Use noninteracting NSAID  if possible (eg, sulindac).  Monitor blood pressure.  Increase beta-blocker dose  if necessary.   Monitor cardiovascular  status. Decrease dose of one  or both drugs if necessary.   Epinephrine, see Antihypertensive and Cardiovascular Agents  (Miscellaneous Antihypertensive and Cardiovascular Agents)   Monitor blood pressure. Use  combination with caution.  Halothane concentration  should not exceed 3%.   Monitor cardiovascular  status. Decrease metoprolol  dose if necessary as patient  becomes euthyroid. Use  alternative beta-blocker  (eg, atenolol, nadolol).   Monitor cardiovascular  status. Decrease propranolol  dose if necessary as patient  becomes euthyroid. Use  alternative beta-blocker  (eg, atenolol, nadolol).   Digoxin, see Antihypertensive and Cardiovascular Agents  (Miscellaneous Antihypertensive and Cardiovascular Agents)   Monitor carbamazepine  concentrations. Adjust dose  as needed when starting  or stopping diltiazem.   Monitor theophylline  concentrations. Adjust  theophylline dose as  needed when starting or  stopping diltiazem.   Adjust nifedipine dose  as needed when starting,  stopping, or changing  dose of cimetidine. Use  alternative histamine  H 2 -antagonist (eg, ranitidine).   Monitor cardiovascular  status. Adjust nisoldipine  dose when starting, stopping,  or changing dose  of hydantoin.   Calcium Salts [calcium  acetate, calcium carbonate,  calcium chloride, calcium  citrate, calcium glubionate,  calcium gluconate, calcium  glycerophosphate, calcium  lactate, calcium levulinate,  tricalcium phosphate]   Monitor cardiovascular  status. Calcium may be  used to reverse verapamil  toxicities.   Monitor cardiovascular  status and digoxin  concentrations. Decrease  digoxin dose if necessary.   Avoid combination if possible.  Monitor respiratory function.  Adjust nondepolarizing  muscle relaxant dose  as needed.    Digoxin, see Antihypertensive and Cardiovascular Agents  (Miscellaneous Antihypertensive and Cardiovascular Agents)   Avoid combination if possible.  Otherwise, monitor  hemodynamic status and  manage with supportive  treatment as needed.   Monitor cardiovascular  status and for signs/  symptoms of hydantoin  toxicity. Adjust dose of one  or both drugs as needed.   Monitor cardiovascular  status and anticholinergic  effects. Increase  disopyramide dose if  necessary.   Administer bolus lidocaine  at a slow rate to avoid high  peak concentrations and  toxicity. Monitor lidocaine  concentrations. Decrease  lidocaine dose if necessary.   Monitor lidocaine  concentrations. Decrease  lidocaine dose if necessary.  Use alternative histamine H 2 -  antagonist (eg, ranitidine).   Monitor ECG when starting,  stopping, or changing dose  of cimetidine. Decrease  moricizine dose if necessary.  Use alternative histamine H 2 -  antagonist (eg, ranitidine).   Monitor serum procainamide  and N-acetylprocainamide  concentrations. Decrease  procainamide dose  if necessary.   Monitor serum procainamide  and N-acetylprocainamide  concentrations. Decrease  procainamide dose  if necessary.   Monitor cardiovascular  status. Decrease  propafenone dose or extend  dosing interval if necessary.   Avoid combination if  possible. Otherwise, monitor  quinidine concentrations  and decrease quinidine dose  if necessary.   Monitor quinidine  concentrations. Adjust  quinidine dose as needed  when starting, stopping,  or changing dose  of barbiturate.   Avoid combination,  if possible. Otherwise,  monitor quinidine  concentrations and  decrease quinidine dose  if necessary.   Digoxin, see Antihypertensive and Cardiovascular Agents  (Miscellaneous Antihypertensive and Cardiovascular Agents)   Monitor cardiovascular  status and quinidine  concentrations. Adjust  quinidine dose as needed  when starting or  stopping diltiazem.   Monitor quinidine  concentrations when  starting, stopping, or  changing dose of rifamycin.  Adjust quinidine dose  as needed.   Stop one or both drugs if  interaction develops and  treat symptomatically.   Monitor digoxin  concentrations and for  signs/symptoms of digoxin  toxicity. Decrease digoxin  dose if necessary.   Monitor digoxin  concentrations and for  signs/symptoms of digoxin  toxicity. Decrease digoxin  dose if necessary.   Monitor digoxin  concentrations and for  signs/symptoms of digoxin  toxicity. Decrease  digoxin dose if necessary.   Monitor digoxin  concentrations and for  signs/symptoms of digoxin  toxicity. Decrease  digoxin dose if necessary.   Monitor serum potassium and  magnesium concentrations.  Supplement electrolytes  if necessary. Restrict dietary  and sodium intake or use  potassium-sparing diuretics.   Monitor digoxin  concentrations and for  signs/symptoms of digoxin  toxicity. Decrease digoxin  dose if necessary.   Monitor digoxin  concentrations and for  signs/symptoms of digoxin  toxicity. Increase digoxin  dose if necessary.   Monitor digoxin  concentrations and for  signs/symptoms of digoxin  toxicity. Decrease digoxin  dose if necessary.   