Drug Interaction Report

12/18/2018 Drug Interaction Report - Drugs.
com
Drug Interaction Report

Drug interactions for the following 15 drug(s):
My Interactions List: (Unsaved)
OxyContin (oxycodone)
acetaminophen / oxycodone
Wellbutrin (bupropion)
Prozac (fluoxetine)
Klonopin (clonazepam)
Xanax (alprazolam)
amitriptyline
Remeron (mirtazapine)
Restoril (temazepam)
lisinopril
hydrochlorothiazide
Levoxyl (levothyroxine)
Lipitor (atorvastatin)
Lantus (insulin glargine)
Novolog (insulin aspart)
Interactions between your drugs
Major
buPROPion  FLUoxetine
https://www.drugs.com/interactions-check.php?drug_list=1770-2012,72-0,440-203,1115-648,703-357,133-54,168-0,1640-1015,2153-1402,1476-0,12… 1/22
12/18/2018 Drug Interaction Report - Drugs.com
Applies to: Wellbutrin (bupropion), Prozac (fluoxetine)

Talk to your doctor before using buPROPion together with FLUoxetine. Combining these medications
may increase the risk of seizures, which may occur rarely with either medication. In addition, buPROPion
can increase the blood levels of FLUoxetine, which may increase other side effects. You may be more
likely to experience seizures with these medications if you are elderly, undergoing alcohol or drug
withdrawal, have a history of seizures, or have a condition affecting the central nervous system such as a
brain tumor or head trauma. Your doctor may be able to prescribe alternatives that do not interact, or
you may need a dose adjustment or more frequent monitoring by your doctor to safely use both
medications. You should avoid or limit the use of alcohol during treatment. 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.
Major buPROPion  oxyCODONE

Applies to: Wellbutrin (bupropion), OxyContin (oxycodone), acetaminophen / oxycodone
BuPROPion may rarely cause seizures, and combining it with other medications that can also cause
seizures such as oxyCODONE may increase that risk. You may be more susceptible if you are elderly,
undergoing alcohol or drug withdrawal, have a history of seizures, or have a condition affecting the
central nervous system such as a brain tumor or head trauma. 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 by your doctor to safely use both medications.
You should avoid or limit the use of alcohol while being treated with these medications. Also avoid
activities requiring mental alertness such as driving or operating hazardous machinery until you know
how the medications affect you. 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.
Major ALPRAZolam  oxyCODONE

Applies to: Xanax (alprazolam), OxyContin (oxycodone), acetaminophen / oxycodone
Using narcotic pain or cough medications together with other medications that also cause central
nervous system depression can lead to serious side effects including respiratory distress, coma, and even
death. 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. Do not drink alcohol or self-medicate with these medications without your
doctor's approval, and do not exceed the doses or frequency and duration of use prescribed by your
doctor. Also, you should avoid driving or operating hazardous machinery until you know how these
medications affect you. 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.
Major oxyCODONE  temazepam

Applies to: OxyContin (oxycodone), acetaminophen / oxycodone, Restoril (temazepam)
Major amitriptyline  mirtazapine

Applies to: amitriptyline, Remeron (mirtazapine)
Using amitriptyline together with mirtazapine can increase the risk of a rare but serious condition called
the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme
changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred
vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and
diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention
if you experience these symptoms while taking the medications. Talk to your doctor if you have any
questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the
best course of treatment for you and has taken appropriate precautions and is monitoring you closely
for any potential complications. It is important to tell your doctor about all other medications you use,
Major buPROPion  mirtazapine

Applies to: Wellbutrin (bupropion), Remeron (mirtazapine)
BuPROPion may rarely cause seizures, and combining it with other medications that can also cause
seizures such as mirtazapine may increase that risk. You may be more susceptible if you are elderly,
undergoing alcohol or drug withdrawal, have a history of seizures, or have a condition affecting the
central nervous system such as a brain tumor or head trauma. 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 by your doctor to safely use both medications.
You should avoid or limit the use of alcohol while being treated with these medications. Also avoid
activities requiring mental alertness such as driving or operating hazardous machinery until you know
how the medications affect you. It is important to tell your doctor about all other medications you use,
Major clonazePAM  oxyCODONE

