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Interactions between your drugs

Major
rifAMPin amLODIPine
Applies to: isoniazid / pyrazinamide / rifampin, amlodipine

RifAMPin may significantly reduce the blood levels of amLODIPine, which may
make the medication ineffective or less effective in treating your condition. Talk
to your doctor if you have any questions or concerns. Your doctor may be able to
prescribe alternatives that do not interact, or you may need a dose adjustment or
more frequent monitoring to safely use both medications. It is important to tell
your doctor about all other medications you use, including vitamins and herbs.
Do not stop using any medications without first talking to your doctor.

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Major
rifAMPin ketoconazole
Applies to: isoniazid / pyrazinamide / rifampin, ketoconazole

RifAMPin may significantly reduce the blood levels of ketoconazole, which may
make the medication less effective in treating your infection. Talk to your doctor
if you have any questions or concerns. Your doctor may be able to prescribe
alternatives that do not interact, or you may need a dose adjustment or more
frequent monitoring to safely use both medications. It is important to tell your
doctor about all other medications you use, including vitamins and herbs. Do
not stop using any medications without first talking to your doctor.

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Moderate
sodium bicarbonate levoFLOXacin
Applies to: sodium bicarbonate, levofloxacin

Talk to your doctor before using sodium bicarbonate together


with levoFLOXacin. Sodium bicarbonate can change the acidity of your urine,
which may cause levoFLOXacin to crystallize and form stones. This may also occur
if you are dehydrated, so you should drink plenty of fluids during treatment with
levoFLOXacin. Let your doctor know if you experience flank pain, painful
urination, or blood in the urine. It is important to tell your doctor about all other
medications you use, including vitamins and herbs. Do not stop using any
medications without first talking to your doctor.

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Moderate
fluconazole amLODIPine
Applies to: fluconazole, amlodipine

Fluconazole may increase the blood levels of amLODIPine. This may increase
the risk of serious side effects such as irregular heart rhythm, fluid retention,
swelling, heart failure, and excessively low blood pressure. You may need a
dose adjustment or more frequent monitoring by your doctor to safely use both
medications. You should seek medical attention if you develop dizziness or
fainting; sudden, unexplained weight gain; swelling of the hands, ankles, or feet;
chest pain; or difficulty breathing during treatment with these medications. Avoid
driving or operating hazardous machinery until you know how the medications
affect you, and use caution when getting up from a sitting or lying position. It is
important to tell your doctor about all other medications you use, including
vitamins and herbs. Do not stop using any medications without first talking to
your doctor.

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Moderate
ketoconazole amLODIPine
Applies to: ketoconazole, amlodipine

Ketoconazole may increase the blood levels of amLODIPine. This may increase
the risk of serious side effects such as irregular heart rhythm, fluid retention,
swelling, heart failure, and excessively low blood pressure. You may need a
dose adjustment or more frequent monitoring by your doctor to safely use both
medications. You should seek medical attention if you develop dizziness or
fainting; sudden, unexplained weight gain; swelling of the hands, ankles, or feet;
chest pain; or difficulty breathing during treatment with these medications. Avoid
driving or operating hazardous machinery until you know how the medications
affect you, and use caution when getting up from a sitting or lying position. It is
important to tell your doctor about all other medications you use, including
vitamins and herbs. Do not stop using any medications without first talking to
your doctor.

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Moderate
calcium carbonate amLODIPine
Applies to: calcium carbonate, amlodipine

Using amLODIPine together with calcium carbonate can decrease the effects of
amLODIPine. Talk with your doctor before using amLODIPine and calcium
carbonate together. You may need a dose adjustment or need your blood
pressure checked more often if you take both medications. It is important to tell
your doctor about all other medications you use, including vitamins and herbs.
Do not stop using any medications without first talking to your doctor.

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Moderate
fluconazole levoFLOXacin
Applies to: fluconazole, levofloxacin

Using fluconazole together with levoFLOXacin can affect the rhythm of your
heart. Call your doctor if you have symptoms of irregular heartbeat, chest
tightness, dizziness, blurred vision or nausea. It is important to tell your doctor
about all other medications you use, including vitamins and herbs. Do not stop
using any medications without first talking to your doctor.