Monitor digoxin  concentrations and for  signs/symptoms of digoxin  toxicity. Decrease digoxin  dose if necessary.   Monitor digoxin  concentrations and for  signs/symptoms of digoxin  toxicity. Decrease digoxin  dose if necessary.   Monitor digoxin  concentrations and for  signs/symptoms of digoxin  toxicity. Decrease digoxin  dose if necessary.   Monitor serum potassium and  magnesium concentrations.  Supplement electrolytes if  necessary. Restrict dietary  and sodium intake or use  potassium-sparing diuretics.   Monitor digoxin  concentrations and for  signs/symptoms of digoxin  toxicity. Decrease digoxin  dose if necessary.   Increase digoxin dose  if necessary in hypothyroid  patients if they become  euthyroid.   Monitor digoxin  concentrations and for signs/  symptoms of digoxin toxicity.  Decrease digoxin dose if  necessary.   3 days priorto epinephrine  use if possible. Otherwise,  monitor vital signs and use IV  chlorpromazine, IV  hydralazine, IV aminophylline,  and/or IV atropine if  necessary.   Beta-Blockers, see Antihypertensive and Cardiovascular Agents  (Cardio-Selective and Noncardio-Selective Beta-Blockers j   Cephalosporins  [cefamandole, cefazolin,  cefonicid, cefoperazone,  cefotaxime, cefotetan,  cefoxitin, ceftazidime,  ceftizoxime, ceftriaxone,  cefuroxime, cephalothin,  cephapirin, cephradine]    Digoxin, see Antihypertensive and Cardiovascular Agents  (Miscellaneous Antihypertensive and Cardiovascular Agents)   Avoid excessive doses of  either drug. Monitor  aminoglycoside  concentrations. Use  alternative antibiotic  if possible.    NSAIDs [diclofenac,  etodolac,fenoprofen,  flubiprofen, ibuprofen,  indomethacin, ketoprofen,  ketorolac, meclofenamate,  mefenamic acid,  nabumetone, naproxen,  oxaprozin, piroxicam,  sulindac, tolmetin]   Avoid combination if possible.  Otherwise, decrease  aminoglycoside dose before  starting NSAID. Monitor  aminoglycoside  concentrations and renal  function.   Do not mix drugs in same  solution. Separate  administration times by at  least 2 hours.   Cefamandole, Cefazolin, Cefonicid, Cefoperazone, Cefotaxime, Cefotetan,  Cefoxitin, Ceftazidime, Ceftizoxime, Ceftriaxone, Cefuroxime, Cephalothin,  Cephapirin, Cephradine   Monitor for signs/symptoms  of bromocriptine toxicity.  Decrease bromocriptine  dose if necessary.   Administer erythromycin  stearate and non-enteric  tablets at least 2 hours  before or after a meal.   Monitor for increased  rifamycin adverse effects and  decreased response to  macrolide antibiotic. Use  alternative antibiotic (eg,  azithromycin, dirithromycin).   Amoxicillin, Ampicillin, Bacampicillin, Carbenicillin, Cloxacill in,  Dicloxacillin, Methicillin, Mezlocillin, Penicillin G, Penicillin V,   Ciprofloxacin, Gatifloxacin, Gemifloxacin, Levofloxacin, Lomefloxacin,  Moxifloxacin, Nalidixic Acid, Norfloxacin, Ofloxacin, Sparfloxacin,  Trovafloxacin   Administer didanosine at  least 6 hours before or 2  hours after quinolone    Phosphate Binders/Antacids  [aluminum hydroxide,  aluminum-magnesium  hydroxide, calcium acetate,  calcium carbonate,  magnesium hydroxide]    Iron Salts (Oral) [ferrous  fumarate, ferrous gluconate,  ferrous sulfate,  iron polysaccharide]    Phosphate Binders/Antacids  (aluminum carbonate,  aluminum hydroxide,  calcium acetate, calcium  carbonate, calcium citrate,  calcium glubionate, calcium  gluconate, calcium lactate,  tricalcium phosphate,  magaldrate, magnesium  carbonate, magnesium  gluconate, magnesium  hydroxide, magnesium oxide,  magnesium sulfate,  magnesium trisilicate)   Urinary Alkalinizers  [potassium citrate, sodium  acetate, sodium bicarbonate,  sodium citrate, sodium  lactate, tromethamine]   Separate administration  times by at least 3-4 hours.  Increase tetracycline  dose if necessary.   Barbiturates [amobarbital,  aprobarbital, butabarbital,  butalbital, mephobarbital,  metharbital, pentobarbital,  phenobarbital, primidone,  secobarbital]   Digoxin, see Antihypertensive and Cardiovascular Agents (Miscellaneous Antihypertensive and  Cardiovascular Agents) — Tetracyclines   Aluminum Salts  [aluminum carbonate,  aluminum hydroxide,  aluminum phosphate,  attapulgite, kaolin,  magaldrate]   Monitor for metronidazole  treatment failure. Increase  metronidazole dose if  necessary. Use higher initial  metronidazole dose.   Nondepolarizing Muscle  Relaxants [atracurium,  gallamine triethiodide,  metocurine iodide,  pancuronium, pipecuronium,  tubocurarine, vecuronium]   Avoid combination if possible.  Otherwise, monitor  respiratory function and  adjust nondepolarizing  muscle relaxant dose as  needed.   Avoid combination if possible.  Otherwise, increase azole  antifungal dose if necessary.   Digoxin, see Antihypertensive and Cardiovascular Agents (Miscellaneous Antihypertensive and  Cardiovascular Agents)   Avoid combination if possible.  Otherwise, administer  itraconazole with an acidic  beverage (cola).   Avoid combination if possible.  Otherwise, administer  ketoconazole with an  acidic beverage (cola).   Monitor liver function tests.  