Applies to: Klonopin (clonazepam), OxyContin (oxycodone), acetaminophen / oxycodone
Major FLUoxetine  mirtazapine

Applies to: Prozac (fluoxetine), Remeron (mirtazapine)
Using FLUoxetine together with mirtazapine can increase the risk of a rare but serious condition called
the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme
changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred
vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and
diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention
if you experience these symptoms while taking the medications. Talk to your doctor if you have any
questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the
best course of treatment for you and has taken appropriate precautions and is monitoring you closely
for any potential complications. It is important to tell your doctor about all other medications you use,
Major amitriptyline  buPROPion

Applies to: amitriptyline, Wellbutrin (bupropion)
Talk to your doctor before using buPROPion together with amitriptyline. Combining these medications
may increase the risk of seizures, which may occur rarely with either medication. In addition, buPROPion
can increase the blood levels of amitriptyline, which may increase other side effects. You may be more
likely to experience seizures with these medications if you are elderly, undergoing alcohol or drug
withdrawal, have a history of seizures, or have a condition affecting the central nervous system such as a
brain tumor or head trauma. Your doctor may be able to prescribe alternatives that do not interact, or
you may need a dose adjustment or more frequent monitoring by your doctor to safely use both
medications. You should avoid or limit the use of alcohol during treatment. It is important to tell your
Major amitriptyline  FLUoxetine

Applies to: amitriptyline, Prozac (fluoxetine)
Talk to your doctor before using amitriptyline and FLUoxetine. This combination may cause sedation, dry
mouth, blurred vision, constipation, and urinary retention. You could also have high levels of FLUoxetine
which include altered consciousness, confusion, poor muscle coordination, abdominal cramping,
shivering, dilation of the pupils, sweating, high blood pressure, and increased heart beat. It is important
to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using
your medications without talking to your doctor first.
Moderate FLUoxetine  insulin aspart

Applies to: Prozac (fluoxetine), Novolog (insulin aspart)
Using FLUoxetine together with insulin or certain other diabetes medications may increase the risk of
hypoglycemia, or low blood sugar. Symptoms of hypoglycemia include headache, dizziness, drowsiness,
nervousness, confusion, tremor, nausea, hunger, weakness, perspiration, palpitation, and rapid heartbeat.
Talk to your doctor if you have any questions or concerns. You may need a dose adjustment or more
frequent monitoring of your blood sugar to safely use both medications. It is important to tell your
Moderate hydroCHLOROthiazide  lisinopril

Applies to: hydrochlorothiazide, lisinopril
Although hydroCHLOROthiazide and lisinopril are frequently combined together, their effects may be
additive on lowering your blood pressure. You may need a dose adjustment or special tests to safely take
both medications. Contact your doctor if you have a reduced heart rate, dizziness, fainting, or
headaches. 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.
Moderate FLUoxetine  oxyCODONE

Applies to: Prozac (fluoxetine), OxyContin (oxycodone), acetaminophen / oxycodone
Using oxyCODONE together with FLUoxetine can increase the risk of a rare but serious condition called
the serotonin syndrome, which may include symptoms such as confusion, hallucinations, seizures,
extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking,
blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and
diarrhea. Severe cases may result in coma and even death. You should contact your doctor immediately if
you experience these symptoms during treatment. In addition, combining these medications may
increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also
experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol
while being treated with these medications. Avoid driving or operating hazardous machinery until you
know how the medications affect you. 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.
Moderate hydroCHLOROthiazide  temazepam

Applies to: hydrochlorothiazide, Restoril (temazepam)
HydroCHLOROthiazide and temazepam may have additive effects in lowering your blood pressure. You
may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate.
These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or
when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms
and they do not go away after a few days or they become troublesome. 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,
Moderate hydroCHLOROthiazide  oxyCODONE

Applies to: hydrochlorothiazide, OxyContin (oxycodone), acetaminophen / oxycodone
HydroCHLOROthiazide and oxyCODONE may have additive effects in lowering your blood pressure. You
Moderate FLUoxetine  insulin glargine

Applies to: Prozac (fluoxetine), Lantus (insulin glargine)
Using FLUoxetine together with insulin or certain other diabetes medications may increase the risk of
Moderate lisinopril  insulin aspart