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Moderate
ketoconazole levoFLOXacin
Applies to: ketoconazole, levofloxacin
Using levoFLOXacin together with ketoconazole can increase the risk of an
irregular heart rhythm that may be serious and potentially life-threatening,
although it is a relatively rare side effect. You may be more susceptible if you
have a heart condition called congenital long QT syndrome, other cardiac
diseases, conduction abnormalities, or electrolyte disturbances (for example,
magnesium or potassium loss due to severe or prolonged diarrhea or vomiting).
Talk to your doctor if you have any questions or concerns. You should seek
immediate medical attention if you develop sudden dizziness, lightheadedness,
fainting, shortness of breath, or heart palpitations during treatment with these
medications, whether together or alone. It is important to tell your doctor about
all other medications you use, including vitamins and herbs. Do not stop using
any medications without first talking to your doctor.

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Moderate
calcium carbonate levoFLOXacin
Applies to: calcium carbonate, levofloxacin

LevoFLOXacin and calcium carbonate should not be taken orally at the same
time. Products that contain magnesium, aluminum, calcium, iron, and/or other
minerals may interfere with the absorption of levoFLOXacin into the bloodstream
and reduce its effectiveness. If possible, it may be best to avoid taking calcium
carbonate while your are being treated with levoFLOXacin. Otherwise, you should
take levoFLOXacin either 2 to 4 hours before or 4 to 6 hours after the calcium
carbonate dose. Talk to a healthcare professional if you are not sure whether a
product contains something that could potentially interact with your medication
or if you have questions on how to take this or other medications you are
prescribed. It is important to tell your doctor about all other medications you use,
including vitamins and herbs. Do not stop using any medications without first
talking to your doctor.

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Moderate
ketoconazole sodium bicarbonate
Applies to: ketoconazole, sodium bicarbonate
Using ketoconazole together with sodium bicarbonate can decrease the effects
of ketoconazole. Talk with your doctor before using ketoconazole while you are
using sodium bicarbonate. Separation of doses by two or more hours is
recommended. It is important to tell your doctor about all other medications you
use, including vitamins and herbs. Do not stop using any medications without
first talking to your doctor.

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Moderate
rifAMPin sodium bicarbonate
Applies to: isoniazid / pyrazinamide / rifampin, sodium bicarbonate

Using sodium bicarbonate together with rifAMPin may decrease the effects of
rifAMPin. RifAMPin should be administered at least 1 hour before sodium
bicarbonate. If your doctor does prescribe these medications together, you may
need a dose adjustment or special test to safely use both medications. It is
important to tell your doctor about all other medications you use, including
vitamins and herbs. Do not stop using any medications without first talking to
your doctor.

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Moderate
ketoconazole calcium carbonate
Applies to: ketoconazole, calcium carbonate

Using ketoconazole together with calcium carbonate can decrease the effects of
ketoconazole. Talk with your doctor before using ketoconazole while you are
using calcium carbonate. Separation of doses by two or more hours is
recommended. It is important to tell your doctor about all other medications you
use, including vitamins and herbs. Do not stop using any medications without
first talking to your doctor.

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Moderate
rifAMPin calcium carbonate
Applies to: isoniazid / pyrazinamide / rifampin, calcium carbonate

Using calcium carbonate together with rifAMPin may decrease the effects of
rifAMPin. RifAMPin should be administered at least 1 hour before calcium
carbonate. If your doctor does prescribe these medications together, you may
need a dose adjustment or special test to safely use both medications. It is
important to tell your doctor about all other medications you use, including
vitamins and herbs. Do not stop using any medications without first talking to
your doctor.

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Moderate
isoniazid ketoconazole
Applies to: isoniazid / pyrazinamide / rifampin, ketoconazole

Ask your doctor before using isoniazid together with ketoconazole. Using these
medications together may decrease the effects of ketoconazole. Contact your
doctor if your condition or infection worsens. If your doctor prescribes these
medications together, you may need a dose adjustment or special tests to safely
use both medications. It is important to tell your doctor about all other
medications you use, including vitamins and herbs. Do not stop using any
medications without first talking to your doctor.