Discontinue one or both  drugs if necessary.   Avoid combination if possible.  Otherwise, monitor renal  function and discontinue  foscarnet if necessary.   Separate administration  times by at least 1 hour on  an empty stomach.   Use alternative nonhormonal  or additional method of  contraception. Use  alternative protease inhibitor  (eg, indinavir).   Use alternative nonhormonal  or additional method of  contraception. Use  alternative protease inhibitor  (eg, indinavir).   Avoid combination if possible.  Otherwise, decrease  rifabutin dose by 50%.  Increase ritonavir dose  if necessary.   No special precautions  needed when using  adenosine to terminate SVT  due to its short half-life.  Decrease initial infusion rate  of adenosine when using it to  simulate exercise during  cardiac imaging.   Limit acetaminophen use.  Monitor INR more frequently  with chronic or high doses of  acetaminophen.   Monitor INR. Adjust warfarin  dose as needed when  starting or stopping  aminoglutethimide.   Monitor INR. Decrease  warfarin dose empirically and  adjust warfarin dose as  needed.   Avoid combination if possible.  Otherwise, monitor INR and  decrease warfarin dose  if necessary.   Monitor INR. Adjust warfarin  dose as needed when  starting or stopping azole  antifungal.   Monitor INR. Adjust warfarin  dose as needed when  starting or stopping  carbamazepine.   Avoid combination if possible.  Otherwise, monitor INR and  decrease warfarin dose if  necessary. Use alternative  histamine H 2 -antagonist(eg,  ranitidine).   Monitor INR. Adjust warfarin  dose as needed when  starting, stopping, or  changing dose of  griseofulvin.   Monitor INR. Adjust warfarin  dose as needed when  starting or stopping HMG-  CoA reductase inhibitor.   Monitor INR when starting or  stopping levamisole. Adjust  warfarin dose as needed.    NSAIDs [diclofenac,  etodolac,fenoprofen,  flurbiprofen, ibuprofen,  indomethacin, ketoprofen,  ketorolac, meclofenamate,  nabumetone, naproxen,  oxaprozin, piroxicam,  sulindac, tolmetin]    Penicillins [ampicillin,  dicloxacillin, methicillin,  mezlocillin, nafcillin,  oxacillin, penicillin G,  piperacillin, ticarcillin]   Increased effects of warfarin  with large doses of IV  penicillin. Nafcillin and  dicloxacillin can cause  warfarin resistance.   Monitor INR. Adjust warfarin  dose as needed when  starting or stopping rifamycin.   Increased effects of warfarin  with large doses of salicylate.  Increased risk of bleeding  with any aspirin dose.   Avoid large doses of aspirin.  Monitor INR and for  signs/symptoms of bleeding.  Treat symptomatically.   Monitor INR. Adjust warfarin  dose as needed when  starting, stopping, or  changing dose of thyroid  hormone.   Avoid or minimize intake of  foods with high vitamin K.  Monitor INR. Adjust  warfarin dose as needed.   Avoid combination  if possible. Otherwise,  monitor carbamazepine  concentrations. Decrease  dose if necessary. Use  alternative histamine H 2 -  antagonist (eg, ranitidine).   Monitor liver function tests.  Monitor carbamazepine  concentrations. Decrease  carbamazepine dose  if necessary.   Avoid combination  if possible. Otherwise,  monitor carbamazepine  concentrations and  decrease dose if necessary.   Increased risk of severe  adverse effects (hyperpyrexia,  hyperexcitability, muscle rigidity,  seizures).   Avoid combination.  Discontinue MAO inhibitor  at least 14 days prior to  starting carbamazepine.   Monitor carbamazepine and  primidone concentrations.  Adjust dose of one or both  drugs as needed.   Avoid combination  if possible. Otherwise,  monitor carbamazepine  concentrations and  decrease dose if necessary.   Monitor carbamazepine and  tricyclic antidepressant  concentrations. Adjust dose  of one or both drugs  as needed.   Adjust dose of lamotrigine  as needed when starting,  stopping, or changing  dose of carbamazepine.   "Monitor free  (unbound) phenytoin  concentrations in  patients with renal  insufficiency or failure.   Monitor phenytoin  concentrations*  and signs/symptoms of  phenytoin toxicity. Monitor  for loss of amiodarone  effect. Adjust doses of one  or both drugs as needed.   Monitor for altered response  to phenytoin or anticoagulant.  Monitor phenytoin  concentrations* and INR.  Adjust dose of one or both  drugs as needed.    Corticosteroids, see Corticosteroids — Hydantoins  Cyclosporine, see Transplant Immunosuppressants — Hydantoins    Monitor carbamazepine and  phenytoin concentrations*.  Adjust dose of one or both  drugs as needed.   Monitor phenytoin  concentrations .* Adjust  dose of one or both  drugs as needed.   Monitor felbamate and  phenytoin concentrations .*  Adjust dose of one or both  drugs as needed.   Nisoldipine, see Antihypertensive Agents and Cardiovascular Agents  (Calcium-Channel Blockers) — Hydantoins   Monitor free phenytoin and  valproic acid concentrations.  Adjust dose of one or both  both drugs as needed.   Monitor valproic acid  concentrations, seizure  activity, and signs/symptoms  of toxicity for at least a month  after starting or stopping  either drug. Increase  valproic acid dose  if necessary.   