Clicking moves left

Enhanced Elimination in Toxicology

Enhanced Elimination in Toxicology Extracorporeal eliminationExtracorpore [...]

Decontamination in Toxicology

Decontamination in ToxicologyorHow to Decontamination in ToxicologySingle-dose [...]

Resuscitation in Toxicology

Resuscitation in ToxicologySupportive careInitial resuscitation should be based [...]

Key investigations of Toxicology

Key investigations of Toxicology In this topic: Electrocardiography Drug conce [...]

Arterial blood gases in Toxicology

Arterial blood gases in Toxicology Arterial blood gases are an important in [...]

Clicking moves right
M O V I E
TRAVELING
Pharmacology of Disopyramide
31 Mar 2012 0 comments

Pharmacology of Disopyramide Indication For the treatment of documented ventricular arrhythmias, such as [...]

Pharmacology of Ranolazine
31 Mar 2012 0 comments

Pharmacology of Ranolazine Indication For the treatment of chronic angina. It should be used in combinati [...]

Pharmacology of Milrinone
31 Mar 2012 0 comments

Pharmacology of Milrinone Indication Indicated for the treatment of congestive heart failure. Pharma [...]

Pharmacology of Midodrine
31 Mar 2012 0 comments

Pharmacology of Midodrine   Indication For the treatment of symptomatic orthostatic hypotension [...]

Pharmacology of Dofetilide
31 Mar 2012 0 comments

Pharmacology of Dofetilide  Indication For the maintenance of normal sinus rhythm (delay in time to [...]

GALLERY
Classification of Anxiety Disorders
10 Mar 2012 0 comments

Anxiety disorders may be classified asgeneralized anxiety disorder, panic disorder, obsessive-compu [...]

Post-Traumatic Stress Disorder
10 Mar 2012 0 comments

Post-Traumatic Stress DisorderPost-traumatic stress disorder develops following a traumatic event that elicit [...]

Social Anxiety Disorder
10 Mar 2012 0 comments

Social Anxiety DisorderSocial anxiety disorder, formerly known as social phobia, is characterized by an inten [...]

TOP LINE
Classification of Anxiety Disorders
10 Mar 2012 0 comments

Anxiety disorders may be classified asgeneralized anxiety disorder, panic disorder, obsessive-compulsive disorder, social anxiety disorder, post-traumatic stress disorder. Click to view each type....

Post-Traumatic Stress Disorder
Social Anxiety Disorder
Obsessive-Compulsive Disorder
Panic Disorder
Generalized Anxiety Disorder
REVIEW
Hormonal contraceptives
25 Apr 2011 0 comments

Hormonal contraceptivesHormonal contraceptives inhibit ovulation. Contraceptives typically contain a combination of hormones. Fo...

Erectile dysfunction therapy drugs

Erectile dysfunction therapy drugsErectile dysfunction therapy drugs treat penile erectile dysfunction that results from a lack ...

Urinary tract antispasmodics

Urinary tract antispasmodicsUrinary tract antispasmodics help decrease urinary tract muscle spasms. They include darifenacin, fl...

ANALYSIS
Pharmacology of Disopyramide
31 Mar 2012 0 comments

Pharmacology of Disopyramide Indication For the treatment of documented ventricular arrhythmias, such as sustained ventricul...

Pharmacology of Ranolazine

Pharmacology of Ranolazine Indication For the treatment of chronic angina. It should be used in combination with amlodipine, ...

Pharmacology of Milrinone

Pharmacology of Milrinone Indication Indicated for the treatment of congestive heart failure. Pharmacodynamics Milri...

HIGHLIGHT
[ more from label ]
Classification of Anxiety Disorders
Post-Traumatic Stress Disorder
Social Anxiety Disorder
Obsessive-Compulsive Disorder
Latest News Updates
PERFORMANCE
Pharmacology of Disopyramide
31 Mar 2012 0 comments

Pharmacology of Disopyramide Indication For the treatment of documented ventricular arrhythmias, such as ...

Pharmacology of Ranolazine
Pharmacology of Milrinone
FEATURE
Classification of Anxiety Disorders
10 Mar 2012 0 comments

Anxiety disorders may be classified asgeneralized anxiety disorder, panic disorder, obsessive-compu...