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Moderate
fluconazole ketoconazole
Applies to: fluconazole, ketoconazole

Using fluconazole together with ketoconazole can increase the risk of an irregular
heart rhythm that may be serious and potentially life-threatening, although it is a
relatively rare side effect. You may be more susceptible if you have a heart
condition called congenital long QT syndrome, other cardiac diseases,
conduction abnormalities, or electrolyte disturbances (for example, magnesium
or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your
doctor if you have any questions or concerns. You should seek immediate
medical attention if you develop sudden dizziness, lightheadedness, fainting,
shortness of breath, or heart palpitations during treatment with these
medications, whether together or alone. It is important to tell your doctor about
all other medications you use, including vitamins and herbs. Do not stop using
any medications without first talking to your doctor.

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Moderate
ethambutol isoniazid
Applies to: ethambutol, isoniazid / pyrazinamide / rifampin

Using ethambutol together with isoniazid may increase the risk of nerve
damage, which is a potential side effect of both medications. Talk to your doctor
if you have any questions or concerns. Your doctor may be able to prescribe
alternatives that do not interact, or you may need a dose adjustment or more
frequent monitoring to safely use both medications. Let your doctor know if you
develop weakness, numbness, pain, burning, or tingling in your hands, feet, or
limbs. It is important to tell your doctor about all other medications you use,
including vitamins and herbs. Do not stop using any medications without first
talking to your doctor.

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Moderate
acetaminophen isoniazid
Applies to: Paracetamol (acetaminophen), isoniazid / pyrazinamide / rifampin

Using acetaminophen together with isoniazid may alter the effects of


acetaminophen and cause serious side effects that may affect your liver. Call your
doctor immediately if you experience a fever, chills, joint pain or swelling,
excessive tiredness or weakness, unusual bleeding or bruising, skin rash or
itching, loss of appetite, nausea, vomiting, or yellowing of the skin or the whites
of your eyes. If your doctor does prescribe these medications together, you may
need a dose adjustment or special tests to safely take both medications. It is
important to tell your doctor about all other medications you use, including
vitamins and herbs. Do not stop using any medications without first talking to
your doctor.
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Moderate
rifAMPin fluconazole
Applies to: isoniazid / pyrazinamide / rifampin, fluconazole

Using rifAMPin together with fluconazole may decrease the effects of


fluconazole. Contact your doctor if your condition changes. If your doctor does
prescribe these medications together, you may need a dose adjustment or
special test to safely use both medications. It is important to tell your doctor
about all other medications you use, including vitamins and herbs. Do not stop
using any medications without first talking to your doctor.

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Minor
rifAMPin acetaminophen
Applies to: isoniazid / pyrazinamide / rifampin, Paracetamol (acetaminophen)
Consumer information for this minor interaction is not currently available. Some
minor drug interactions may not be clinically relevant in all patients. Minor drug
interactions do not usually cause harm or require a change in therapy. However,
your healthcare provider can determine if adjustments to your medications are
needed.

For clinical details see professional interaction data.

No other interactions were found between your selected drugs.


Note: this does not necessarily mean no interactions exist. Always consult with
your doctor or pharmacist.

Other drug and disease interactions


 candesartan interacts with more than 200 other drugs and 8 diseases.
 Paracetamol (acetaminophen) interacts with more than 90 other
drugs and 3 diseases.
 amlodipine interacts with more than 300 other drugs and 4 diseases.
 calcium carbonate interacts with more than 100 other drugs and 5
diseases.
 sodium bicarbonate interacts with more than 100 other drugs.
 folic acid interacts with more than 10 other drugs and 1 diseases.
 acetylcysteine interacts with 3 other drugs and 2 diseases.
 cefixime interacts with more than 30 other drugs and 5 diseases.
 ammonium chloride interacts with more than 20 other drugs.
 isoniazid / pyrazinamide / rifampin interacts with more than 700 other
drugs and more than 10 diseases.
 ethambutol interacts with more than 100 other drugs.
 levofloxacin interacts with more than 400 other drugs and 9 diseases.
 fluconazole interacts with more than 400 other drugs and 4 diseases.
 ketoconazole interacts with more than 500 other drugs and 4 diseases.