Applies to: lisinopril, Novolog (insulin aspart)
Using lisinopril together with insulin or certain other diabetes medications may increase the risk of
Moderate hydroCHLOROthiazide  mirtazapine

Applies to: hydrochlorothiazide, Remeron (mirtazapine)
HydroCHLOROthiazide and mirtazapine may have additive effects in lowering your blood pressure. You
Moderate hydroCHLOROthiazide  insulin glargine

Applies to: hydrochlorothiazide, Lantus (insulin glargine)
HydroCHLOROthiazide may interfere with blood glucose control and reduce the effectiveness of insulin
glargine and other diabetic medications. Monitor your blood sugar levels closely. You may need a dose
adjustment of your diabetic medications during and after treatment with hydroCHLOROthiazide. 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.
Moderate lisinopril  insulin glargine

Applies to: lisinopril, Lantus (insulin glargine)
Using lisinopril together with insulin or certain other diabetes medications may increase the risk of
Moderate lisinopril  mirtazapine

Applies to: lisinopril, Remeron (mirtazapine)
Lisinopril and mirtazapine may have additive effects in lowering your blood pressure. You may
experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These
side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when
treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and
they do not go away after a few days or they become troublesome. Avoid driving or operating
Moderate temazepam  mirtazapine

Applies to: Restoril (temazepam), Remeron (mirtazapine)
Using temazepam together with mirtazapine may increase side effects such as dizziness, drowsiness,
confusion, and difficulty concentrating. Some people, especially the elderly, may also experience
impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol
while being treated with these medications. Also avoid activities requiring mental alertness such as
driving or operating hazardous machinery until you know how the medications affect you. Talk to your
doctor if you have any questions or concerns. 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.
Moderate temazepam  lisinopril

Applies to: Restoril (temazepam), lisinopril
Lisinopril and temazepam may have additive effects in lowering your blood pressure. You may
Moderate oxyCODONE  mirtazapine

Applies to: OxyContin (oxycodone), acetaminophen / oxycodone, Remeron (mirtazapine)
Consumer information for this interaction is not currently available.
MONITOR: Opioids may potentiate the effects of serotonergic agents and increase the risk of serotonin
syndrome. The interaction has primarily been reported with the phenylpiperidine opioids (e.g.,
meperidine, fentanyl) and tramadol, which are known to possess some serotonergic activity, although a
few cases have involved other opioids such as oxycodone, methadone, morphine, hydromorphone,
codeine, and buprenorphine. Serotonin syndrome is a rare but serious and potentially fatal condition
thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Symptoms of the
serotonin syndrome may include mental status changes such as irritability, altered consciousness,
confusion, hallucinations, and coma; autonomic dysfunction such as tachycardia, hyperthermia,
diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as
hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal
cramping, nausea, vomiting, and diarrhea. Since many serotonergic agents can also cause central
nervous system depression, concomitant use with opioids may result in increased sedation and
impairment of judgment, thinking, and psychomotor skills.
MANAGEMENT: Caution is advised when opioids are used concomitantly with serotonergic agents such
as selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors
(SNRIs), monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs), other
antidepressants/psychotropic agents (e.g., amoxapine, buspirone, lithium, maprotiline, mirtazepine,
nefazodone, trazodone, vilazodone), 5-HT1 receptor agonists (triptans), 5-HT3 receptor antagonists,
cyclobenzaprine, dextromethorphan, 5-hydroxytryptophan, and St. John's wort. Patients should be
monitored for symptoms of the serotonin syndrome during treatment. Particular caution is advised when
increasing the dosages of these agents. If serotonin syndrome develops or is suspected during the
course of therapy, all serotonergic agents should be discontinued immediately and supportive care
rendered as necessary. Moderately ill patients may also benefit from the administration of a serotonin
antagonist (e.g., cyproheptadine, chlorpromazine). Severe cases should be managed under consultation
with a toxicologist and may require sedation, neuromuscular paralysis, intubation, and mechanical
ventilation in addition to the other measures. Patients should also be advised of potentially additive
central nervous system effects from these agents and to avoid hazardous activities requiring complete
mental alertness and motor coordination until they know how these agents affect them.
Moderate oxyCODONE  lisinopril