Post-Traumatic Stress Disorder
Social Anxiety Disorder
Home » , , , » Drug interactions with anxiolytics and hypnotics (Table 8.14L)
Drug interactions with anxiolytics and hypnotics (Table 8.14L)
Monday, January 9, 2012 Posted by Piscean



Drug interactions with anxiolytics and hypnotics (Table 8.14L)
Anxiolytics include benzodiazepines and buspirone. Hypnotics include benzodiazepines, zolpidem and zopiclone.
Drug
Rating [NB1]
Interaction
Recommended action
Analgesics, opioid (including tramadol)
2
Respiratory depression with benzodiazepines, especially if given parenterally.
Monitor for respiratory depression.
Antiretrovirals: ritonavir, saquinavir
3
Increase plasma concentration of alprazolam, buspirone and triazolam (CYP3A4 inhibition).
Monitor for adverse effects.
Consider use of an alternative anxiolytic or hypnotic, eg lorazepam, oxazepam or temazepam.
Azole antifungals: fluconazole, itraconazole, ketoconazole
2
May increase plasma concentrations of alprazolam, triazolam, buspirone, zolpidem and zopiclone (CYP3A4 inhibition).
Monitor for adverse effects. Use an alternative benzodiazepine or alternative antifungal drug, eg terbinafine.
Calcium channel blockers
3
Diltiazem and verapamil may increase plasma concentrations of buspirone and triazolam (CYP3A4 inhibition).
Monitor for adverse effects. Use an alternative calcium channel blocker or alternative anxiolytic, eg lorazepam, oxazepam or temazepam.
Cimetidine
3
Increases plasma concentrations of alprazolam, diazepam, nitrazepam and triazolam (CYP3A4 inhibition).
Monitor for adverse effects. Use an alternative H2-receptor blocker or alternative benzodiazepine, eg lorazepam, oxazepam or temazepam.
Clarithromycin -
Disulfiram
3
Decreases diazepam metabolism.
Monitor for adverse effects. Use an alternative drug, eg alprazolam, oxazepam or lorazepam.
ECT
2
Benzodiazepines raise seizure threshold, which may impair the efficacy of the ECT.
Taper and cease benzodiazepines before ECT.
Erythromycin -
Esomeprazole -
Macrolide antibiotics: clarithromycin, erythromycin
2
Increase plasma concentrations of alprazolam, triazolam, buspirone, and zopiclone (CYP3A4 inhibition).
Monitor for adverse effects. Use an alternative antibiotic, eg roxithromycin, or alternative anxiolytic, eg lorazepam, oxazepam or temazepam.
MAOIs, irreversible nonselective
3
Hypertension reported rarely with buspirone.
Monitor for increased blood pressure or use an alternative drug.
Nefazodone -
Omeprazole -
Proton pump inhibitors: esomeprazole, omeprazole
3
Decreased clearance of diazepam reported (possibly inhibition of CYP3A, CYP2C9 or CYP2C19).
Monitor for adverse effects of diazepam or use alternative benzodiazepine or alternative proton pump inhibitor, eg rabeprazole
Rifabutin, rifampicin
3
Increased buspirone, diazepam, nitrazepam, triazolam, zolpidem and zopiclone metabolism. Temazepam not affected.
Monitor for decreased effect of anxiolytic or hypnotic.
Ritonavir -
Saquinavir -
SSRIs and nefazodone
2
Nefazodone inhibits metabolism (CYP3A4) of alprazolam, triazolam and zopiclone. Fluoxetine and fluvoxamine increase plasma alprazolam and diazepam concentrations. Unlikely with paroxetine or sertraline.
Monitor for benzodiazepine adverse effects or use alternative anxiolytic, eg lorazepam, oxazepam or temazepam.
3
Several reports of adverse effects with fluoxetine and buspirone.
Monitor for increased adverse effects such as worsening of psychiatric symptoms, serotonergic effects or seizure with buspirone and fluoxetine.
Tramadol -
NB1:
Rating 1 – Avoid combination; risk always outweighs benefit.
Rating 2 – Usually avoid combination; use combination only under special circumstances.
Rating 3 – Minimise risk; take action as necessary to reduce risk.

Piscean

Thanks for your visit..!

0 comments for "Drug interactions with anxiolytics and hypnotics (Table 8.14L)"

   

Leave a reply

    April - 2025
    SMTWTFS
      12345
    6789101112
    13141516171819
    20212223242526
    27282930