Drug and food interactions


Moderate
isoniazid food
Applies to: isoniazid / pyrazinamide / rifampin

Food decreases the levels of isoniazid in your body. Take isoniazid on an empty
stomach at least 1 hour before or 2 hours after a meal. This will make it easier for
your body to absorb the medication. If nausea occurs, ask your doctor if you can
take isoniazid with food. Avoid alcohol while taking isoniazid. Alcohol may
increase the risk of damage to the liver during isoniazid treatment. Alcohol can
also cause isoniazid side effects to get worse. Contact your doctor if you
experience flushing, chills, headache, nausea, vomiting, and diarrhea.

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Moderate
levoFLOXacin food
Applies to: levofloxacin

When levoFLOXacin as the oral solution is given with enteral (tube) feedings,
levoFLOXacin may not work as well. You could interrupt the feeding for 1 hour
before and 2 hours after the levoFLOXacin dose. However, this still may not
entirely avoid the interaction and may not always be feasible. LevoFLOXacin oral
tablets may be taken without regard to food. It is important to tell your doctor
about all other medications you use, including vitamins and herbs. Do not stop
using any medications without first talking to your doctor.

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Moderate
candesartan food
Applies to: candesartan

If you are taking candesartan you should avoid potassium-containing salt


substitutes or over-the-counter potassium supplements without first talking to
your doctor. This can cause high levels of potassium in your blood. High levels of
potassium can cause weakness, irregular heartbeat, confusion, tingling of the
extremities, or feelings of heaviness in the legs. Call your doctor at once if you
have any of these symptoms.

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Minor
amLODIPine food
Applies to: amlodipine
Consumer information for this minor interaction is not currently available. Some
minor drug interactions may not be clinically relevant in all patients. Minor drug
interactions do not usually cause harm or require a change in therapy. However,
your healthcare provider can determine if adjustments to your medications are
needed.

For clinical details see professional interaction data.

Therapeutic duplication warnings


Therapeutic duplication is the use of more than one medicine from the same
drug category or therapeutic class to treat the same condition. This can be
intentional in cases where drugs with similar actions are used together for
demonstrated therapeutic benefit. It can also be unintentional in cases where a
patient has been treated by more than one doctor, or had prescriptions filled at
more than one pharmacy, and can have potentially adverse consequences.

Duplication
Anti-infectives
Therapeutic duplication

The recommended maximum number of medicines in the 'anti-infectives'


category to be taken concurrently is usually three. Your list
includes six medicines belonging to the 'anti-infectives' category:

 cefixime
 isoniazid/pyrazinamide/rifampin
 ethambutol
 levofloxacin
 fluconazole
 ketoconazole

Note: The benefits of taking this combination of medicines may outweigh any
risks associated with therapeutic duplication. This information does not take the
place of talking to your doctor. Always check with your healthcare provider to
determine if any adjustments to your medications are needed.

Duplication
Antifungal agents
Therapeutic duplication

The recommended maximum number of medicines in the 'antifungal agents'


category to be taken concurrently is usually one. Your list includes two medicines
belonging to the 'antifungal agents' category:

 fluconazole
 ketoconazole

Note: The benefits of taking this combination of medicines may outweigh any
risks associated with therapeutic duplication. This information does not take the
place of talking to your doctor. Always check with your healthcare provider to
determine if any adjustments to your medications are needed.
Duplication
Miscellaneous antituberculosis agents
Therapeutic duplication

The recommended maximum number of medicines in the 'miscellaneous


antituberculosis agents' category to be taken concurrently is usually one. Your list
includes two medicines belonging to the 'miscellaneous antituberculosis agents'
category:

 isoniazid/pyrazinamide/rifampin
 ethambutol

Note: The benefits of taking this combination of medicines may outweigh any
risks associated with therapeutic duplication. This information does not take the
place of talking to your doctor. Always check with your healthcare provider to
determine if any adjustments to your medications are needed.

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