergic agents that produce dry mouth, constipation, and other anticholinergic pharmacological effects may increase the frequency and/or severity of such effects.


This interaction should be given consideration in patients taking NSAIDs concomitantly with ACE inhibitors.


Before taking this medication, tell your doctor if you are taking a tricyclic antidepressant such as amitriptyline (Elavil), amoxapine (Asendin), doxepin (Sinequan), nortriptyline (Pamelor), imipramine (Tofranil), clomipramine (Anafranil), protriptyline (Vivactil), or desipramine (Norpramin).


Fenofibrate: In a pharmacokinetic study, concomitant fenofibrate administration increased total ezetimibe concentrations approximately 1.5-fold.


Although such a reaction has not been demonstrated with roxithromycin, concomitant administration of roxithromycin with terfenadine or astemizole is not recommended.


However, interactions may be expected and FLOMAX capsules should NOT be used in combination with other alpha-adrenergic blocking agents.


An inhibitor of CYP2C8 (such as gemfibrozil) may increase the AUC of rosiglitazone and an inducer of CYP2C8 (such as rifampin) may decrease the AUC of rosiglitazone.


One case of hypertensive crisis has been reported in a patient taking the recommended doses of selegiline and a sympathomimetic medication (ephedrine).


If glucocorticoid replacement is required, the glucocorticoid dose should be carefully adjusted.


These data suggest that GH administration may alter the clearance of compounds known to be metabolized by CP450 liver enzymes (e.g., corticosteroids, sex steroids, anticonvulsants, cyclosporin).


Drugs such as troleandomycin and ketoconazole may inhibit the metabolism of methylprednisolone and thus decrease its clearance.


A calcium dose of 800 mg diminished absorption of 5 mg heme iron by 37.7%.


Fluconazole tablets coadministered with ethinyl estradiol- and levonorgestrel-containing oral contraceptives produced an overall mean increase in ethinyl estradiol and levonorgestrel levels;


Cholestyramine and Drugs that Bind Bile Acids: These drugs interrupt enterohepatic recirculation and reduce MPA exposure when coadministered with mycophenolate mofetil.


Posicor inhibits some of the liver's ability to metabolize some other drugs - terfenadine, astemizole, cisapride, cyclosporine, and tricyclic antidepressants.


Coadministration of methyldopa with ferrous sulfate or ferrous gluconate is not recommended.


Other drugs which may enhance the neuromuscular blocking action of nondepolarizing agents such as MIVACRON include certain antibiotics (e.g., aminoglycosides, tetracyclines, bacitracin, polymyxins, lincomycin, clindamycin, colistin, and sodium colistimethate), magnesium salts, lithium, local anesthetics, procainamide, and quinidine.


Thiabendazole may compete with other drugs, such as theophylline, for sites of metabolism in the liver, thus elevating the serum levels of such compounds to potentially toxic levels.


Concurrent use of alcohol and other CNS depression-producing drugs may increase the CNS depressant effects of methyprylon or these other medications.


Use with Other Central Nervous System Depressants: The depressant effects of morphine are potentiated by the presence of other CNS depressants such as alcohol, sedatives, antihistaminics, or psychotropic drugs.


Concomitant administration of low-dose aspirin with MOBIC may result in an increased rate of GI ulceration or other complications, compared to use of MOBIC alone.


norepinephrine and dobutamine are incompatible with sodium bicarbonate solution.


Methscopolamine may interact with antidepressants (tricyclic type), MAO inhibitors (e.g., phenelzine, linezolid, tranylcypromine, isocarboxazid, selegiline, furazolidone), quinidine, amantadine, antihistamines (e.g., diphenhydramine), other anticholinergics, potassium chloride supplements, antacids, absorbent-type anti-diarrhea medicines (e.g., kaolin-pectin), phenothiazines (e.g., chlorpromazine, promethazine).


There have been spontaneous reports of increase or decrease in prothrombin times in patients concomitantly taking oral terbinafine and warfarin, however, a causal relationship between LAMISIL    Tablets and these changes has not been established.


The neuromuscular blocking effect of MIVACRON may be enhanced by drugs that reduce plasma cholinesterase activity (e.g., chronically administered oral contraceptives, glucocorticoids, or certain monoamine oxidase inhibitors) or by drugs that irreversibly inhibit plasma cholinesterase . Resistance to the neuromuscular blocking action of nondepolarizing neuromuscular blocking agents has been demonstrated in patients chronically administered phenytoin or carbamazepine.