Separate administration  times by at least 3 hours.  Monitor valproic acid  concentrations. Increase  valproic acid dose  if necessary.   Salicylates [aspirin,  bismuth subsalicylate,  choline salicylate,  magnesium salicylate,  salsalate, sodium salicylate,  sodium thiosalicylate]   Monitor free valproic acid  concentrations. Decrease  valproic acid dose  if necessary.   Allopurinol, see Arthritis and Gout Agents  (Miscellaneous Arthritis and Gout Agents) — Thiopurines   NSAIDs [diclofenac,  etodolac,fenoprofen,  flubiprofen, ibuprofen,  indomethacin, ketoprofen,  ketorolac, meclofenamate,  mefenamic acid,  nabumetone, naproxen,  oxaprozin, piroxicam,  sulindac, tolmetin]   Monitor for renal impairment  and signs/symptoms of  toxicity. Monitor  methotrexate concentrations.  Consider extended  leucovorin rescue therapy.   [amoxicillin, ampicillin,  bacampicillin, carbenicillin,  cloxacillin, dicloxacillin,  methicillin, mezlocillin,  penicillin G, penicillin V,  piperacillin, ticarcillin]   Monitor for signs/symptoms  of toxicity. Monitor  methotrexate concentrations.  Consider extended  leucovorin rescue therapy.   Decrease methotrexate dose.  Monitor for signs/symptoms  of toxicity. Monitor  methotrexate concentrations.  Consider extended  leucovorin rescue therapy.    Salicylates [aspirin,  bismuth subsalicylate,  choline magnesium  salicylate, choline salicylate,  magnesium salicylate,  salsalate, sodium salicylate,  sodium thiosalicylate]   Decrease methotrexate dose.  Monitor for signs/symptoms  of toxicity. Monitor  methotrexate concentrations.  Consider extended  leucovorin rescue therapy.   Avoid combination  if possible. Otherwise,  monitor for signs/symptoms  of hematologic toxicity.  Administer leucovorin  if necessary.   Decrease thiopurine dose  by 25-33%. Monitor  hematologic function  (bone marrow suppression).   Diclofenac, Diflunisal, Etodolac, Fenoprofen, Flubiprofen, Ibuprofen,  Indomethacin, Ketoprofen, Ketorolac, Meclofenamate, Mefenamic Acid,  Nabumetone, Naproxen, Piroxicam, Sulindac, Tolmetin   Beta-Blockers, see Antihypertensive and Cardiovascular Agents  (Cardio-Selective and Noncardio-Selective Beta-Blockers ) — NSAIDs   Beta-Blockers, see Antihypertensive and Cardiovascular Agents  (Cardio-Selective and Noncardio-Selective Beta-Blockers) — NSAIDs    Digoxin, see Antihypertensive and Cardiovascular Agents  (Miscellaneous Antihypertensive and Cardiovascular Agents)   Beta-Blockers, see Antihypertensive and Cardiovascular Agents  (Cardio-Selective and Noncardio-Selective Beta-Blockers) — NSAIDs   Beta-Blockers, see Antihypertensive and Cardiovascular Agents  (Cardio-Selective and Noncardio-Selective Beta-Blockers) — NSAIDs   Increased concentrations  of theophylline. Pharmacologic  antagonism may decrease  effects of one or both drugs.   Monitor theophylline  concentrations. Decrease  theophylline dose by 20-40%  when starting cimetidine.   Monitor theophylline and  phenytoin concentrations.  Adjust dose of one or both  drugs as needed.   Decreased theophylline  concentrations in hyperthyroid  patients; returns to normal  once euthyroid state achieved.   Monitor theophylline  concentrations. Adjust  theophylline dose as needed.  Achieve euthyroid state  as soon as possible.   Decreased theophylline  concentrations in hyperthyroid  patients; returns to normal  once euthyroid state achieved.   Monitor theophylline  concentrations. Adjust  theophylline dose as needed.  Achieve euthyroid state  as soon as possible.   Monitor theophylline  concentrations. Decrease  theophylline dose by 50%  when starting zileuton.   Betamethasone, Corticotropin, Cortisone, Cosyntropin, Dexamethasone,  Fludrocortisone, Hydrocortisone, Methylprednisolone, Prednisolone,  Prednisone, Triamcinolone    Estrogens [chlorotrianisene,  conjugated estrogens,  diethylstilbesterol,  esterified estrogens,  estradiol, estrone,  estropipate, ethinyl estradiol,  quinestrol]    Estrogens [chlorotrianisene,  conjugated estrogens,  diethylstilbesterol,  esterified estrogens,  estradiol, estrone,  estropipate, ethinyl estradiol,  quinestrol]    Digoxin, see Antihypertensive and Cardiovascular Agents  (Miscellaneous Antihypertensive and Cardiovascular Agents)   Adjust diuretic dose as  needed. Monitor electrolyte  abnormalities and hydration  status when starting  combination therapy.   Monitor for toxicity. Use  alternative histamine  H 2 -antagonist (eg, ranitidine).   Aluminum Salts (Aluminum Carbonate, Aluminum Hydroxide) Calcium Salts  (Calcium Carbonate, Calcium Acetate), Magnesium Salts  (Magnesium Carbonate, Magnesium Hydroxide)   Verapamil, see Antihypertensive and Cardiovascular Agents  (Calcium-Channel Blockers) — Calcium Salts   Verapamil, see Antihypertensive and Cardiovascular Agents  (Calcium-Channel Blockers) — Calcium Salts   No drug-drug interaction studies were performed in humans. There is a possibility that sevelamer  hydrochloride may bind concomitantly administered drugs and decrease their bioavailability.    