Modify Therapy/Monitor Closely. Avoid or Use Alternate Drug. paroxetine will increase the level or effect of lofepramine by affecting hepatic enzyme CYP2D6 metabolism. oxaprozin decreases effects of eplerenone by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Either increases toxicity of the other by unspecified interaction mechanism. Comment: Inhibition of uptake by adrenergic neurons. Avoid or Use Alternate Drug. Modify Therapy/Monitor Closely. Modify Therapy/Monitor Closely. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. clonidine, aripiprazole. doxepin and paroxetine both increase QTc interval. Avoid or Use Alternate Drug. Mechanism: pharmacodynamic synergism. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. bismuth subsalicylate decreases levels of doxycycline by inhibition of GI absorption. Monitor Closely (1)quinapril, eplerenone. Avoid or Use Alternate Drug.fluphenazine and paroxetine both increase QTc interval. paroxetine will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. lithium and paroxetine both increase QTc interval. Use Caution/Monitor. Use Caution/Monitor. SSRIs may inhibit platelet aggregation, thus increase bleeding risk when coadministered with anticoagulants. Minor/Significance Unknown. Serious - Use Alternative (1)azathioprine and hydroxychloroquine sulfate both increase immunosuppressive effects; risk of infection. Minor (1)azithromycin and paroxetine both increase QTc interval. Inititiation of weak CYP2C19 inhibitors may require decreased mavacamten dose. Use Caution/Monitor. Modify Therapy/Monitor Closely. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. phenytoin decreases levels of doxycycline by increasing metabolism. Either increases effects of the other by pharmacodynamic synergism. hydroxychloroquine sulfate and gemifloxacin both increase QTc interval. Monitor Closely (1)doxycycline will increase the level or effect of suvorexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. NSAIDs decrease prostaglandin synthesis. Minor/Significance Unknown. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Avoid or Use Alternate Drug. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Applies only to oral form of both agents. Use Caution/Monitor. Avoid coadministration of tazemetostat with moderate CYP3A4 inhibitors. Serious - Use Alternative (1)anakinra and hydroxychloroquine sulfate both increase immunosuppressive effects; risk of infection. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. pharmacodynamic antagonism. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Serious - Use Alternative (1)paroxetine and dosulepin both increase serotonin levels. Separate by 2 hours. serotonin uptake by platelets. Monitor Closely (2)paroxetine will increase the level or effect of tropisetron by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown. Minor/Significance Unknown. bismuth subsalicylate, sotalol. Monitor Closely (1)paroxetine, flurbiprofen. Minor (1)bismuth subsalicylate increases effects of aspirin/citric acid/sodium bicarbonate by pharmacodynamic synergism. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Rolapitant may increase plasma concentrations of CYP2D6 substrates for at least 28 days following rolapitant administration. To prevent any reactions while you are stopping treatment with this drug, your doctor may reduce your dose gradually. Comment: Decreased symptoms of hypoglycemia. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). Minor/Significance Unknown. Modify Therapy/Monitor Closely. Serious - Use Alternative (1)chlorpromazine decreases effects of ropinirole by pharmacodynamic antagonism. Serious - Use Alternative (1)efavirenz and hydroxychloroquine sulfate both increase QTc interval. Modify Therapy/Monitor Closely. Serious - Use Alternative (1)hydroxychloroquine sulfate, axicabtagene ciloleucel. If concomitant use is necessary, may require less frequent oliceridine dosing. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. You may report side effects to Health Canada at 1-866-234-2345. Minor/Significance Unknown. Monitor Closely (1)hydroxychloroquine sulfate and mercaptopurine both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Avoid or Use Alternate Drug. Avoid or Use Alternate Drug. Monitor heart rate in patients receiving concomitant verapamil and clonidine. 20021188558-overviewDiseases & Conditions, 20021188327-overviewDiseases & Conditions, encoded search term (ropinirole (Requip%2C Requip XL)) and ropinirole (Requip, Requip XL), Continuous L-Dopa Enteric Infusion Relieves RLS Symptoms, AAN Releases First Treatment Guideline on Restless Legs Syndrome, Drug Mix-Up Puts Patients at Serious Risk, FDA Warns. Mechanism: decreased hypoglycemia induced catecholamine production. Avoid or Use Alternate Drug. Contraindicated. Use Caution/Monitor. Do not stop taking this medication without consulting your doctor. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed. bosentan will decrease the level or effect of eplerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. clonidine, guanfacine. Minor (2)clonidine decreases effects of insulin aspart by pharmacodynamic antagonism. Avoid or Use Alternate Drug. If coadministered, monitor appropriately. ferric citrate will decrease the level or effect of doxycycline by drug binding in GI tract. Additive hypotensive effects; potential delirium. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. Monitor Closely (1)secukinumab, clonidine. lurasidone, paroxetine. Coadministration with SSRIs, TCAs, or trazodone may require dose titration of antidepressant to desired effect (eg, using the lowest feasible initial or maintenance dose). Monitor Closely (1)doxycycline decreases effects of cefoxitin by pharmacodynamic antagonism. Mechanism: pharmacodynamic synergism. clonidine, metyrosine. Mechanism: pharmacodynamic synergism. doxycycline, methoxyflurane. saquinavir increases levels of eplerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Consider decreasing dosage of antihypertensive agent. Comment: Inhibition of uptake by adrenergic neurons. Monitor Closely (1)carbidopa increases effects of eplerenone by pharmacodynamic synergism. A: Generally acceptable. Use Caution/Monitor. Monitor Closely (1)sacubitril/valsartan, eplerenone. Avoid or Use Alternate Drug. All material on this website is protected by copyright, Copyright 1994-2022 by WebMD LLC. Use Caution/Monitor. Other (see comment). Glycerol phenylbutyrate is a weak inducer of CYP3A4. Contraindicated. USES: This medication is used to treat occasional upset stomach, heartburn, and nausea. Contraindicated. Modify Therapy/Monitor Closely. Additive hypotensive effects; potential delirium. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment. Minor/Significance Unknown. In some cases, sleep occurred without any feelings of drowsiness beforehand. Other (see comment). Minor (1)salicylates (non-asa) decreases effects of eplerenone by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity. Minor (1)doxycycline will decrease the level or effect of pyridoxine (Antidote) by altering intestinal flora. It works by helping to restore the balance of a certain natural substance (serotonin) in the brain.Paroxetine is known as a selective serotonin reuptake inhibitor (SSRI). Use Caution/Monitor. Contraindicated. Monitor Closely (1)green tea, paroxetine. Monitor Closely (1)paroxetine and ergotamine both increase serotonin levels. Coadministration enhances CNS depressant effects. hydroxychloroquine sulfate decreases effects of influenza virus vaccine trivalent by pharmacodynamic antagonism. estropipate increases levels of ropinirole by unspecified interaction mechanism. Avoid or Use Alternate Drug. Use Caution/Monitor. Either increases effects of the other by QTc interval. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. Avoid or Use Alternate Drug. bacteriostatic agents may inhibit the effects of bactericidal agents. Use Caution/Monitor. fexinidazole will increase the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Either increases toxicity of the other by pharmacodynamic synergism. Serious - Use Alternative (1)doxycycline will increase the level or effect of siponimod by affecting hepatic enzyme CYP2E1 metabolism. Examples of affected drugs include atomoxetine, phenothiazines, pimozide, risperidone, tamoxifen, tetrabenazine, antiarrhythmics such as propafenone/flecainide, TCA antidepressants such as desipramine/amitriptyline, among others.Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Monitor Closely (1)paroxetine and daridorexant both increase sedation. Contraindicated (1)dichlorphenamide increases levels of bismuth subsalicylate by unknown mechanism. Children and teenagers younger than 18 years should not take this product if they have chickenpox, flu, or any undiagnosed illness or if they have recently received a vaccine. Either increases toxicity of the other by pharmacodynamic synergism. Monitor Closely (1)cimetidine will increase the level or effect of eplerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. paroxetine will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor (1)hydrocortisone will decrease the level or effect of eplerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines. Use Caution/Monitor. Monitor Closely (1)doxycycline will increase the level or effect of sufentanil SL by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor Closely (1)paroxetine, ketoprofen. Monitor Closely (1)trazodone and paroxetine both increase QTc interval. Caution if coadministered with a P-gp substrate with a narrow therapeutic index. Minor/Significance Unknown. Use Caution/Monitor. Coadministration enhances CNS depressant effects. Modify Therapy/Monitor Closely. Serious - Use Alternative (1)hydroxychloroquine sulfate increases levels of digoxin by unknown mechanism. Minor (1)fosphenytoin decreases levels of doxycycline by increasing metabolism. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs to avoid unintended additive immunosuppressive effects. Monitor Closely (1)rolapitant will increase the level or effect of paroxetine by affecting hepatic enzyme CYP2D6 metabolism. Avoid repeating rimegepant dose within 48 hr if coadministered with a moderate CYP3A4 inhibitor. Use Caution/Monitor.paroxetine and dexfenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely. unspecified interaction mechanism. Do not exceed 18 mg/dose and 36 mg/day of deutetrabenazine if coadministered with strong CYP2D6 inhibitors. Modify Therapy/Monitor Closely. Use Caution/Monitor. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs in order to avoid unintended additive immunosuppressive effects. erythromycin lactobionate and paroxetine both increase QTc interval. Comment: Exposure to topical antibiotics has been shown to degrade Gintuit; if exposed, irrigate the wound thoroughly with saline and allow a suitable wash-out period to elapse before applying Gintuit. Serious - Use Alternative (1)hydroxychloroquine sulfate and rilonacept both increase immunosuppressive effects; risk of infection. ethinylestradiol will increase the level or effect of ropinirole by affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. USES: Hydroxychloroquine is used to prevent or treat malaria caused by mosquito bites. Serious - Use Alternative (1)potassium chloride, eplerenone. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. hydroxychloroquine sulfate and infliximab both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. doxycycline will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Immunosuppressants also increase risk of infection with concomitant live vaccines. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines. Coadministration with moderate CYP3A4 inhibitors, reduce ibrutinib dose to 280 mg qDay (B-cell malignancies) or 420 mg qDay (graft versus host disease). Avoid or Use Alternate Drug. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Minor/Significance Unknown. Modify Therapy/Monitor Closely. Use Caution/Monitor. Minor (1)doxycycline increases effects of argatroban by pharmacodynamic synergism. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Comment: Clonidine may either increase or decrease the blood glucose lowering effect of antidiabetic agents; clonidine may also mask hypoglycemic symptoms. Contraindicated. which may affect how methylergonovine works. Other (see comment). Coadministration enhances CNS depressant effects. Immediate release: 0.25 mg/day PO 1-3 hr before bedtime; after day 2, may be increased to 0.5 mg/day PO; at end of week 1, increased to 1 mg/day, then increased weekly by 0.5 mg/day up to 4 mg/day, See Administration for discontinuation instructions. Serious - Use Alternative (1)doxycycline increases effects of atracurium by pharmacodynamic synergism. May lower seizure threshold; keep bupropion dose as low as possible. Take at least 2 hours before and not less than 6 hours after administration of sodium picosulfate, magnesium oxide and anhydrous citric acid to avoid magnesium chelation. Applies only to oral form of both agents. pitolisant will decrease the level or effect of clonidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Use Caution/Monitor. Serious - Use Alternative (1)hydroxychloroquine sulfate and lapatinib both increase QTc interval. Zanubrutinib-induced cytopenias increases risk of hemorrhage. Minor/Significance Unknown. Use Caution/Monitor. Either increases effects of the other by pharmacodynamic synergism. . Mechanism: pharmacodynamic synergism. Modify Therapy/Monitor Closely. Use Caution/Monitor. methylene blue and paroxetine both increase serotonin levels. Canada residents can call a provincial poison control center. Avoid or Use Alternate Drug. Hyperkalemia. Either increases toxicity of the other by pharmacodynamic synergism. crofelemer increases levels of eplerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. Sinus bradycardia resulting in hospitalization and pacemaker insertion has been reported in association with the use of clonidine concurrently with verapamil. hydroxychloroquine sulfate and arsenic trioxide both increase QTc interval. Blockage of renal prostaglandin synthesis; may cause severe hypertension. Avoid or Use Alternate Drug. Hydromorphone may contribute to the total analgesic effect of hydrocodone. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines. Use Caution/Monitor. Contraindicated. 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, slow/irregular heartbeat, mental/mood changes (such as irritability, depression).A very serious allergic reaction to this drug is rare. Comment: Decreased symptoms of hypoglycemia. Use Caution/Monitor. Either increases effects of the other by serotonin levels. Do not substitute tablets with capsules. Either increases toxicity of the other by pharmacodynamic synergism. Avoid concurrent or sequential use to decrease risk for ototoxicity. Modify Therapy/Monitor Closely. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product). siponimod and hydroxychloroquine sulfate both increase QTc interval. Use Caution/Monitor. Do not double the dose to catch up. Use Caution/Monitor. Risk of hyperkalemia. If coadministered with strong CYP2D6 inhibitors, initiate pitolisant at 8.9 mg/day and increase after 7 days to maximum of 17.8 mg/day. Contraindicated. Serious - Use Alternative (1)ponesimod, clonidine. Use Caution/Monitor. Serious - Use Alternative (1)tedizolid, paroxetine. hydroxychloroquine sulfate decreases effects of rabies vaccine chick embryo cell derived by pharmacodynamic antagonism. Share cases and questions with Physicians on Medscape consult. Avoid coadministration of sensitive CYP1A2 substrates with givosiran. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. bismuth subsalicylate will decrease the level or effect of sarecycline by inhibition of GI absorption. clonidine, insulin lispro. voriconazole will increase the level or effect of eplerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. clonidine decreases effects of tolazamide by pharmacodynamic antagonism. omeprazole increases levels of bismuth subsalicylate by enhancing GI absorption. Serious - Use Alternative (1)hydroxychloroquine sulfate decreases effects of typhoid vaccine live by pharmacodynamic antagonism. Minor/Significance Unknown. serotonin uptake by platelets. Contraindicated. Discuss the risks and benefits with your doctor.This drug passes into breast milk and may have undesirable effects on a nursing infant. Minor (1)tolmetin decreases effects of eplerenone by pharmacodynamic antagonism. doxycycline will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)clonidine, dronabinol. paroxetine increases levels of eluxadoline by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Minor/Significance Unknown. Increases risk for constipation related serious adverse reactions. Use lowest dose possible and monitor for respiratory depression and sedation. Avoid or Use Alternate Drug. Avoid or Use Alternate Drug. Separate by 2 hours. NSAIDs decrease prostaglandin synthesis. yohimbe decreases effects of clonidine by pharmacodynamic antagonism. Increased risk of upper GI bleeding. potassium chloride, eplerenone. clonidine, vildagliptin. This drug is available at a middle level co-pay. Minor (2)clonidine decreases effects of nateglinide by pharmacodynamic antagonism. Avoid or Use Alternate Drug. . Risk of hyperkalemia. Serious - Use Alternative (1)bismuth subsalicylate decreases levels of oxytetracycline by inhibition of GI absorption. The "adhesive cover" does not contain any medication. Use Caution/Monitor. CYP3A4 substrates may require dosage adjustment. Minor (1)DHEA, herbal will increase the level or effect of eplerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. hydroxychloroquine sulfate and ibutilide both increase QTc interval. Serious - Use Alternative (1)doxycycline will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. If inhibitor is discontinued, consider increase oliceridine dosage until stable drug effects are achieved. Contraindicated (1)tranylcypromine and paroxetine both increase serotonin levels. Either increases toxicity of the other by pharmacodynamic synergism. Monitor Closely (1)doxycycline will increase the level or effect of cannabidiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). Individual plans may vary Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Avoid or Use Alternate Drug. bacteriostatic agents may inhibit the effects of bactericidal agents. Use Caution/Monitor. Either increases effects of the other by pharmacodynamic synergism. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. abrocitinib will increase the level or effect of clonidine by P-glycoprotein (MDR1) efflux transporter. Do not double the dose to catch up. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Modify Therapy/Monitor Closely. Monitor Closely (1)diazepam intranasal, paroxetine. Use Caution/Monitor. Avoid or Use Alternate Drug. Modify Therapy/Monitor Closely. serotonin uptake by platelets. Contraindicated. Avoid or Use Alternate Drug. Mechanism: pharmacodynamic synergism. Other (see comment). Use Caution/Monitor. Minor (1)darifenacin will increase the level or effect of paroxetine by affecting hepatic enzyme CYP2D6 metabolism. milnacipran and paroxetine both increase serotonin levels. Use Caution/Monitor. Minor/Significance Unknown. Minor/Significance Unknown. The risk for these side effects is increased with long-term use of this medication and with taking this medication in high doses. paroxetine will increase the level or effect of promazine by affecting hepatic enzyme CYP2D6 metabolism. Monitor Closely (1)ritonavir will increase the level or effect of paroxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Monitor Closely (1)chlorpromazine and paroxetine both increase QTc interval. Contraindicated. Modify Therapy/Monitor Closely. Other (see comment). Modify Therapy/Monitor Closely. Mechanism: decreased hypoglycemia induced catecholamine production. sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of hydroxychloroquine sulfate by QTc interval. NSAIDs decrease prostaglandin synthesis. Do not stop taking it without talking with your doctor, especially if you are taking it for malaria. Avoid or Use Alternate Drug.meperidine, paroxetine. Contraindicated. clonidine, betaxolol. cornsilk decreases effects of dabigatran by pharmacodynamic antagonism. doxycycline will decrease the level or effect of estropipate by altering intestinal flora. paroxetine, indomethacin. Avoid or Use Alternate Drug. Avoid use of amisulpride, a dopamine receptor antagonist, with dopamine agonists. Monitor Closely (1)paroxetine, meloxicam. Minor/Significance Unknown. Mechanism: pharmacodynamic synergism. Discuss the risks and benefits with your doctor.This medication passes into breast milk. Immunosuppressants also increase risk of infection with concomitant live vaccines. Avoid or Use Alternate Drug. Use Caution/Monitor. USES: This medication is used alone or in combination with other medicines to treat high blood pressure. Contraindicated (1)itraconazole will increase the level or effect of eplerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. paroxetine, loxapine. Avoid or Use Alternate Drug. Use Caution/Monitor.