However, increased prothrombin time and bleeding have been reported in patients on concomitant TOLECTIN and warfarin therapy.


Human pharmacologic studies have shown that Ritalin may inhibit the metabolism of coumarin anticoagulants, anticonvulsants (phenobarbital, diphenylhydantoin, primidone), phenylbutazone, and tricyclic drugs (imipramine, clomipramine, desipramine).


Scopolamine should be used with care in patients taking other drugs that are capable of causing CNS effects such as sedatives, tranquilizers, or alcohol.


Other drugs eliminated via renal secretion: Population pharmacokinetic analysis suggests that coadministration of drugs that are secreted by the cationic transport system (e.g., cimetidine, ranitidine, diltiazem, triamterene, verapamil, quinidine, and quinine) decreases the oral clearance of pramipexole by about 20%, while those secreted by the anionic transport system (e.g., cephalosporins, penicillins, indomethacin, hydrochlorothiazide, and chlorpropamide) are likely to have little effect on the oral clearance of pramipexole.


Use of neuroleptics in conjunction with oral morphine may increase the risk of respiratory depression, hypotension and profound sedation or coma.


These are described in greater detail below:  Oral hypoglycemics, Coumarin-type anticoagulants, Phenytoin, Cyclosporine, Rifampin, Theophylline, Terfenadine, Cisapride, Astemizole, Rifabutin, Tacrolimus, Short-acting benzodiazepines,  Oral hypoglycemics: Clinically significant hypoglycemia may be precipitated by the use of DIFLUCAN with oral hypoglycemic agents;


In an in vitro assay, lapatinib induced HER2 expression at the cell surface of HER2-positive breast cancer cell lines, leading to the enhancement of Herceptin-mediated ADCC.


Some drug interactions are:  - birth control pills - corticosteroids - medicines for angina or high blood pressure - medicines for pain - medicines to control seizures such as phenytoin or carbamazepine - certain antibiotics given by injection - cisplatin - edrophonium - neostigmine - polymyxin B or bacitracin - local anesthetics such as procaine - general anesthetics - succinylcholine or other muscle relaxants


Fibrates: The safety and effectiveness of ezetimibe administered with fibrates have not been established.


Anticholinesterases: Concurrent use of procaine hydrochloride and anticholinesterase agents may result in increased systemic toxicity since anticholinesterases inhibit the breakdown of procaine hydrochloride.


It may also interact with thiazides (increased thrombocytopenia), cyclosporine (increased nephrotoxicity), sulfonylurea agents (increased hypoglycemic response), warfarin (increased anticoagulant effect), methotrexate (decreased renal excretion of methotrexate), phenytoin (decreased hepatic clearance of phenytoin).


Digitalis Glycosides: Diuretic-induced hypokalemia can increase the sensitivity of the myocardium to digitalis.


The CNS depressant effects of oxycodone hydrochloride may be additive with that of other CNS depressants..


This increase was observed at the first test point which was the second day after starting Mexitil   . Theophylline plasma levels returned to pre-Mexitil    values within 48 hours after discontinuing Mexitil   . If Mexitil and theophylline are to be used concurrently, theophylline blood levels should be monitored, particularly when the Mexitil    dose is changed.


MAO inhibitors and beta adrenergic blockers increase the effects of pseudoephedrine.


Drugs such as erythromycin, diltiazem, verapamil, ketoconazole, fluconazole and itraconazole were shown to significantly increase the C max and AUC of orally administered midazolam.


Methscopolamine may interact with antidepressants (tricyclic type), MAO inhibitors (e.g., phenelzine, linezolid, tranylcypromine, isocarboxazid, selegiline, furazolidone), quinidine, amantadine, antihistamines (e.g., diphenhydramine), other anticholinergics, potassium chloride supplements, antacids, absorbent-type anti-diarrhea medicines (e.g., kaolin-pectin), phenothiazines (e.g., chlorpromazine, promethazine).