Applies to: OxyContin (oxycodone), acetaminophen / oxycodone, lisinopril
Lisinopril and oxyCODONE may have additive effects in lowering your blood pressure. You may
Moderate levothyroxine  insulin aspart

Applies to: Levoxyl (levothyroxine), Novolog (insulin aspart)
Levothyroxine may interfere with blood glucose control and reduce the effectiveness of insulin aspart
and other diabetic medications. Monitor your blood sugar levels closely. You may need a dose
adjustment of your diabetic medications during and after treatment with levothyroxine. 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.
Moderate
levothyroxine  insulin glargine
Applies to: Levoxyl (levothyroxine), Lantus (insulin glargine)
Levothyroxine may interfere with blood glucose control and reduce the effectiveness of insulin glargine
and other diabetic medications. Monitor your blood sugar levels closely. You may need a dose
adjustment of your diabetic medications during and after treatment with levothyroxine. It is important to
Moderate hydroCHLOROthiazide  insulin aspart

Applies to: hydrochlorothiazide, Novolog (insulin aspart)
HydroCHLOROthiazide may interfere with blood glucose control and reduce the effectiveness of insulin
aspart and other diabetic medications. Monitor your blood sugar levels closely. You may need a dose
adjustment of your diabetic medications during and after treatment with hydroCHLOROthiazide. It is
Moderate
FLUoxetine  hydroCHLOROthiazide
Applies to: Prozac (fluoxetine), hydrochlorothiazide
Treatment with FLUoxetine may occasionally cause blood sodium levels to get too low, a condition
known as hyponatremia, and using it with hydroCHLOROthiazide can increase that risk. You should seek
medical attention if you experience nausea, vomiting, headache, lethargy, irritability, difficulty
concentrating, memory impairment, confusion, muscle spasm, weakness or unsteadiness, as these may
be symptoms of hyponatremia. More severe cases may lead to hallucination, fainting, seizure, coma, and
even death. FLUoxetine can also affect your blood pressure and heart rate. You may need a dose
adjustment or more frequent monitoring of your blood pressure and pulse to safely use both
medications. You should avoid rising abruptly from a sitting or lying position while taking these
medications, especially at the beginning of treatment or after an increase in dose. Call your doctor if you
experience dizziness, lightheadedness, fainting, or a rapid heart beat. 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.
Moderate clonazePAM  mirtazapine

Applies to: Klonopin (clonazepam), Remeron (mirtazapine)
Using clonazePAM together with mirtazapine may increase side effects such as dizziness, drowsiness,
Moderate clonazePAM  lisinopril

Applies to: Klonopin (clonazepam), lisinopril
Lisinopril and clonazePAM may have additive effects in lowering your blood pressure. You may
Moderate ALPRAZolam  temazepam

Applies to: Xanax (alprazolam), Restoril (temazepam)
Using ALPRAZolam together with temazepam may increase side effects such as dizziness, drowsiness,
Moderate ALPRAZolam  hydroCHLOROthiazide

Applies to: Xanax (alprazolam), hydrochlorothiazide
HydroCHLOROthiazide and ALPRAZolam may have additive effects in lowering your blood pressure. You
Moderate ALPRAZolam  FLUoxetine

Applies to: Xanax (alprazolam), Prozac (fluoxetine)
Using ALPRAZolam together with FLUoxetine may increase your blood levels of ALPRAZolam or cause it
to stay in your body longer. This can cause symptoms such as excessive drowsiness. Talk with your
doctor before using these medications together. You may need a dose adjustment or special tests to
safely take both medications. Avoid driving until you know how these medications will affect you. It is
Moderate ALPRAZolam  buPROPion

Applies to: Xanax (alprazolam), Wellbutrin (bupropion)
Excessive use of ALPRAZolam, or abrupt discontinuation following long-term use, may occasionally
trigger seizures in patients taking buPROPion. Talk to your doctor before using these medications
together if you have any questions or concerns. It is important to tell your doctor about all other
Moderate amitriptyline  lisinopril