Digoxin, see Antihypertensive and Cardiovascular Agents  (Miscellaneous Antihypertensive and Cardiovascular Agents)   Use cardio-selective  beta-blocker. Monitor for  signs/symptoms of  hypoglycemia not  affected by beta-blockers.    Salicylates [aspirin,  bismuth subsalicylate,  choline salicylate,  magnesium salicylate,  salsalate, sodium salicylate,  sodium thiosalicylate]   Avoid combination.  Discontinue metformin for at  least 48 hours prior to and  subsequent to the use of IV  iodinated contrast materials.   Monitor blood glucose  concentration. Decrease  sulfonylurea dose  if necessary. Use  noninteracting sulfonylurea  (eg, glyburide).   Increased concentrations  of fasting blood glucose.  Decreased hypoglycemic  effects of sulfonylurea.    Urinary Alkalinizers  [potassium citrate, sodium  acetate, sodium bicarbonate,  sodium citrate, sodium  lactate, tromethamine]   Digoxin, see Antihypertensive and Cardiovascular Agents  (Miscellaneous Antihypertensive and Cardiovascular Agents)   Avoid combination if possible.  Otherwise, monitor for  signs/symptoms of statin  toxicity. Decrease statin  dose if necessary.   Avoid combination if possible.  Otherwise, monitor for  signs/symptoms of statin  toxicity. Decrease statin  dose if necessary.   Avoid combination if possible.  Otherwise, monitor for  signs/symptoms of statin  toxicity. Use noninteracting  statin (eg, fluvastatin,  pravastatin).   Avoid combination. Advise  chronic ethanol consumers  to avoid excessive or  prolonged use of  acetaminophen.   Avoid chronic and excessive  use of acetaminophen with  regular hydantoin therapy.   Avoid chronic and excessive  use of acetaminophen with  regular sulfinpyrazone  therapy.   Increased risk of carbonic  anhydrase inhibitor toxicity  (CNS depression,  metabolic acidosis).   Agitation, seizures, diaphoresis  and fever. May progress to  coma, apnea, and death.   Decreased effects of  methadone. Possible with-  drawal symptoms in patients  on chronic methadone therapy.   Monitor clinical response  when starting and stopping  fluvoxamine in patients on  chronic methadone therapy.   Decreased effects of  methadone. Possible with-  drawal symptoms in patients  on chronic methadone therapy.   Decreased effects  of methadone. Possible with-  drawal symptoms in patients  on chronic methadone therapy.   Decreased effects  of methadone. Possible with-  drawal symptoms in patients  on chronic methadone therapy.   Increased risk of propoxyphene  toxicity (seizures, respiratory  depression, apnea, cardiac  arrhythmias, pulmonary edema).   Increased risk of serotonin  syndrome (CNS irritability,  shivering, myoclonus,  altered consciousness).   Avoid combination. Allow  at least 2 weeks after  stopping MAO inhibitor  before starting serotonin  reuptake inhibitor, and  vice versa. Allow at least   Sympathomimetics  [amphetamine,  benzphetamine,  dextroamphetamine,  dexfenfluramine,  diethylpropion, fenfluramine,  mazindol, methamphetamine,  phendimetrazine,  phenmetrazine, phentermine]   Increased risk of serotonin  syndrome (CNS irritability,  shivering, myoclonus,  altered consciousness).   CNS toxicity and adjust  dose of one or both drugs  as needed.   Avoid combination if possible.  Otherwise, monitor liver  function tests. Use  alternative serotonin  reuptake inhibitor  (eg, fluoxetine).   Monitor tricyclic  antidpressant concentra-  tions. Adjust tricyclic  antidepressant dose as  needed when starting or  stopping cimetidine. Use  alternative histamine H 2 -  antagonist (eg, ranitidine).   Increased concentrations  of tricyclic antidepressant.  Increased risk of serotonin  syndrome (CNS irritability,  shivering, myoclonus,  altered consciousness).   Monitor tricyclic  antidepressant concentra-  tions and for signs/symptoms  of toxicity. Decrease  tricyclic antidepressant dose  if necessary.   Increased concentrations  of tricyclic antidepressant.  Increased risk of serotonin  syndrome (CNS irritability,  shivering, myoclonus,  altered consciousness).   Monitor tricyclic  antidepressant concentra-  tions and for signs/symptoms  of toxicity. Decrease  tricyclic antidepressant dose  if necessary.   Allow at least 2 weeks  after stopping MAO inhibitor  before starting bupropion.   Angiotensing Converting  Enzyme Inhibitors [benazepril,  captopril, enalapril, fosinopril,  lisinopril, moexipril, quinapril,  ramipril, trandolapril]    Angiotensin II Receptor  Blockers [candesartan,  eprosartan, irbesartan,  losartan, olmesartan,  telmisartan, valsartan]   Monitor for signs/symptoms  of toxicity. Discontine one  or both drugs if necessary.    Iodide Salts [calcium iodide,  hydrogen iodide, iodide,  iodinated glycerol, iodine,  potassium iodide,  sodium iodide]    Urinary Alkalinizers  [potassium citrate, sodium  acetate, sodium bicarbonate,  sodium citrate, sodium  lactate, tromethamine]   Anticholinergics  [atropine, belladonna,  benztropine, biperiden,  clidinium, dicyclomine,  glycopyrrolate,  hyoscyamine, mepenzolate,  methscopolamine,  orphenadrine, oxybutynin,  procyclidine, propantheline,  scopolamine, trihexyphenidyl]   Decreased concentrations  of haloperidol. Worsening of  schizophrenic symptoms.  