Drugs Eliminated by Active Tubular Secretion: Although studies to assess drug-drug interactions with Sanctura have not been conducted, Sanctura has the potential for pharmacokinetic interactions with other drugs that are eliminated by active tubular secretion (e.g. digoxin, procainamide, pancuronium, morphine, vancomycin, metformin and tenofovir).


Due to its effects on gastric emptying, SYMLIN therapy should not be considered for patients taking drugs that alter gastrointestinal motility (e.g., anticholinergic agents such as atropine) and agents that slow the intestinal absorption of nutrients (e.g., alpha glucosidase inhibitors).


Also mirtazapine, which is not believed to interact with warfarin, increased the risk of GI bleeding (OR   =   1.75 [95% CI, 1.30-2.35]).


While no formal drug interaction studies have been performed, the following concomitant drugs were used in at least 10% of patients in either or both Sj   grens efficacy studies: acetylsalicylic acid, artificial tears, calcium, conjugated estrogens, hydroxychloroquine sulfate, ibuprofen, levothyroxine sodium, medroxyprogesterone acetate, methotrexate, multivitamins, naproxen, omeprazole, paracetamol, and prednisone.


Other drugs eliminated via renal secretion: Population pharmacokinetic analysis suggests that coadministration of drugs that are secreted by the cationic transport system (e.g., cimetidine, ranitidine, diltiazem, triamterene, verapamil, quinidine, and quinine) decreases the oral clearance of pramipexole by about 20%, while those secreted by the anionic transport system (e.g., cephalosporins, penicillins, indomethacin, hydrochlorothiazide, and chlorpropamide) are likely to have little effect on the oral clearance of pramipexole.


- did not cause any clinically significant change in plasma profiles of prednisone or prednisolone following administration of either oral prednisone or intravenous prednisolone.


The following agents may increase certain actions or side effects of anticholinergic drugs: amantadine, antiarrhythmic agents of class I (e.g., quinidine), antihistamines, antipsychotic agents (e.g., phenothiazines), benzodiazepines, MAO inhibitors, narcotic analgesics (e.g., meperidine), nitrates and nitrites, sympathomimetic agents, tricyclic antidepressants, and other drugs having anticholinergic activity.


Acromegalic patients with diabetes mellitus being treated with insulin and/or oral hypoglycemic agents may require dose reductions of these therapeutic agents after the initiation of therapy with SOMAVERT.


Therefore, as vitamin K absorption may be decreased with XENICAL, patients on chronic stable doses of warfarin who are prescribed XENICAL should be monitored closely for changes in coagulation parameters.


Other drugs which may enhance the neuromuscular blocking action of nondepolarizing agents such as MIVACRON include certain antibiotics (e.g., aminoglycosides, tetracyclines, bacitracin, polymyxins, lincomycin, clindamycin, colistin, and sodium colistimethate), magnesium salts, lithium, local anesthetics, procainamide, and quinidine.


Decreased seizure threshold has been reported in patients receiving CYLERT concomitantly with antiepileptic medications.


Interactions for Vitamin B1 (Thiamine):  Loop Diuretics, Oral Contraceptives, Stavudine, Tricyclic Antidepressants


In clinical studies of TOBI, patients taking TOBI concomitantly with dornase alfa (PULMOZYME   , Genentech), (beta)-agonists, inhaled corticosteroids, other anti-pseudomonal antibiotics, or parenteral aminoglycosides demonstrated adverse experience profiles similar to the study population as a whole.


Concurrent use of tetracyclines with oral contraceptives may render oral contraceptives less effective.


Concomitant administration of terfenadine with clarithromycin, erythromycin, or troleandomycin is contraindicated: Pending full characterization of potential interactions, concomitant administration of terfenadine with other macrolide antibiotics, including azithromycin, is not recommended.


When phenytoin or other hepatic enzyme inducers such as rifampin and phenobarbital have been taken concurrently with Mexitil   , lowered Mexitil    plasma levels have been reported.


Vindesine can interact with the drugs of the following categories:  - Blood dyscrasia: can cause unpredictable myelotoxicity - Bone marrow depressants: can cause a predictable dose-related myelotoxicity - Radiation therapy: may cause marrow depression - Neurotoxic medications: can cause neurologic toxicity - Phenytoin: can increase seizure activity - Live virus vaccines: may potentiate the replication of the vaccine virus, may increase the side effects of the vaccination, and decrease patient's response to the vaccine - Mitomycin-C: may cause shortness of breath and bronchospasm - Killed virus vaccines: may decrease patient's response to the vaccine


Careful monitoring of phenytoin concentrations in patients receiving DIFLUCAN and phenytoin is recommended.