Applies to: amitriptyline, lisinopril
Lisinopril and amitriptyline may have additive effects in lowering your blood pressure. You may
Moderate
amitriptyline  temazepam
Applies to: amitriptyline, Restoril (temazepam)
Using amitriptyline together with temazepam may increase side effects such as dizziness, drowsiness,
Moderate amitriptyline  hydroCHLOROthiazide

Applies to: amitriptyline, hydrochlorothiazide
HydroCHLOROthiazide and amitriptyline may have additive effects in lowering your blood pressure. You
Moderate amitriptyline  clonazePAM

Applies to: amitriptyline, Klonopin (clonazepam)
Using amitriptyline together with clonazePAM may add to dizziness, drowsiness, breathing problems,
and other side effects. This may be more likely to occur in older adults or those with a debilitating
condition. Talk with your doctor before using clonazePAM together with amitriptyline. It is important to
Moderate ALPRAZolam  lisinopril

Applies to: Xanax (alprazolam), lisinopril
Lisinopril and ALPRAZolam may have additive effects in lowering your blood pressure. You may
Moderate ALPRAZolam  mirtazapine

Applies to: Xanax (alprazolam), Remeron (mirtazapine)
Using ALPRAZolam together with mirtazapine may increase side effects such as dizziness, drowsiness,
Moderate buPROPion  clonazePAM

Applies to: Wellbutrin (bupropion), Klonopin (clonazepam)
Excessive use of clonazePAM, or abrupt discontinuation following long-term use, may occasionally
trigger seizures in patients taking buPROPion. Talk to your doctor before using these medications
together if you have any questions or concerns. It is important to tell your doctor about all other
Moderate clonazePAM  temazepam

Applies to: Klonopin (clonazepam), Restoril (temazepam)
Using clonazePAM together with temazepam may increase side effects such as dizziness, drowsiness,
Moderate amitriptyline  oxyCODONE

Applies to: amitriptyline, OxyContin (oxycodone), acetaminophen / oxycodone
Consumer information for this interaction is not currently available.
MONITOR: Opioids may potentiate the effects of serotonergic agents and increase the risk of serotonin
syndrome. The interaction has primarily been reported with the phenylpiperidine opioids (e.g.,
meperidine, fentanyl) and tramadol, which are known to possess some serotonergic activity, although a
few cases have involved other opioids such as oxycodone, methadone, morphine, hydromorphone,
codeine, and buprenorphine. Serotonin syndrome is a rare but serious and potentially fatal condition
thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Symptoms of the
serotonin syndrome may include mental status changes such as irritability, altered consciousness,
confusion, hallucinations, and coma; autonomic dysfunction such as tachycardia, hyperthermia,
diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as
hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal
cramping, nausea, vomiting, and diarrhea. Since many serotonergic agents can also cause central
nervous system depression, concomitant use with opioids may result in increased sedation and
impairment of judgment, thinking, and psychomotor skills.
MANAGEMENT: Caution is advised when opioids are used concomitantly with serotonergic agents such
as selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors
(SNRIs), monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs), other
antidepressants/psychotropic agents (e.g., amoxapine, buspirone, lithium, maprotiline, mirtazepine,
nefazodone, trazodone, vilazodone), 5-HT1 receptor agonists (triptans), 5-HT3 receptor antagonists,
cyclobenzaprine, dextromethorphan, 5-hydroxytryptophan, and St. John's wort. Patients should be
monitored for symptoms of the serotonin syndrome during treatment. Particular caution is advised when
increasing the dosages of these agents. If serotonin syndrome develops or is suspected during the
course of therapy, all serotonergic agents should be discontinued immediately and supportive care
rendered as necessary. Moderately ill patients may also benefit from the administration of a serotonin
antagonist (e.g., cyproheptadine, chlorpromazine). Severe cases should be managed under consultation
with a toxicologist and may require sedation, neuromuscular paralysis, intubation, and mechanical
ventilation in addition to the other measures. Patients should also be advised of potentially additive
central nervous system effects from these agents and to avoid hazardous activities requiring complete
mental alertness and motor coordination until they know how these agents affect them.
Moderate clonazePAM  hydroCHLOROthiazide

Applies to: Klonopin (clonazepam), hydrochlorothiazide
HydroCHLOROthiazide and clonazePAM may have additive effects in lowering your blood pressure. You
Moderate clonazePAM  FLUoxetine