Development of  tardive dyskinesia.   Adjust haloperidol dose  as needed when starting or  stopping azole antifungal.   Alterations in consciousness,  encephalopathy, extrapyramidal  effects, fever, leukocytosis,  and increased serum enzymes.   Avoid combination if possible.  Otherwise, discontinue  one or both drugs and  provide supportive treatment  if necessary.   Acetophenazine, Chlorpromazine, Fluphenazine, Mesoridazine,  Methotrimeprazine, Perphenazine, Prochlorperazine, Promazine,  Promethazine, Propiomazine, Thiethylperazine, Thioridazine,   Anticholinergics  [atropine, belladonna,  benztropine, biperiden,  clidinium, dicyclomine,  glycopyrrolate, hyoscyamine,  isopropamide, mepenzolate,  orphenadrine, oxybutynin,  oxyphencyclimine,  procyclidine, propantheline,  scopolamine,  trihexyphenidyl]   Increased effects of  phenothiazine. Increased risk  of life-threatening cardiac  arrhythmias with thioridazine.   Avoid combination if possible  (thioridazine is  contraindicated). Adjust  phenothiazine dose  as needed.   Beta-Blockers, see Antihypertensive and Cardiovascular Agents  (Cardio-Selective and Noncardio-Selective Beta-Blockers )   Alprazolam, Chlordiazepoxide, Clonazepam, Clorazepate, Diazepam,  Estazolam, Flurazepam, Halazepam, Lorazepam, Midazolam, Oxazepam,  Quazepam, Temazepam, Triazolam   Benzodiazepines,  Oxidative  Metabolism-class  [alprazolam,  chlordiazepoxide,  clonazepam,  clorazepate, diazepam,  estazolam, flurazepam,  halazepam, midazolam,  quazepam, triazolam]   Avoid combination if possible  (alprazolam and triazolam  are contraindicated with  itraconazole and  ketoconazole). Otherwise,  decrease benzodiazepine  dose.   Decrease benzodiazepine  dose if necessary. Use  alternative benzodiazepine  (eg, lorazepam, oxazepam,  temazepam). Use alternative  macrolide antibiotic  (eg, azithromycin).   Adjust buspirone dose  as needed when starting,  stopping, or changing dose  of azole antifungal.   Adjust buspirone dose  as needed when starting,  stopping, or changing dose  of macrolide antibiotic.   Adjust buspirone dose  as needed when starting,  stopping, or changing dose  of rifamycin.   Monitor cyclosporine  concentrations and for  signs/symptoms of toxicity.  Decrease cyclosporine dose  if necessary.   Monitor cyclosporine  concentrations and for  signs/symptoms of toxicity.  Decrease cyclosporine dose  if necessary.   Monitor cyclosporine  concentrations and for  signs/symptoms of toxicity.  Adjust cyclosporine dose as  needed when starting or  stopping azole antifungal.   Monitor cyclosporine  concentrations and for  signs/symptoms of organ  rejection. Increase  cyclosporine dose  if necessary.   Monitor cyclosporine  concentrations and for  signs/symptoms of toxicity.  Decrease cyclosporine dose  if necessary.   Avoid combination if possible.  Otherwise, monitor for  signs/symptoms of  hepatotoxicty. Discontinue  caspofungin if necessary.   Monitor cyclosporine  concentrations and for  signs/symptoms of toxicity.  Decrease cyclosporine  dose if necessary.    Digoxin, see Antihypertensive and Cardiovascular Agents  (Miscellaneous Antihypertensive and Cardiovascular Agents)   Monitor cyclosporine  concentrations and for  signs/symptoms of toxicity.  Decrease cyclosporine dose  if necessary.   Monitor complete blood  count for increased bone  marrow suppression.  Decrease etoposide dose  if necessary.   Monitor cyclosporine  concentrations and for  signs/symptoms of organ  rejection. Increase  cyclosporine dose  if necessary.   Monitor cyclosporine  concentrations and for  signs/symptoms of toxicity.  Adjust cyclosporine dose  as needed when starting or  stopping macrolide antibiotic.   Monitor cyclosporine  concentrations and for  signs/symptoms of toxicity.  Adjust cyclosporine dose  as needed when starting,  stopping, or changing dose  of metoclopramide.   Monitor cyclosporine  concentrations and for  signs/symptoms of toxicity.  Decrease cyclosporine dose  if necessary.   Monitor cyclosporine  concentrations and for  signs/symptoms of toxicity.  Decrease cyclosporine dose  if necessary.   Monitor cyclosporine  concentrations and for signs/  symptoms of organ rejection.  Increase cyclosporine  dose if necessary.   Avoid combination if possible.  Otherwise, monitor  cyclosporine concentrations  and for signs/symptoms of  organ rejection. Adjust  cyclosporine dose as needed  when starting, stopping, or  changing dose of rifamycin.   Decreased effects of  cyclosporine. Increased risk  of nephrotoxicity with  oral sulfonamides.   Avoid combination if possible.  Otherwise, monitor  cyclosporine concentrations  and for signs/symptoms of  organ rejection. Adjust  cyclosporine dose as needed  when starting, stopping,  or changing dose of  sulfonamide.   