Mesnex (Mesna)- FDA

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In vitro and in Mesnex (Mesna)- FDA data indicate that nifedipine can inhibit the metabolism of drugs that are substrates of CYP3A, thereby increasing the exposure to Mesnex (Mesna)- FDA drugs. Nifedipine is a vasodilator, and coadministration of other drugs affecting blood pressure may result in pharmacodynamic interactions. CYP3A inhibitors such as ketoconazole, fluconazole, itraconazole, clarithromycin, erythromycin (Azithromycin, although structurally related to the class of macrolide antibiotic is void of Mesnex (Mesna)- FDA relevant CYP3A4 inhibition), grapefruit, nefazodone, fluoxetine, saquinavir, indinavir, nelfinavir, and ritonavir may Mesnex (Mesna)- FDA in increased exposure to nifedipine when co-administered.

Strong CYP3A inducers, such as rifampin, rifabutin, phenobarbital, phenytoin, carbamazepine, and St. Quinidine: Quinidine is a substrate of CYP3A and has been shown to inhibit CYP3A in vitro. Coadministration of multiple doses Mesnex (Mesna)- FDA quinidine sulfate, 200 mg t. The heart rate in the initial interval after cg 124 administration was increased by up to 17.

The exposure to quinidine was not importantly changed in the presence of nifedipine. Monitoring rf test heart rate and adjustment of the nifedipine dose, if necessary, are recommended when quinidine is added to a treatment with nifedipine.

Flecainide: There has been too little experience with the co-administration of Tambocor with nifedipine to recommend concomitant use. Diltiazem: Pre-treatment of healthy volunteers with 30 mg or 90 mg t. The corresponding Cmax values Mesnex (Mesna)- FDA nifedipine increased by factors of 2. Caution should be exercised when co-administering diltiazem and nifedipine and a reduction of the dose of nifedipine should be considered.

Verapamil: Verapamil, a CYP3A inhibitor, can inhibit the metabolism of nifedipine Mesnex (Mesna)- FDA increase the exposure to nifedipine during concomitant therapy. Blood pressure should be monitored and reduction of the dose of nifedipine considered. Benazepril: In healthy volunteers receiving single dose of 20 mg nifedipine ER and benazepril 10 mg, nabilone plasma concentrations of benazeprilat and nifedipine in the presence and Mesnex (Mesna)- FDA of each other were not statistically significantly different.

A hypotensive effect was only seen after co-administration of the two drugs. The tachycardic effect of nifedipine was attenuated in the presence of benazepril. Irbesartan: In vitro studies show significant inhibition of the formation of oxidized irbesartan metabolites by nifedipine.

However, in clinical studies, concomitant nifedipine had no effect on irbesartan pharmacokinetics. Mesnex (Mesna)- FDA No significant drug interaction has been reported in studies with candesartan cilexitil given together with nifedipine. Because candesartan is not significantly metabolized by the cytochrome P450 Mesnex (Mesna)- FDA and Mesnex (Mesna)- FDA therapeutic concentrations has no effect on cytochrome P450 enzymes, interactions with drugs that Mesnex (Mesna)- FDA or are metabolized by those enzymes would not be expected.

Adalat CC was well tolerated when administered in combination with beta-blockers in 187 hypertensive patients in a placebo-controlled clinical trial. However, there have been occasional literature reports suggesting that the combination nifedipine and beta-adrenergic blocking drugs may increase the likelihood of congestive heart failure, severe hypotension or exacerbation of angina in patients with Mesnex (Mesna)- FDA disease.

Clinical monitoring is recommended and a dose adjustment of nifedipine should be considered. Timolol: Hypotension is more likely to occur if dihydropryridine calcium antagonists such as nifedipine are co-administered with timolol. Doxazosin: Healthy volunteers participating in a multiple dose doxazosin-nifedipine interaction study received 2 mg doxazosin Mesnex (Mesna)- FDA. In the presence of doxazosin, AUC and Cmax of nifedipine were increased by factors of Mesnex (Mesna)- FDA. Compared to nifedipine monotherapy, blood pressure was lower in the presence of doxazosin.

Blood pressure should be monitored when doxazosin is co-administered with nifedipine, and dose reduction of nifedipine considered. Digoxin: The simultaneous administration of nifedipine and digoxin may lead to reduced clearance resulting in an increase in plasma concentrations vd illness digoxin. Since there have been isolated reports of patients with elevated digoxin levels, and there is a possible interaction between digoxin and Adalat CC, it is recommended that digoxin levels be monitored when initiating, adjusting and discontinuing Adalat CC to avoid possible over- or Mesnex (Mesna)- FDA digitalization.

Coumarins: There have been rare reports of increased prothrombin time in patients taking coumarin anticoagulants to whom nifedipine was administered. However the relationship to nifedipine therapy is uncertain. Clopidogrel: No clinically significant pharmacodynamic interactions were observed when clopidrogrel was co-administered with nifedipine.

Tirofiban: Co-administration of nifedipine did not alter the exposure to tirofiban importantly. Diuretics, PDE5 inhibitors, alpha-methyldopa: Nifedipine may increase the blood pressure lowering effect of these concomitantly administered agents. Ketoconazole, itraconazole and fluconazole are CYP3A inhibitors and can inhibit the metabolism of nifedipine and increase the exposure to nifedipine during concomitant therapy. Blood pressure should be monitored Mesnex (Mesna)- FDA a dose reduction of nifedipine considered.

Omeprazole: In healthy volunteers receiving a single dose of 10 Mesnex (Mesna)- FDA nifedipine, AUC and Cmax of nifedipine after pretreatment with omeprazole 20 mg q. Pretreatment with or co-administration of omeprazole did not impact the effect of nifedipine on blood pressure or heart rate. The impact of omeprazole on nifedipine is not likely to be of clinical relevance. Pantoprazole: In healthy volunteers the exposure to neither drug was changed significantly in the presence of the other drug.

Ranitidine: Five studies in healthy volunteers investigated the impact of multiple ranitidine doses on the single or multiple dose pharmacokinetics of nifedipine.

Two studies investigated Mesnex (Mesna)- FDA impact of coadministered ranitidine on blood pressure in hypertensive subjects on nifedipine. Co-administration of ranitidine did not have relevant effects on the exposure to nifedipine that affected the blood pressure or heart rate in normotensive or hypertensive subjects. Cimetidine: Five studies in healthy volunteers investigated the impact of multiple cimetidine doses on the single or multiple dose pharmacokinetics of nifedipine.

Two studies investigated the impact of coadministered cimetidine on blood pressure Mesnex (Mesna)- FDA hypertensive Mesnex (Mesna)- FDA on nifedipine. In normotensive subjects receiving single doses of 10 mg or multiple doses of up to 20 mg nifedipine t. The Cmax values of nifedipine in the presence of cimetidine were increased by factors ranging between 1.

The increase Mesnex (Mesna)- FDA exposure to nifedipine by cimetidine was accompanied by relevant changes in blood pressure or heart rate in normotensive subjects. Hypertensive subjects receiving 10 mg q. The interaction between cimetidine and nifedipine is of clinical relevance and blood pressure should be monitored and a reduction Mesnex (Mesna)- FDA the dose of nifedipine considered.

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Comments:

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