Applies to: Klonopin (clonazepam), Prozac (fluoxetine)
Using clonazePAM together with FLUoxetine may increase side effects such as dizziness, drowsiness,
Moderate buPROPion  lisinopril

Applies to: Wellbutrin (bupropion), lisinopril
Lisinopril and buPROPion may have additive effects in lowering your blood pressure. You may experience
headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects
are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is
restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go
away after a few days or they become troublesome. 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.
Moderate buPROPion  temazepam

Applies to: Wellbutrin (bupropion), Restoril (temazepam)
Excessive use of temazepam, or abrupt discontinuation following long-term use, may occasionally trigger
seizures in patients taking buPROPion. Talk to your doctor before using these medications together if
you have any questions or concerns. 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.
Moderate buPROPion  hydroCHLOROthiazide

Applies to: Wellbutrin (bupropion), hydrochlorothiazide
HydroCHLOROthiazide and buPROPion may have additive effects in lowering your blood pressure. You
Moderate amitriptyline  ALPRAZolam

Applies to: amitriptyline, Xanax (alprazolam)
Using amitriptyline together with ALPRAZolam may increase side effects such as dizziness, drowsiness,
Minor amitriptyline  levothyroxine

Applies to: amitriptyline, Levoxyl (levothyroxine)
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.
Minor FLUoxetine  levothyroxine

Applies to: Prozac (fluoxetine), Levoxyl (levothyroxine)
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

OxyContin (oxycodone) interacts with more than 400 other drugs and more than 10 diseases.
acetaminophen / oxycodone interacts with more than 500 other drugs and more than 20 diseases.
Wellbutrin (bupropion) interacts with more than 400 other drugs and 8 diseases.
Prozac (fluoxetine) interacts with more than 600 other drugs and more than 10 diseases.
Klonopin (clonazepam) interacts with more than 400 other drugs and 10 diseases.
Xanax (alprazolam) interacts with more than 400 other drugs and 9 diseases.
amitriptyline interacts with more than 600 other drugs and more than 20 diseases.
Remeron (mirtazapine) interacts with more than 500 other drugs and more than 10 diseases.
Restoril (temazepam) interacts with more than 300 other drugs and 10 diseases.
lisinopril interacts with more than 300 other drugs and 8 diseases.
hydrochlorothiazide interacts with more than 400 other drugs and more than 10 diseases.
Levoxyl (levothyroxine) interacts with more than 100 other drugs and 5 diseases.
Lipitor (atorvastatin) interacts with more than 200 other drugs and 5 diseases.
Lantus (insulin glargine) interacts with more than 300 other drugs and 3 diseases.
Novolog (insulin aspart) interacts with more than 300 other drugs and 3 diseases.
Drug and food interactions
Major oxyCODONE  food

Applies to: OxyContin (oxycodone), acetaminophen / oxycodone
Do not use alcohol or medications that contain alcohol while you are receiving treatment with
oxyCODONE. This may increase nervous system side effects such as drowsiness, dizziness,
lightheadedness, difficulty concentrating, and impairment in thinking and judgment. In severe cases, low
blood pressure, respiratory distress, fainting, coma, or even death may occur. You may also want to avoid
or limit the consumption of grapefruit and grapefruit juice, which can significantly increase the blood
levels of oxycodone in some people. Talk to your doctor or pharmacist if you have questions on how to
take this or other medications you are prescribed. Do not use more than the recommended dose of
oxyCODONE, and avoid activities requiring mental alertness such as driving or operating hazardous
machinery until you know how the medication affects you. It is important to tell your doctor about all
other medications you use, including vitamins and herbs. Do not stop using any medication without first
Moderate ALPRAZolam  food

Applies to: Xanax (alprazolam)
Grapefruit and grapefruit juice may interact with ALPRAZolam and lead to potentially dangerous side
effects. Discuss the use of grapefruit products with your doctor. Do not increase or decrease the amount
of grapefruit products in your diet without first talking to your doctor. Do not drink alcohol while taking
ALPRAZolam. This medication can increase the effects of alcohol. You may feel more drowsy, dizzy, or
tired if you take ALPRAZolam with alcohol. Talk to your doctor or pharmacist if you have any questions
or concerns.
Moderate buPROPion  food