Monitor cyclosporine  concentrations and for signs/  symptoms of organ rejection.  Adjust cyclosporine dose  as needed when starting or  stopping terbinafine.   Increased concentrations  of cyclosporine. Possible  nephroprotective effect if  verapamil is adminstered  before cyclosporine.   Monitor cyclosporine  concentrations and for  signs/symptoms of toxicity.  Decrease cyclosporine dose  if necessary.   Iron Salts, Oral  [ferrous fumarate, ferrous  gluconate, ferrous sulfate,  iron polysaccharide]   Monitor mycophenolic acid  levels. Adjust mycophenolate  doses as needed when  starting or stopping  tacrolimus.   Monitor sirolimus  concentrations and for  signs/symptoms of toxicity.  Adjust sirolimus dose as  needed when starting or  stopping azole antifungal.   Administer sirolimus 4 hours  after cyclosporine to  prevent changes in  sirolimus concentrations.   Monitor sirolimus  concentrations and for  signs/symptoms of toxicity.  Adjust sirolimus dose as  needed when starting or  stopping diltiazem.   Monitor tacrolimus  concentrations and for  signs/symptoms of toxicity.  Adjust tacrolimus dose as  needed when starting or  stopping azole antifungal.   Monitor tacrolimus  concentrations. Adjust  tacrolimus dose as needed  when starting or stopping  caspofungin.   Monitor tacrolimus  concentrations and for  signs/symptoms of toxicity.  Decrease tacrolimus dose  if necessary.   Monitor tacrolimus and  phenytoin concentrations.  Adjust doses of one or both  drugs as needed.   Monitor tacrolimus  concentrations and for  signs/symptoms of toxicity.  Adjust tacrolimus dose as  needed when starting or  stopping azole antifungal.   Monitor tacrolimus  concentrations and for  signs/symptoms of toxicity.  Decrease tacrolimus dose  if necessary.   Monitor tacrolimus  concentrations. Adjust  tacrolimus dose as needed  when starting or stopping  rifamycin.   Avoid combination if possible.  Use alternative antibiotic.  Discontinue one or both  drugs if ergotism develops.  Administer sodium  nitroprusside to decrease  macrolide-ergot induced  vasopasm if necessary.   Increased standing systolic  blood pressure. Pharmacologic  antagonism between  dihydroergotamine and  nitroglycerin may decrease  antianginal effects  of nitroglycerin.   Estrogens  [chlorotrianisene,  conjugated estrogens,  diethylstilbesterol,  esterified estrogens,  estradiol, estriol,  estrogenic substance,  estrone, estropipate,  ethinyl estradiol,  mestranol, quinestrol]   Use alternative nonhormonal  or additional method of  contraception. Increase  estrogen dose if necessary.   Use alternative nonhormonal  or additional method of  contraception. Increase  estrogen dose if necessary.   Use alternative nonhormonal  or additional method of  contraception. Increase  estrogen dose if necessary.    Benzodiazepines  [alprazolam,  chlordiazepoxide,  clorazepate, diazepam,  estazolam, flurazepam,  halazepam, lorazepam,  midazolam, oxazepam,  prazepam, quazepam,  temazepam, triazolam]    Phenothiazines  [acetophenazine,  chlorpromazine,fluphenazine,  mesoridazine, perphenazine,  prochlorperazine, promazine,  promethazine, thioridazine,  trifluoperazine,  triflupromazine, trimeprazine]   Separate administration  times by at least 6 hours.  Monitor thyroid function.  Increase levothyroxine dose  if necessary.   Decreased serum  concentrations of free thyroxine.  Increased serum  concentrations of thyrotropin.   Monitor serum thyrotropin  concentrations approximately  12 weeks after starting  estrogen. Adjust  levothyroxine dose  as needed.   Separate administration  times. Monitor thyroid  function. Increase  levothyroxine dose  if necessary.   Separate administration  times by at least 8 hours.  Monitor thyroid function.  Increase levothyroxine dose  if necessary.   Consider doubling  metyrapone dose when  testing pituitary-adrenal  axis function in patients on  chronic hydantoin therapy.   Digoxin, see Antihypertensive and Cardiovascular Agents  (Miscellaneous Antihypertensive and Cardiovascular Agents)   Increased risk of serotonin  syndrome (CNS irritability,  shivering, myoclonus,  altered consciousness).   Avoid combination if possible.  Otherwise, obtain medical  treatment if serotonin  syndrome develops.   Increased risk of serotonin  syndrome (CNS irritability,  shivering, myoclonus,  altered consciousness).   Avoid combination if possible.  Otherwise, obtain medical  treatment if serotonin  syndrome develops.   Increased risk of serotonin  syndrome (CNS irritability,  shivering, myoclonus,  altered consciousness).   Avoid combination if possible.  Otherwise, obtain medical  treatment if serotonin  syndrome develops.   Increased risk of serotonin  syndrome (CNS irritability,  shivering, myoclonus,  altered consciousness).   Allow at least 2 weeks after  stopping MAO inhibitor  before starting sibutramine,  and vice versa.   Increased risk of serotonin  syndrome (CNS irritability,  shivering, myoclonus,  altered consciousness).   Avoid combination if possible.  Otherwise, obtain medical  treatment if serotonin  syndrome develops.   