Use Caution/Monitor. Use Caution/Monitor. Caution should be exercised with concomitant use of moderate CYP3A inhibitors. Modify Therapy/Monitor Closely. hydralazine, dexmethylphenidate. Use Caution/Monitor. Risk of hypertension. Coadministration with blood pressure lowering agents may increase the risk and severity of hypotension associated with amifostine. Use Caution/Monitor. commonly, these are "non-preferred" brand drugs. Either increases effects of the other by pharmacodynamic synergism. verapamil will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Monitor Closely (1)calcium carbonate decreases effects of verapamil by pharmacodynamic antagonism. hydralazine decreases levels of pyridoxine (Antidote) by unspecified interaction mechanism. Serious - Use Alternative (1)St John's Wort will decrease the level or effect of verapamil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. valsartan, insulin degludec. Minor/Significance Unknown. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Use Caution/Monitor.piroxicam decreases effects of valsartan by pharmacodynamic antagonism. Increased flibanserin adverse effects may occur if coadministered with multiple weak CYP3A4 inhibitors. Monitor Closely (1)sulfasalazine decreases effects of hydralazine by pharmacodynamic antagonism. Monitor Closely (1)perindopril, phentolamine. NSAIDs decrease prostaglandin synthesis. Monitor Closely (1)verapamil will increase the level or effect of prednisolone by P-glycoprotein (MDR1) efflux transporter. This product is manufactured and packaged in a facility which may also process milk, soy, wheat, egg, peanuts, tree nuts, fish, and crustacean shellfish. To view formulary information first create a list of plans. nafcillin decreases levels of verapamil by increasing metabolism. Monitor Closely (1)amifostine, verapamil. Modify Therapy/Monitor Closely. Modify Therapy/Monitor Closely. verapamil decreases levels of oxcarbazepine by increasing metabolism. Monitor Closely (1)bosentan will decrease the level or effect of verapamil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Enhanced antiplatelet activity. xipamide increases effects of valsartan by pharmacodynamic synergism. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Most Use Caution/Monitor. Avoid or Use Alternate Drug. Avoid or Use Alternate Drug. Use Caution/Monitor. deferasirox will decrease the level or effect of verapamil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins. Monitor Closely (1)verapamil will increase the level or effect of sufentanil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. verapamil will increase the level or effect of talazoparib by P-glycoprotein (MDR1) efflux transporter. Either increases toxicity of the other by Other (see comment). Minor/Significance Unknown. Use Caution/Monitor. To view formulary information first create a list of plans. Monitor Closely (1)sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of perindopril by Other (see comment). Use Caution/Monitor. Use Caution/Monitor. Modify Therapy/Monitor Closely. Use Caution/Monitor. Use Caution/Monitor. Minor/Significance Unknown. Serious - Use Alternative (1)hydralazine, pretomanid. Use Caution/Monitor. Minor (1)maitake increases effects of perindopril by pharmacodynamic synergism. Either increases toxicity of the other by pharmacodynamic synergism. Monitor Closely (1)hydralazine, norepinephrine. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. See zanubrutinib Dosage Modifications for precise recommendation. Mechanism: pharmacodynamic synergism. Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase the risk of toxicities of these drugs. Observe for possible additive hypotensive effects during concomitant use. verapamil will increase the level or effect of posaconazole by P-glycoprotein (MDR1) efflux transporter. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. Monitor Closely (1)valsartan increases effects of albiglutide by Other (see comment). Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternative therapies. Consider decreasing dosage of antihypertensive agent. Monitor Closely (1)perindopril increases levels of potassium chloride by decreasing elimination. Additionally, the reduction in blood pressure was small, and adding fiber should not be the only method used to manage high blood pressure. Use Caution/Monitor. Monitor Closely (1)hydralazine, isoproterenol. Avoid or Use Alternate Drug. Mechanism: pharmacodynamic synergism. Effect of interaction is not clear, use caution. Use Caution/Monitor. Use Caution/Monitor. . Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events. Modify Therapy/Monitor Closely. amlodipine and verapamil both increase anti-hypertensive channel blocking. Coadministration may result in a significant decrease in renal function. Sympathomimetics can antagonize the activity of some antihypertensive agents. Everolimus prescribing information lists indication-specific dosing recommendations.Serious - Use Alternative (3)verapamil will increase the level or effect of everolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)hydralazine, methylphenidate. Modify Therapy/Monitor Closely. Either increases toxicity of the other by Other (see comment). May advise patients to limit or minimize the intake of caffeinated products to minimize caffeine-related side effects. Use Caution/Monitor. Serious - Use Alternative (2)verapamil will increase the level or effect of venetoclax by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Avoid or Use Alternate Drug. Use Caution/Monitor. Monitor Closely (1)verapamil will increase the level or effect of amikacin by P-glycoprotein (MDR1) efflux transporter. Coadministration may result in a significant decrease in renal function. Use Caution/Monitor. meclofenamate, perindopril. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Reviewed in the United States on September 15, 2021. Monitor Closely (1)perindopril increases levels of potassium acid phosphate by decreasing elimination. Avoid or Use Alternate Drug. The recommended Alpha Lipoic Acid dosage will depend on why this supplement is being used and who is taking it. Additive hypotensive effects. Serious - Use Alternative (1)rifampin will decrease the level or effect of verapamil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. The results from an in vitro study with human liver tissue indicate that valsartan is a substrate of the hepatic uptake transporter OATP1B1; coadministration with OATP1B1 inhibitors may increase valsartan systemic exposure, Monitor Closely (1)erythromycin ethylsuccinate will increase the level or effect of valsartan by Other (see comment). Use Caution/Monitor.verapamil will increase the level or effect of ritonavir by P-glycoprotein (MDR1) efflux transporter. Coadministration may result in a significant decrease in renal function. The results from an in vitro study with human liver tissue indicate that valsartan is a substrate of the hepatic uptake transporter OATP1B1; coadministration with OATP1B1 inhibitors may increase valsartan systemic exposure ritonavir will increase the level or effect of valsartan by Mechanism: decreasing hepatic clearance. Comment: Low molecular weight heparins may suppress adrenal aldosterone secretion, which can potentially cause hyperkalemia. cobicistat will increase the level or effect of verapamil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Minor/Significance Unknown. verapamil will increase the level or effect of triazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. Monitor Closely (1)ketoconazole will increase the level or effect of valsartan by Other (see comment). Monitor digoxin levels closely when coadministered with drugs that may decrease glomerular filtration or tubular secretion. Patients who transfer to buprenorphine long-acting injection from transmucosal buprenorphine coadministered with CYP3A4 inhibitors should be monitored to ensure buprenorphine plasma levels are adequate. If coadministration of CYP3A4 inhibitors with fentanyl is necessary, monitor patients for respiratory depression and sedation at frequent intervals and consider fentanyl dose adjustments until stable drug effects are achieved. Avoid or Use Alternate Drug. Either increases toxicity of the other by pharmacodynamic synergism. verapamil will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid coadministration of neratinib with strong/moderate CYP3A4 inhibitors. Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Avoid or Use Alternate Drug. Use Caution/Monitor.Serious - Use Alternative (1)verapamil will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Apalutamide weakly induces OATP1B1 and may decrease systemic exposure of drugs that are OATP1B1 substrates. Use Caution/Monitor.Minor (1)verapamil will increase the level or effect of imatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.valsartan, meclofenamate. . Use Caution/Monitor. Use Caution/Monitor. Monitor for hypotension or muscle weakness in patients receiving calcium channel blockers with elevated serum magnesium concentrations. Additive hypotensive effects. Monitor Closely (1)mipomersen, verapamil. verapamil increases effects of cisatracurium by pharmacodynamic synergism. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. sulfamethoxazole will increase the level or effect of verapamil by basic (cationic) drug competition for renal tubular clearance. Monitor Closely (1)verapamil will increase the level or effect of methadone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Either increases effects of the other by pharmacodynamic synergism. TCA level may be increased. Monitor blood pressure and adjust dose of antihypertensive agent as needed. Between 1 - 3 g per day. Avoid or Use Alternate Drug. Monitor Closely (1)hydralazine increases levels of ivacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Coadministration may result in a significant decrease in renal function. Methylphenidate may diminish antihypertensive effects. valsartan and diclofenac both increase serum potassium. Use Caution/Monitor. Use Caution/Monitor. IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. glyburide will increase the level or effect of valsartan by Other (see comment). Most supplement manufacturers sell a combination form of this ingredient that contains both the R- and S- forms of the supplement, but there are some brands that sell pure R-Lipoic Acid. Monitor Closely (1)encorafenib will increase the level or effect of valsartan by Other (see comment). Avoid or Use Alternate Drug. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: fainting, symptoms of a high potassium blood level (such as muscle weakness, slow/irregular heartbeat).Although valsartan may be used to prevent kidney problems or treat people who have kidney problems, it may also rarely cause serious kidney problems or make them worse. Monitor Closely (3)verapamil will increase the level or effect of methylprednisolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. verapamil will increase the level or effect of levoketoconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. NVAF: No dose reduction recommended. Mechanism: pharmacodynamic synergism. Monitor Closely (1)verapamil will increase the level or effect of bortezomib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. View the formulary and any restrictions for each plan. Reishi Mushroom; Shroom Tech Immune; Turmeric; Inflamation & Joints. lornoxicam decreases effects of perindopril by pharmacodynamic antagonism. valsartan and fenoprofen both increase serum potassium. Use Caution/Monitor. Monitor for adverse reactions. Avoid or Use Alternate Drug. , Manufacturer 04/06/2022. Use Caution/Monitor. But tart cherry juice can be high in sugar so it's best to limit the amount you drink to about 4 oz to 6 oz, or no more than 8 oz per day in the context of an overall lower-sugar diet. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Minor (1)brimonidine increases effects of hydralazine by pharmacodynamic synergism. Coadministration with strong or moderate CYP3A4 inhibitors is contraindicated. Monitor Closely (3)valsartan, aspirin. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. If any of these effects last or get worse, tell your doctor or pharmacist promptly.To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. stiripentol, verapamil. Authorized health claims you can use on your label. You may report side effects to Health Canada at 1-866-234-2345. carbidopa increases effects of verapamil by pharmacodynamic synergism. valsartan and ketorolac both increase serum potassium. pharmacodynamic antagonism. perindopril, etodolac. Between 1 - 3 g per day. Calcium Channel Blockers, Non-dihydropyridine. Use Caution/Monitor. pharmacodynamic antagonism. Additive hypotensive effects. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. Both drugs decrease blood glucose. Monitor Closely (1)dasatinib will increase the level or effect of verapamil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. levodopa increases effects of hydralazine by pharmacodynamic synergism. Risk of acute hypotension, renal insufficiency. commonly, these are generic drugs. Either increases toxicity of the other by unspecified interaction mechanism. Most Use Caution/Monitor. These supplements have also been used to promote cognitive function, mood balance, energy levels, and to improve the appearance of facial wrinkles and skin damage caused by the sun. Consider reducing dose when used concomitantly with lomitapide. But tart cherry juice can be high in sugar so it's best to limit the amount you drink to about 4 oz to 6 oz, or no more than 8 oz per day in the context of an overall lower-sugar diet. It ranges from 21 to 26 grams of fiber daily for women and 30 to 38 grams daily for men, depending on age. WebDosage. Use Caution/Monitor. Use Caution/Monitor. verapamil will increase the level or effect of dihydroergotamine intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. verapamil increases levels of lofepramine by decreasing metabolism. Serious - Use Alternative (1)dalteparin increases toxicity of perindopril by Other (see comment). Use Caution/Monitor. Use Caution/Monitor. Coadministration may result in a significant decrease in renal function. aspirin decreases effects of hydralazine by pharmacodynamic antagonism. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. valsartan and piroxicam both increase serum potassium. Contraindicated. Not a fan of this serving scheme for supplements. methylphenidate transdermal decreases effects of perindopril by anti-hypertensive channel blocking. Consider reducing the dose of P-glycoprotein (P-gp) substrates, if adverse reactions are experienced when administered concomitantly with stiripentol. voxelotor will increase the level or effect of verapamil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. Enhanced antiplatelet activity. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment. Monitor Closely (1)verapamil will increase the level or effect of etonogestrel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor (1)thioridazine increases effects of perindopril by unspecified interaction mechanism. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.valsartan, ketoprofen. Modify Therapy/Monitor Closely. Modify Therapy/Monitor Closely. This drug is available at the lowest co-pay. diflunisal decreases effects of valsartan by pharmacodynamic antagonism. verapamil will increase the level or effect of romidepsin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. CrCl 30 mL/min: No dose adjustment necessary, CrCl <30 mL/min: No dosage adjustments provided in the manufacturers labeling; use caution, Dialysis: Drug is not significantly removed through dialysis, Mild-to-moderate liver impairment: No dosage adjustments necessary, Severe liver impairment: No dosage adjustments provided in the manufacturers labeling, 1 mg/kg PO qDay (up to 40 mg total); adjust dosage according to BP response, Consider higher starting dose of 2 mg/kg in selected cases when a greater BP reduction is needed, Adjust according to BP response and tolerability, not to exceed 4 mg/kg qDay (160 mg/day), Mild-to-moderate: Limited clinical experience; not dosage adjustment necessary, Severe: No dosing recommendation can be provided, Whom calculated dose (mg/kg) does not correspond to available tablet strengths, insulin isophane human/insulin regular human, ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC), sodium sulfate/?magnesium sulfate/potassium chloride, sodium sulfate/potassium sulfate/magnesium sulfate, Digestive: Elevated liver enzymes and very rare reports of hepatitis, Renal: Impaired renal function, renal failure, Dermatologic: Alopecia, bullous dermatitis, Discontinue immediately when pregnancy is detected, Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus, Excessive hypotension rarely occurs in patients with uncomplicated hypertension, Symptomatic hypotension may occur in patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients receiving high doses of diuretics, symptomatic hypotension may occur, If excessive hypotension occurs, place patient in supine position and, if necessary, give IV 0.9 NaCl, A transient hypotensive response is not a contraindication to further treatment, which usually can be continued without difficulty once stabilized, Potassium-sparing diuretics, potassium supplements or salt substitutes may lead to increases in serum potassium, and in heart failure patients, increases in serum creatinine, NSAID, including selective cyclooxygenase-2 inhibitors (COX-2 Inhibitors), use may lead to increased risk of renal impairment and loss of antihypertensive effect, Dual blockade of renin-angiotensin system (RAS) with angiotensin receptor blockers, ACE inhibitors, or aliskiren is associated with increased risks of hypotension, hyperkalemia, and changes in renal function, Closely monitor BP, renal function and electrolytes when treated with agents that affect the RAS, Do not coadminister with aliskiren in patients with diabetes or patients with renal impairment (GFR <60 mL/min), Increases in serum lithium level and lithium toxicity reported; monitor serum lithium levels, Hypertension in pregnancy increases maternal risk for pre-eclampsia, gestational diabetes, premature delivery, and delivery complications (eg, need for cesarean section, and postpartum hemorrhage), Hypertension increases fetal risk for intrauterine growth restriction and intrauterine death; carefully monitor pregnant women with hypertension and managed accordingly, Oligohydramnios in pregnant women who use drugs affecting the RAS in second and third trimesters of pregnancy can result in reduced fetal renal function leading to anuria and renal failure, fetal lung hypoplasia, skeletal deformations, including skull hypoplasia, hypotension and death, Perform serial ultrasound examinations to assess the intra-amniotic environment; fetal testing may be appropriate, based on gestation week; oligohydramnios may not appear until after