Applies to: Wellbutrin (bupropion)
Using buPROPion with alcohol may increase the risk of uncommon side effects such as seizures,
hallucinations, delusions, paranoia, mood and behavioral changes, depression, suicidal thoughts, anxiety,
and panic attacks. On the other hand, sudden withdrawal from alcohol following regular or chronic use
can also increase your risk of seizures during treatment with buPROPion. If you are prone to frequent or
excessive alcohol use, talk to your doctor before starting buPROPion. In general, you should avoid or
limit the use of alcohol while being treated with buPROPion. Also avoid activities requiring mental
alertness such as driving or operating hazardous machinery until you know how the medication affects
you. 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.
Moderate FLUoxetine  food

Applies to: Prozac (fluoxetine)
Alcohol can increase the nervous system side effects of FLUoxetine such as dizziness, drowsiness, and
difficulty concentrating. Some people may also experience impairment in thinking and judgment. You
should avoid or limit the use of alcohol while being treated with FLUoxetine. Do not use more than the
recommended dose of FLUoxetine, and avoid activities requiring mental alertness such as driving or
operating hazardous machinery until you know how the medication affects you. Talk to your doctor or
pharmacist if you have any questions or concerns.
Moderate levothyroxine  food

Applies to: Levoxyl (levothyroxine)
The timing of meals relative to your levothyroxine dose can affect absorption of the medication.
Therefore, levothyroxine should be taken on a consistent schedule with regard to time of day and
relation to meals to avoid large fluctuations in blood levels, which may alter its effects. In addition,
absorption of levothyroxine may be decreased by foods such as soybean flour, cotton seed meal,
walnuts, dietary fiber, calcium, and calcium fortified juices. These foods should be avoided within several
hours of dosing if possible. It is important to tell your doctor about all other medications you use,
When levothyroxine is given during continuous enteral nutrition (tube feedings) for more than 7 days,
the tube feeding should be interrupted for at least one hour before and one hour after the dose of
levothyroxine. You may need more frequent blood tests to monitor levothyroxine levels.
Moderate
lisinopril  food
Applies to: lisinopril
It is recommended that if you are taking lisinopril you should be advised to avoid moderately high or
high potassium dietary intake. This can cause high levels of potassium in your blood. Do not use salt
substitutes or potassium supplements while taking lisinopril, unless your doctor has told you to.
Moderate mirtazapine  food

Applies to: Remeron (mirtazapine)
Alcohol can increase the nervous system side effects of mirtazapine such as dizziness, drowsiness, and
difficulty concentrating. Some people may also experience impairment in thinking and judgment. You
should avoid or limit the use of alcohol while being treated with mirtazapine. Do not use more than the
recommended dose of mirtazapine, and avoid activities requiring mental alertness such as driving or
operating hazardous machinery until you know how the medication affects you. Talk to your doctor or
pharmacist if you have any questions or concerns.
Moderate atorvastatin  food

Applies to: Lipitor (atorvastatin)
Grapefruit juice can increase the blood levels of atorvastatin. This can increase the risk of side effects
such as liver damage and a rare but serious condition called rhabdomyolysis that involves the
breakdown of skeletal muscle tissue. In some cases, rhabdomyolysis can cause kidney damage and even
death. You should limit your consumption of grapefruit juice to no more than 1 quart per day during
treatment with atorvastatin. Let your doctor know immediately if you have unexplained muscle pain,
tenderness, or weakness during treatment, especially if these symptoms are accompanied by fever or
dark colored urine. You should also seek immediate medical attention if you develop fever, chills, joint
pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea,
vomiting, dark colored urine, and/or yellowing of the skin or eyes, as these may be signs and symptoms
of liver damage. It is important to tell your doctor about all other medications you use, including
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 Central Nervous System (CNS) Drugs

Therapeutic duplication
The recommended maximum number of medicines in the 'Central Nervous System (CNS) Drugs'
category to be taken concurrently is usually three. Your list includes seven medicines belonging to the
'Central Nervous System (CNS) Drugs' category:
Prozac (fluoxetine)
Xanax (alprazolam)
amitriptyline
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 Psychotropic agents