Drugs which may potentiate the myeloproliferative effects of Leukine, such as lithium and corticosteroids, should be used with caution.


Monoamine oxidase inhibitors or tricyclic antidepressants may potentiate the action of sympathomimetic amines.


We concluded that the combined administration of dexmedetomidine with ephedrine may have beneficial effects in the treatment of pain without causing sedation, which limits the use of dexmedetomidine as an analgesic in humans.


In conclusion, we demonstrated an isolated effect of calcium (as chloride) on absorption of 5 mg of iron provided as nonheme (as sulfate) and heme (as CRBC) iron.


Limited published data indicate that GH treatment increases cytochrome P450 (CP450) mediated antipyrine clearance in man.


Phenytoin, Carbamazepine, and Rifampicin: In patients treated with potent inducers of CYP3A4 (i.e., phenytoin, carbamazepine, and rifampicin), the clearance of ondansetron was significantly increased and ondansetron blood concentrations were decreased.


Absorption of tetracyclines is impaired by antacids containing aluminum, calcium or magnesium, and iron-containing preparations.


Cimetidine: Cimetidine, a known inhibitor of renal tubular secretion of organic bases via the cationic transport system, caused a 50% increase in pramipexole AUC and a 40% increase in half-life (N= 12).


one fatality has been reported from hypoglycemia in association with combined DIFLUCAN and glyburide use.


Thalidomide has been reported to enhance the sedative activity of barbiturates, alcohol, chlorpromazine, and reserpine.


Before taking this medication, tell your doctor if you are taking a tricyclic antidepressant such as amitriptyline (Elavil), amoxapine (Asendin), doxepin (Sinequan), nortriptyline (Pamelor), imipramine (Tofranil), clomipramine (Anafranil), protriptyline (Vivactil), or desipramine (Norpramin).


Caution should be used when EVISTA is coadministered with other highly protein-bound drugs, such as clofibrate, indomethacin, naproxen, ibuprofen, diazepam, and diazoxide.


Trilostane may interact with aminoglutethimide or mitotane (causing too great a decrease in adrenal function).


Methscopolamine may interact with antidepressants (tricyclic type), MAO inhibitors (e.g., phenelzine, linezolid, tranylcypromine, isocarboxazid, selegiline, furazolidone), quinidine, amantadine, antihistamines (e.g., diphenhydramine), other anticholinergics, potassium chloride supplements, antacids, absorbent-type anti-diarrhea medicines (e.g., kaolin-pectin), phenothiazines (e.g., chlorpromazine, promethazine).


This may be of clinical relevance for compounds predominantly metabolized by this enzyme, such as tricyclic antidepressants,    -blockers, selective serotonin reuptake inhibitors (SSRIs), and monoamine oxidase inhibitors (MAO-Is) Type B, if they have a narrow therapeutic window.


There is evidence that meropenem may reduce serum levels of valproic acid to subtherapeutic levels (therapeutic range considered to be 50 to 100    g/mL total valproate).


When oxandrolone therapy is initiated in a patient already receiving treatment with warfarin, the INR or prothrombin time (PT) should be monitored closely and the dose of warfarin adjusted as necessary until a stable target INR or PT has been achieved.


Given the primary CNS effects of paliperidone, INVEGA    should be used with caution in combination with other centrally acting drugs and alcohol.


Therefore, the use of sumatriptan succinate tablets in patients receiving MAO-A inhibitors is contraindicated . Selective serotonin reuptake inhibitors (SSRIs) (e.g., fluoxetine, fluvoxamine, paroxetine, sertraline) have been reported, rarely, to cause weakness, hyperreflexia, and incoordination when coadministered with sumatriptan.


The use of MIVACRON before succinylcholine to attenuate some of the side effects of succinylcholine has not been studied.


The FDA has approved ticagrelor (Brilinta-AstraZeneca), an oral antiplatelet drug, for use with low-dose aspirin to reduce the rate of thrombotic cardiovascular events in patients with acute coronary syndrome (ACS).