the fetus has sustained irreversible injury, If oligohydramnios is observed, consider alternative therapy; closely observe neonates with histories of in utero exposure to the drug for hypotension, oliguria, and hyperkalemia; in neonates with a history of in utero exposure to the drug, if oliguria or hypotension occurs, support BP and renal perfusion, Exchange transfusions or dialysis may be required as a means of reversing hypotension and replacing renal function, Tablet: Food decreases AUC by ~40% and peak plasma concentration by ~50%, For patients who cannot swallow tablets, or children for whom calculated dosage (mg/kg) does not correspond to the available tablet strengths, Note: When replacing tablet for suspension, valsartan dose may have to be increased, Exposure to valsartan with suspension is 1.6x greater than with tablet, Store at room temperature (<30C/86F) for up to 30 days OR, Refrigerate at 2-8C (35-46F) for up to 75 days in the glass bottle with a child-resistant screw-cap closure, Store at 25C (77F); excursions permitted to 15-30C (59-86F). Use Caution/Monitor. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Use Caution/Monitor. verapamil increases levels of encainide by decreasing metabolism. Use Caution/Monitor. valsartan, entecavir. Minor/Significance Unknown. Use Caution/Monitor. Sympathomimetics can antagonize the activity of some antihypertensive agents. Avoid or Use Alternate Drug. The idea of "boosting your immune system" can be misleading. There are no reports of beta-glucan deficiency. Use Caution/Monitor. Monitor Closely (1)levodopa increases effects of hydralazine by pharmacodynamic synergism. Monitor Closely (2)voclosporin and perindopril both increase serum potassium. Bioavailability: Slow acetylator: 30-50%; rapid acetylator: 22-30%, Onset: 5-20 min, maximum effect 10-80 min (IV); 20-30 min (PO), Significantly metabolized in liver by acetylation; slow and rapid acetylator, Metabolites: Phthalazine and pyruvic acid hydrazone metabolites (inactive metabolite), Half-life: 2-8 hr (normal renal function); 7-16 hr (end-stage renal disease), HLA-DRw4 appears in 73% of patients experiencing hydralazine-associated SLE, Solution: D5W, D10/LR, fructose 10%, fructose 10%/NS, Additive: Aminophylline, ampicillin, chlorothiazide, dobutamine, CaNa2EDTA, ethacrynate, hydrocortisone sodium succinate, mephentermine, methohexital, nitroglycerin, phenobarbital, verapamil, Y-site: Aminophylline, ampicillin, diazoxide, furosemide, Solution: Dextrose-Ringer combinations, D5/LR, dextrose 2.5%/LR, dextrose-saline combinations, D10W, Ringer, LR, NS, NS, Na-lactate 1/6M, Y-site: Heparin, hydrocortisone sodium succinate, nitroglycerin (compatible for 3 hr; may form slight ppt), KCl, verapamil, vit B/C, Minimize contact with metal parts during preparation and administration, Administer undiluted IM or as slow IV push directly into vein; in children maximum rate is 5 mg/min; may also administer as continuous infusion. verapamil increases levels of bosutinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. WebReishi Mushroom Elixir Mix by Four Sigmatic | Coffee Alternative with Organic Reishi Mushroom Powder, Tulsi, Rose Hips & Mint | Support Stress & Sleep | Decaf, Vegan, Gluten-Free & Keto | 20 Packets 4.5 out of 5 stars 3,492 Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. valsartan and ibuprofen both increase serum potassium. If a moderate CYP3A inhibitor must be used, administer the moderate CYP3A inhibitor for <14 days and monitor closely for adverse reactions, particularly musculoskeletal adverse reactions. verapamil will increase the level or effect of efavirenz by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Coadministration with blood pressure lowering agents may increase the risk and severity of hypotension associated with amifostine. valsartan increases and methyclothiazide decreases serum potassium. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)verapamil, atenolol. Resume previous entrectinib dose after discontinuing moderate CYP3A inhibitor for 3-5 elimination half-lives. Monitor Closely (1)calcium acetate decreases effects of verapamil by pharmacodynamic antagonism. Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis. perindopril increases effects of chlorpropamide by pharmacodynamic synergism. Monitor digoxin levels closely when coadministered with drugs that may decrease glomerular filtration or tubular secretion. Either increases toxicity of the other by unspecified interaction mechanism. verapamil will increase the level or effect of digoxin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor Closely (1)verapamil will increase the level or effect of clomipramine by affecting hepatic enzyme CYP1A2 metabolism. May cause hyperkalemia, particularly with high doses, renal insufficiency, or when combined with other drugs that cause hyperkalemia. Monitor Closely (2)verapamil will increase the level or effect of clozapine by affecting hepatic enzyme CYP1A2 metabolism. Coadministration may result in a significant decrease in renal function. Monitor Closely (1)hydralazine, methamphetamine. No dose adjustment is warranted at the 75 mcg dose. Ca Channel Blockers interfere w/Ach release from prejunctional axon. Risk of hypotension. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis. It is also sold as a supplement. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Use Caution/Monitor. Use Caution/Monitor. verapamil will increase the level or effect of montelukast by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)amlodipine and verapamil both increase anti-hypertensive channel blocking. Additive hypotensive effects.carvedilol increases effects of hydralazine by pharmacodynamic synergism. Use Caution/Monitor. Avoid or Use Alternate Drug.Minor (1)verapamil will increase the level or effect of alosetron by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Concomitant use of insulin and ARBs may require insulin dosage adjustment and increased glucose monitoring. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. Always ask your health care professional for complete information about this product and your specific health needs. Modify Therapy/Monitor Closely. Therapy with carbidopa, given with or without levodopa or carbidopa-levodopa combination products, is started, dosage adjustment of the antihypertensive drug may be required. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Avoid or Use Alternate Drug. Reduced berotralstat dose to 110 mg/day when coadministered with P-gp inhibitors. Effect of interaction is not clear, use caution. Dual blockade of renin-angiotensin system increases risks of hypotension, hyperkalemia, and renal impairment. valsartan and pindolol both increase serum potassium. Use Caution/Monitor. Either increases toxicity of the other by Other (see comment). May inhibit organic anion transporter polypeptides; decrease dose of angiotensin receptor blockers and monitor patients for signs and symptoms of hypotension and/or worsening renal function; if such events occur, consider further dose reduction of angiotensin receptor blocker or switching to alternative to angiotensin receptor blocker Minor (1)ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC) will increase the level or effect of valsartan by decreasing elimination. Monitor Closely (1)armodafinil will decrease the level or effect of verapamil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Product labeling for PO topotecan recommends avoiding concomitant use of P-gp inhibitors; the interaction with IV topotecan may be less severe but is still likely of clinical significance. valsartan increases and cyclopenthiazide decreases serum potassium. Coadministration of doxorubicin and calcium channel blockers may increase the risk of doxorubicin cardiotoxicity. Change to oral therapy as soon as possible, 5-10 mg IV/IM initially, THEN 5-10 mg q20-30min PRN, OR, Infants and older: 0.75-3 mg/kg/day PO divided q6-12hr; not to exceed 200 mg/day or 7 mg/kg/day. verapamil will increase the level or effect of ondansetron by affecting hepatic enzyme CYP1A2 metabolism. PRECAUTIONS: Before taking verapamil, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. Concomitant use of a moderate 3A4 inhibitor such as verapamil may significantly increase the plasma concentrations of everolimus following oral administration.verapamil will increase the level or effect of everolimus by P-glycoprotein (MDR1) efflux transporter. The risk of bradycardia increases with coadministration of drugs that slow heart rate (eg, digoxin, amiodarone, beta-blockers). Monitor Closely (1)verapamil will increase the level or effect of etoposide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Use Caution/Monitor. Modify Therapy/Monitor Closely. Avoid or Use Alternate Drug. Use Caution/Monitor.tolmetin decreases effects of valsartan by pharmacodynamic antagonism. Use Caution/Monitor. phenoxybenzamine and verapamil both increase anti-hypertensive channel blocking. Minor/Significance Unknown. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension. verapamil, cyclosporine. Avoid or Use Alternate Drug. Use Caution/Monitor. 2022;61(4):1749-1778. doi:10.1007/s00394-021-02763-1, Francelino Andrade E, Vieira Lobato R, Vasques Arajo T, Gilberto Zangernimo M, Vicente Sousa R, Jos Pereira L. Effect of beta-glucans in the control of blood glucose levels of diabetic patients: a systematic review. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternative therapies. Modify Therapy/Monitor Closely. naproxen decreases effects of hydralazine by pharmacodynamic antagonism. Use Caution/Monitor. Monitor Closely (1)secobarbital will decrease the level or effect of verapamil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. sacubitril/valsartan, perindopril. Use Caution/Monitor. Use Caution/Monitor. Dual blockade of renin-angiotensin system increases risks of hypotension, hyperkalemia, and renal impairment. carbamazepine will increase the level or effect of valsartan by Other (see comment). sevelamer decreases levels of verapamil by increasing elimination. Monitor Closely (1)valsartan increases and ethacrynic acid decreases serum potassium. Use Caution/Monitor.ketoprofen decreases effects of valsartan by pharmacodynamic antagonism. Additive hypotensive effects. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious - Use Alternative (1)ketorolac intranasal, perindopril. Use Caution/Monitor. Avoid or Use Alternate Drug. Use Caution/Monitor. Mechanism: pharmacodynamic antagonism. carvedilol and verapamil both increase anti-hypertensive channel blocking. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation. Reduce lumateperone dose to 21 mg/day if coadministered with moderate CYP3A4 inhibitors. pharmacodynamic antagonism. The results from an in vitro study with human liver tissue indicate that valsartan is a substrate of the hepatic uptake transporter OATP1B1; coadministration with OATP1B1 inhibitors may increase valsartan systemic exposure. Use Caution/Monitor.budesonide will decrease the level or effect of verapamil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Minor (2)verapamil will increase the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Use Caution/Monitor. Risk of hypertension. This drug is available at a higher level co-pay. Monitor heart rate in patients taking ivabradine with other negative chronotropes. The results from an in vitro study with human liver tissue indicate that valsartan is a substrate of the hepatic uptake transporter OATP1B1; coadministration with OATP1B1 inhibitors may increase valsartan systemic exposure. Comment: Risk of anaphylactic reaction. lasmiditan increases levels of verapamil by P-glycoprotein (MDR1) efflux transporter. verapamil will increase the level or effect of cinacalcet by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs. Use Caution/Monitor. verapamil will increase the level or effect of dexamethasone by P-glycoprotein (MDR1) efflux transporter. Comment: Theoretically, shepherd's purse may interfere with BP control. Modify Therapy/Monitor Closely. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)verapamil, sotalol. Can increase risk of bradycardia. Read More; I Have it Every Night! Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Use Caution/Monitor. DRUG INTERACTIONS: See also Precautions section.Drug interactions may change how your medications work or increase your risk for serious side effects. verapamil will increase the level or effect of sirolimus by P-glycoprotein (MDR1) efflux transporter. Adjust dose according to prescribing information if needed. Use Caution/Monitor. valsartan and potassium chloride both increase serum potassium. Please confirm that you would like to log out of Medscape. Most Use Caution/Monitor. Use Caution/Monitor. Minor (1)promethazine increases effects of perindopril by unspecified interaction mechanism. Use Caution/Monitor.Minor (1)verapamil will increase the level or effect of paclitaxel protein bound by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Do not substitute tablets with capsules. If concomitant use is necessary, may require less frequent oliceridine dosing. IDM Members' meetings for 2022 will be held from 12h45 to 14h30.A zoom link or venue to be sent out before the time.. Wednesday 16 February; Wednesday 11 May; Wednesday 10 August; Wednesday 09 November Avoid or Use Alternate Drug. Monitor Closely (1)dronedarone will increase the level or effect of verapamil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (3)valsartan, meclofenamate. Use Caution/Monitor. Use Caution/Monitor. verapamil, mavacamten. Use Caution/Monitor. verapamil will increase the level or effect of cortisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Consult your doctor for more details. WebAdjust according to BP response and tolerability, not to exceed 4 mg/kg qDay (160 mg/day) Dosage Modifications Renal impairment. Modify Therapy/Monitor Closely. piroxicam decreases effects of valsartan by pharmacodynamic antagonism. AVOID FORMULAS THAT USE MYCELIUM (the root system). NSAIDs decrease prostaglandin synthesis. Modify Therapy/Monitor Closely. Most Coadministration may result in a significant decrease in renal function. 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