The recommended maximum number of medicines in the 'psychotropic agents' category to be taken
concurrently is usually three. Your list includes seven medicines belonging to the 'psychotropic agents'
category:
Prozac (fluoxetine)
Xanax (alprazolam)
amitriptyline
Duplication Antidepressants
The recommended maximum number of medicines in the 'antidepressants' category to be taken
concurrently is usually one. Your list includes four medicines belonging to the 'antidepressants' category:
Prozac (fluoxetine)
amitriptyline
Duplication Tranquilizers
The recommended maximum number of medicines in the 'tranquilizers' category to be taken
concurrently is usually one. Your list includes two medicines belonging to the 'tranquilizers' category:
Xanax (alprazolam)
Duplication Benzodiazepines
The recommended maximum number of medicines in the 'benzodiazepines' category to be taken
concurrently is usually one. Your list includes three medicines belonging to the 'benzodiazepines'
category:
Xanax (alprazolam)
Drug Interaction Classification

The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is
difficult to determine using this tool alone given the large number of variables that may apply.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to
circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.
Do not stop taking any medications without consulting your healthcare provider.
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your
personal circumstances.

Drug Interaction Report

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Drug Interaction Report

Uploaded by

Copyright:

Available Formats

12/18/2018 Drug Interaction Report - Drugs.

Drug Interaction Report

My Interactions List: (Unsaved)

Lantus (insulin glargine)

Novolog (insulin aspart)

Interactions between your drugs

Applies to: Wellbutrin (bupropion), Prozac (fluoxetine)

Major buPROPion  oxyCODONE

Major ALPRAZolam  oxyCODONE

Major oxyCODONE  temazepam

Major amitriptyline  mirtazapine

Major buPROPion  mirtazapine

Major clonazePAM  oxyCODONE

Major FLUoxetine  mirtazapine

Major amitriptyline  buPROPion

Major amitriptyline  FLUoxetine

Moderate FLUoxetine  insulin aspart

Moderate hydroCHLOROthiazide  lisinopril

Moderate FLUoxetine  oxyCODONE

Moderate hydroCHLOROthiazide  temazepam

Moderate hydroCHLOROthiazide  oxyCODONE

Moderate FLUoxetine  insulin glargine

Moderate lisinopril  insulin aspart

Moderate hydroCHLOROthiazide  mirtazapine

Moderate hydroCHLOROthiazide  insulin glargine

Moderate lisinopril  insulin glargine

Moderate lisinopril  mirtazapine

Moderate temazepam  mirtazapine

Moderate temazepam  lisinopril

Moderate oxyCODONE  mirtazapine

Moderate oxyCODONE  lisinopril

Moderate levothyroxine  insulin aspart

Moderate hydroCHLOROthiazide  insulin aspart

Moderate clonazePAM  mirtazapine

Moderate clonazePAM  lisinopril

Moderate ALPRAZolam  temazepam

Moderate ALPRAZolam  hydroCHLOROthiazide

Moderate ALPRAZolam  FLUoxetine

Moderate ALPRAZolam  buPROPion

Moderate amitriptyline  lisinopril

Moderate amitriptyline  hydroCHLOROthiazide

Moderate amitriptyline  clonazePAM

Moderate ALPRAZolam  lisinopril

Moderate ALPRAZolam  mirtazapine

Moderate buPROPion  clonazePAM

Moderate clonazePAM  temazepam

Moderate amitriptyline  oxyCODONE

Moderate clonazePAM  hydroCHLOROthiazide

Moderate clonazePAM  FLUoxetine

Moderate buPROPion  lisinopril

Moderate buPROPion  temazepam

Moderate buPROPion  hydroCHLOROthiazide

Moderate amitriptyline  ALPRAZolam

Minor amitriptyline  levothyroxine

For clinical details see professional interaction data.

Minor FLUoxetine  levothyroxine

For clinical details see professional interaction data.

No other interactions were found between your selected drugs.

Other drug and disease interactions

Drug and food interactions

Major oxyCODONE  food

Moderate ALPRAZolam  food

Moderate buPROPion  food

Moderate FLUoxetine  food