Insulins: (Minor) Monitor patients receiving insulin closely for worsening glycemic control when bumetanide, furosemide, and torsemide are instituted. Modify Therapy/Monitor Closely. Well-controlled hypertensive patients receiving pseudoephedrine at recommended doses do not appear at high risk for significant elevations in blood pressure; however, increased blood pressure (especially systolic hypertension) has been reported in some patients. difelikefalin and carbamazepine both increase sedation. Clinicians should be aware that this may occur even in patients with minor or transient renal impairment. Avoid or Use Alternate Drug. In patients with creatinine clearances > 30 ml/min, the combinations may also lead to profound fluid and electrolyte loss in some patients. Alpha-glucosidase Inhibitors: (Minor) Loop diuretics may cause hyperglycemia and glycosuria in patients with diabetes mellitus, probably due to diuretic-induced hypokalemia. carbamazepine will decrease the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. (Moderate) The cardiovascular effects of sympathomimetics may reduce the antihypertensive effects produced by diuretics. carbamazepine will decrease the level or effect of lansoprazole by affecting hepatic enzyme CYP2C19 metabolism. Monitor Closely (1)felodipine increases levels of carbamazepine by decreasing metabolism. Avoid or Use Alternate Drug. Drugs that are strong inducers of CYP2C19 or CYP2C9 decreases the combined exposure of abrocitinib and its active metabolites, resulting in loss of or reduced clinical response. Minor/Significance Unknown. Monitor Closely (1)carbamazepine will decrease the level or effect of fentanyl by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Use Caution/Monitor. Avoid or Use Alternate Drug. Potential for false positive test results if macimorelin and strong CYP3A4 inducers are coadministered. Avoid or Use Alternate Drug. stiripentol, carbamazepine. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Contraceptirve failure possible. Avoid or Use Alternate Drug. phenytoin decreases levels of mebendazole by increasing metabolism. Contraindicated. Furosemide has been shown to cause unexplained maternal deaths and abortions in rabbits at 2, 4, and 8 times the maximum recommended human dose. carbamazepine will decrease the level or effect of fentanyl by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. alpelisib will decrease the level or effect of phenytoin by pharmacodynamic synergism. Consider increasing the rivaroxaban dose if these drugs must be coadministered. Thus, use cautiously and with monitoring of renal function, blood pressure, cardiac status, electrolytes (especially potassium), and monitor the clinical response for the condition treated. Tacrolimus dosage requirements may be greater when administered concurrently with phenytoin. Avoid or Use Alternate Drug. NSAIDs have been associated with an inhibition of prostaglandin synthesis, which may result in reduced renal blood flow leading to renal insufficiency and increases in blood pressure that are often accompanied by peripheral edema and weight gain. Contraindicated. Avoid taking selinexor with other medications that may cause dizziness or confusion. Modify Therapy/Monitor Closely. Use Caution/Monitor. Use Caution/Monitor. This interference can lead to a loss of diabetic control, so diabetic patients should be monitored closely if these drugs are initiated. Use Caution/Monitor. Serious - Use Alternative (1)carbamazepine will decrease the level or effect of tepotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. phenytoin will decrease the level or effect of vilanterol/fluticasone furoate inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Thus, use cautiously and with monitoring of renal function, blood pressure, cardiac status, electrolytes (especially potassium), and monitor the clinical response for the condition treated. Minor/Significance Unknown. Minor/Significance Unknown. Monitor Closely (1)carbamazepine will decrease the level or effect of cyclophosphamide by affecting hepatic enzyme CYP2B6 metabolism. Contraindicated. Monitor plasma levels when used concomitantlySerious - Use Alternative (1)carbamazepine will decrease the level or effect of quetiapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Diuresis generally begins about 5 minutes after IV administration of furosemide. Minor/Significance Unknown. phenytoin will decrease the level or effect of fluticasone inhaled by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Fexofenadine; Pseudoephedrine: (Moderate) The cardiovascular effects of sympathomimetics may reduce the antihypertensive effects produced by diuretics. Avoid or Use Alternate Drug. Drugs A to Z. Browse drug monographs by A to Z. Approximately 70% of absorbed methyldopa is excreted in the urine as unchanged parent drug (24%) and -methyldopa mono-O-sulfate (64%), 6,11 with variability.3-O-methyl--methyldopa accounted for about 4% of urinary excretion products. Use Caution/Monitor. Monitor Closely (1)tecovirimat will increase the level or effect of phenytoin by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Chlophedianol; Guaifenesin; Phenylephrine: (Moderate) The cardiovascular effects of sympathomimetics may reduce the antihypertensive effects produced by diuretics. To help you remember, take it at the same times each day. Monitor Closely (2)vindesine decreases levels of phenytoin by inhibition of GI absorption. clopidogrel increases levels of phenytoin by decreasing metabolism. Monitor Closely (2)carbamazepine will decrease the level or effect of imipramine by affecting hepatic enzyme CYP1A2 metabolism. Monitor for increased effects/toxicities if combined with CYP2B6 inducers.carbamazepine increases toxicity of ifosfamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Use Caution/Monitor. carbamazepine will decrease the level or effect of primaquine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. If co-administration is required then consider increasing initial dose of deferasirox to 30 mg/kg and monitor ferritin levels and clinical response. Comment: Concomitant use of proton pump inhibitors with erlotinib should be avoided if possible. Avoid or Use Alternate Drug. Enhanced metabolism incr levels of hepatotoxic metabolites. carbamazepine decreases levels of bazedoxifene/conjugated estrogens by increasing metabolism. Avoid or Use Alternate Drug. Monitor Closely (1)carbamazepine will decrease the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Well-controlled hypertensive patients receiving pseudoephedrine at recommended doses do not appear at high risk for significant elevations in blood pressure; however, increased blood pressure (especially systolic hypertension) has been reported in some patients. Most carbamazepine will decrease the level or effect of ethinylestradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Serious - Use Alternative (1)rifampin will decrease the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Modify Therapy/Monitor Closely. CYP3A4 substrates may require dosage adjustment.Serious - Use Alternative (2)carbamazepine will decrease the level or effect of stiripentol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. phenytoin will decrease the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. levoketoconazole will increase the level or effect of phenytoin by affecting hepatic enzyme CYP2C9/10 metabolism. Taking oral hydralazine with food improves the bioavailability of the drug. Use Caution/Monitor. NSAIDs may reduce the natriuretic effect of diuretics in some patients. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the P-gp substrate and titrate to clinical effect. Increased phenytoin levels may be seen with acute alcohol ingestion. To use the sharing features on this page, please enable JavaScript. Minor/Significance Unknown. Carbamazepine may increase or decrease phenytoin levels. .lumacaftor/ivacaftor, phenytoin. Serious - Use Alternative (1)omeprazole, secretin. US residents can call their local poison control center at 1-800-222-1222. Use Caution/Monitor. Monitor plasma levels when used concomitantlycarbamazepine will decrease the level or effect of erythromycin lactobionate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Chlorpheniramine; Phenylephrine: (Moderate) The cardiovascular effects of sympathomimetics may reduce the antihypertensive effects produced by diuretics. carbamazepine will increase the level or effect of clopidogrel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.carbamazepine will decrease the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Coadministration with strong CYP3A4 inducers can result in decreased serum concentrations and loss of antimalarial efficacyMonitor Closely (1)artemether/lumefantrine will decrease the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)triclabendazole will increase the level or effect of phenytoin by affecting hepatic enzyme CYP2C19 metabolism. Nitisinone inhibits OAT3. carbamazepine will increase the level or effect of valsartan by Other (see comment). esketamine intranasal, carbamazepine. Data sources include IBM Watson Micromedex (updated 1 Nov 2022), Cerner Multum (updated 25 Oct 2022), ASHP (updated 12 Oct 2022) and others. Because of this, a potential pharmacodynamic interaction exists between these drugs and all antidiabetic agents, including incretin mimetics. Levothyroxine / liothyronine is only available as a generic drug. bosentan will decrease the level or effect of omeprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor Closely (1)carbamazepine will decrease the level or effect of desogestrel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. omeprazole will increase the level or effect of nateglinide by affecting hepatic enzyme CYP2C9/10 metabolism. Monitor Closely (1)phenytoin will decrease the level or effect of amikacin by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown. Avoid or Use Alternate Drug. Closely monitor patients taking ifosfamide with CYP3A4 inducers for toxicities and consider dose adjustment. omeprazole will increase the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Monitor Closely (1)phenytoin will decrease the level or effect of iloperidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Olmesartan; Hydrochlorothiazide, HCTZ: (Moderate) Coadministration of furosemide and Angiotensin-converting enzyme inhibitors (ACE inhibitors) or angiotensin II receptor antagonists may result in severe hypotension and deterioration in renal function, including renal failure. This information does not assure that this product is safe, effective, or appropriate for you. High doses of furosemide may inhibit the binding of thyroid hormones to carrier proteins, resulting in a transient increase in free thyroid hormones followed by an overall decrease in total thyroid hormone concentrations. Because of this, a potential pharmacodynamic interaction exists between these drugs and all antidiabetic agents, including incretin mimetics. Always ask your health care professional for complete information about this product and your specific health needs. Use Caution/Monitor. Applies only to oral form of both agents. Strong CYP3A4 inducers may decrease midostaurin concentrations resulting in reduced efficacy. phenytoin, enoxaparin. Use Caution/Monitor. Monitor Closely (1)sulfamethoxazole will increase the level or effect of phenytoin by affecting hepatic enzyme CYP2C9/10 metabolism. Low serum magnesium may lead to serious adverse events such as muscle spasm, seizures, and arrhythmias. Thus, use cautiously and with monitoring of renal function, blood pressure, cardiac status, electrolytes (especially potassium), and monitor the clinical response for the condition treated. Serious - Use Alternative (1)phenytoin decreases levels of pomalidomide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. Medical conditions associated with thyroid drugs: Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Double brexpiprazole dose over 1-2 weeks if administered with a strong CYP3A4 inducer. Use Caution/Monitor. Monitor Closely (1)DHEA, herbal will increase the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Applies only to oral form of both agents. Use Caution/Monitor. Contraindicated. Minor/Significance Unknown. Other (see comment). Serious - Use Alternative (1)carbamazepine will decrease the level or effect of ulipristal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor Closely (1)dupilumab, carbamazepine. This effect is of particular concern in the setting of acute myocardial infarction, unstable angina, or other acute hemodynamic compromise. Application:Select a flat, hairless or nearly hairless application site on the abdomen. Blood pressure and electrolytes should be routinely monitored.
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