Increased risk of serotonin  syndrome (CNS irritability,  shivering, myoclonus,  altered consciousness).   Avoid combination if possible.  Otherwise, obtain medical  treatment if serotonin  syndrome develops.   Increased risk of serotonin  syndrome (CNS irritability,  shivering, myoclonus,  altered consciousness).   Avoid combination if possible.  Otherwise, obtain medical  treatment if serotonin  syndrome develops.   Amobarbital, 10, 12, 13, 16, 23, 24, 26, 29, 38, 40, 47,  52 , 57, 58  Amoxapine, 9, 49  Amoxicillin, 21 , 36  Amphetamine, 48  Ampicillin, 11,19,21,31,36  Amprenavir, 57  Amyl Nitrite, 17 , 57  Androgens, 9 , 29, 53   Angiotensin Converting Enzyme Inhibitors, 10  Angiotensin II Receptor Blockers, 10 , 50  Anisidione, 33   Antiarrhythmic Agents, 14, 52  Anticholinergics, 51  Anticholinesterases, 40  Anticoagulants, 33  Antineoplastic Agents, 17, 34  Aprobarbital, 10, 12, 13, 16, 23, 24, 26, 29, 38, 40, 47,  52,57   Azole Antifungals, 24 , 27, 28, 29, 40, 45, 51, 52, 53, 56   Barbiturates, 10, 12, 13, 16, 23, 24, 25, 26, 29,35,38,  40, 47, 52 , 57, 58  Belladonna, 51  Benazepril, 10 , 50  Bendroflumethiazide, 18, 41, 44, 50  Benzodiazepines, 52 , 58  Benzphetamine, 48  Benzthiazide, 41 , 44 , 50  Benztropine, 51  Bepridil, 12 , 17, 22   Butabarbital, 10, 12, 13, 16, 23, 24, 26, 29, 38, 40, 47,  52 , 57, 58   Butalbital, 10, 12, 13, 16, 23, 24, 26, 29, 38, 40, 47, 52,  57, 58   Calcium Acetate, 9, 13, 22, 23, 42  Calcium Carbonate, 9, 13, 22, 23, 42  Calcium Chloride, 13  Calcium Citrate, 13, 23  Calcium Glubionate, 13, 23  Calcium Gluconate, 13, 23  Calcium Glycerophosphate, 13  Calcium Iodide, 50  Calcium Lactate, 13, 23  Calcium Levulinate, 13  Calcium Salts, 42    Page numbers appearing in bold represent location of the medication in the "DRUG" column of the Table.   Cimetidine, 10, 13, 15, 16, 25, 30, 31, 34, 38, 41, 43, 49  Ciprofloxacin, 21, 22, 39, 55  Cisplatin, 34, 41  Citolapram, 47   Clarithromycin, 18, 20, 30, 32, 39, 45, 53, 54, 56, 57    Clonazepam, 52  Clonidine, 9  Clorazepate, 52, 58  □oxacillin, 21,36  Clozapine, 50  Codeine, 46  Colchicine, 37, 54  Colestipol, 40, 41,44, 45  Conjugated Estrogens, 40, 41, 57, 59  Contraceptives, Oral, 38  Corticosteroids, 40, 46  Corticotropin, 40  Cortisone, 40, 46  Cosyntropin, 40  Cyclophosphamide, 17  Cyclosporine, 17, 27, 45, 48, 53, 56  Cyproheptadine, 48, 59  Cytarabine, 17  Danazol, 29,32, 53  Dapsone,24  Delavirdine, 27, 57  Demeclocycline, 18, 21, 22  Desflurane, 11  Desipramine, 9, 32,49  Desoxycorticosterone, 46  Dexamethasone, 40, 46  Dexfenfluramine, 48  Dextroamphetamine, 48  Dextromethorphan, 59  Dextrothyroxine, 30, 39  Diazepam, 52, 58  Diazoxide, 34, 43  Dichlorphenamide, 46  Diclofenac, 19, 31, 36, 37, 50  Dicloxacillin, 21,31,36  Dicumarol, 33, 44  Dicyclomine, 51  Didanosine, 21, 25, 27  Diethylpropion, 48  Diethylstilbesterol, 40, 41, 57  Diflunisal, 37  Digoxin, 13, 17  Dihydroergotamine, 57  Diltiazem, 12, 16, 32, 38, 45, 52, 54, 56  Dipyridamole, 29  Dirithromycin, 39  Disopyramide, 14, 52  Disulfiram, 24, 30, 34, 38, 58  Divalproex, 33, 35, 49    Page numbers appearing in bold represent location of the medication in the "DRUG" column of the Table.    Divalproex Sodium, 33, 35  Dobutamine, 9, 49  Dopamine, 9, 34,49  Doxacurium, 14  Doxepin, 9, 32, 49  Doxorubicin, 17  Doxycycline, 18,21,22, 23  Dyphylline, 38  Efavirenz, 57  Enalapril, 10 , 50  Encainide, 28  Endrophonium, 40  Enflurane, 11  Enoxacin, 39  Ephedrine, 9, 49  Epinephrine, 9, 19 , 49  Epoetin Alfa, 9  Eprosartan, 10 , 50  Ergot Alkaloids, 57 , 59  Ergotamine, 57   Erythromycin, 13, 18, 20 , 30, 32, 39, 40, 45, 53, 54, 56,  57   Escitalopram, 47  Esmolol, 9, 10  Esomeprazole, 25, 42  Estazolam, 52 , 58  Esterified Estrogens, 40, 41 , 57 , 59  Esthinyl Estradiol, 59  Estradiol, 40, 41 , 57 , 59  Estriol, 57   Ethotoin, 13, 14, 15, 23, 25, 33, 37, 40, 46, 47, 54, 57, 59    Ferrous Fumarate, 9 , 22, 37, 55, 59  Ferrous Gluconate, 9 , 22, 37, 55, 59  Ferrous Sulfate, 9 , 22, 37, 55, 59  Fibric Acids, 30  Flecainide, 14 , 28  Flubiprofen, 19, 36,37   Fluconazole, 24 , 25 , 27, 28, 29, 34, 40, 44, 45, 51 , 52,  53, 56   Fluoxetine, 32, 34, 47 , 48 , 49, 50, 52, 60   Fosphenytoin, 13, 14, 15, 16, 23, 25, 33 , 37, 39, 40, 46,  47, 54, 56, 57, 59  Furazolindone, 58  Furosemide, 18, 19, 41  Gallamine Triethiodide, 24  Ganciclovir, 27  Gatifloxacin, 12, 14, 15, 21  Gemfibrozil, 30, 45  Gemifloxacin, 21  Gentamicin, 19  Glimepride, 43, 44  Glipizide, 43 , 59  Glucagon, 30  Glutethimide, 30, 58  Glyburide, 43 , 59  Glycopyrrolate, 51   Histamine H 2 -Antagonists, 25, 41  HMG-CoA Reductase Inhibitors, 30, 45  Hydantoins, 13, 14, 15, 16, 23, 25, 33 , 37, 39, 40, 46,  47, 54, 56, 57, 59  Hydralazine, 10, 19  Hydrochlorothiazide, 18, 41 , 44, 50  Hydrocortisone, 40 , 46  Hydroflumethiazide, 18, 41 , 44, 50    Page numbers appearing in bold represent location of the medication in the "DRUG" column of the Table. 
PharmacologyByLipincott MEDFACTS POCKET GUIDE OF DRUG INTERACTIONS_djvu.txt