8 Interactions found for:
Drug Interactions
Moderate
Amlodipine
+ Farxiga
The following applies to the ingredients: Amlodipine and Dapagliflozin (found in Farxiga)
Dapagliflozin may cause salt and water loss, which may increase the risk of dehydration and low blood pressure when used with amLODIPine or similar medications. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. Use caution when getting up from a sitting or lying position, and let your doctor know if you develop these symptoms. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Keep yourself hydrated by drinking plenty of fluids unless otherwise directed. 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.
Drug and Food Interactions
Moderate
Farxiga
+ Food
The following applies to the ingredients: Dapagliflozin (found in Farxiga)
Alcohol may affect blood glucose levels in patients with diabetes. Both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) may occur, depending on how much and how often you drink. You should avoid using alcohol if your diabetes is not well controlled or if you have high triglycerides, neuropathy (nerve damage), or pancreatitis. Moderate alcohol consumption generally does not affect blood glucose levels if your diabetes is under control. However, it may be best to limit alcohol intake to one drink daily for women and two drinks daily for men (1 drink = 5 oz wine, 12 oz beer, or 1.5 oz distilled spirits) in conjunction with your normal meal plan. Avoid drinking alcohol on an empty stomach or following exercise, as it may increase the risk of hypoglycemia. 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
Amlodipine
+ Food
The following applies to the ingredients: Amlodipine
AmLODIPine and ethanol 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.
The following applies to the ingredients: Amlodipine
Using amLODIPine together with multivitamin with minerals can decrease the effects of amLODIPine. Talk with your doctor before using amLODIPine and multivitamin with minerals 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.
Minor
Amlodipine
+ Food
The following applies to the ingredients: Amlodipine
Professional Content
The consumption of grapefruit juice may slightly increase plasma concentrations of amlodipine. The mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. Data have been conflicting and the clinical significance is unknown. Monitoring for calcium channel blocker adverse effects (e.g., headache, hypotension, syncope, tachycardia, edema) is recommended.
References
- Bailey DG, Arnold JMO, Spence JD "Grapefruit juice and drugs - how significant is the interaction." Clin Pharmacokinet 26 (1994): 91-8
- Josefsson M, Zackrisson AL, Ahlner J "Effect of grapefruit juice on the pharmacokinetics of amlodipine in healthy volunteers." Eur J Clin Pharmacol 51 (1996): 189-93
- Bailey DG, Malcolm J, Arnold O, Spence JD "Grapefruit juice-drug interactions." Br J Clin Pharmacol 46 (1998): 101-10
- Vincent J, Harris SI, Foulds G, Dogolo LC, Willavize S, Friedman HL "Lack of effect of grapefruit juice on the pharmacokinetics and pharmacodynamics of amlodipine." Br J Clin Pharmacol 50 (2000): 455-63
- Josefsson M, Ahlner J "Amlodipine and grapefruit juice." Br J Clin Pharmacol 53 (2002): 405; discussion 406
- Kane GC, Lipsky JJ "Drug-grapefruit juice interactions." Mayo Clin Proc 75 (2000): 933-42
Drug and Pregnancy Interactions
Major
Amlodipine
+ Pregnancy
The following applies to the ingredients: Amlodipine
Professional Content
This drug should be used during pregnancy only if the benefit outweighs the risk to the fetus.
-According to some authorities: Use is contraindicated.
AU TGA pregnancy category: C
US FDA pregnancy category: Not assigned
Risk summary: Based on animal data, this drug may cause fetal harm. Inadequate data available on the use of this drug in pregnant women to inform a drug-related risk.
Comments:
-Use of adequate methods of contraception should be encouraged.
-If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential harm to the fetus.
Animal studies have shown significantly decreased litter size, increased intrauterine deaths and prolongation of gestation and duration of labor when this drug was given before mating, throughout mating, and during gestation. There are no controlled data in human pregnancy.
Reversible biochemical changes in the head of spermatozoa occurred in some patients treated with calcium channel blockers. There are no controlled data for this drug, but animal models have shown adverse effects on male fertility.
AU TGA pregnancy category C: Drugs which, owing to their pharmacological effects, have caused or may be suspected of causing, harmful effects on the human fetus or neonate without causing malformations. These effects may be reversible. Accompanying texts should be consulted for further details.
US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out.
References
- "Product Information. Norvasc (amlodipine)." Pfizer U.S. Pharmaceuticals PROD (2002):
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
- "Product Information. Norliqva (amLODIPine)." Carolina Medical Products Company (2022):
Major
Farxiga
+ Pregnancy
The following applies to the ingredients: Dapagliflozin (found in Farxiga)
Professional Content
Not recommended during the second and third trimesters of pregnancy
AU TGA pregnancy category: D
US FDA pregnancy category: Not Assigned
Risk Summary: There is insufficient data in pregnant women to determine a drug-associated risk for major birth defects or miscarriage; animal data has shown adverse renal effects with this drug during the renal development period which corresponds to the late second and third trimesters of human pregnancy.
Comments:
-When pregnancy is detected, this drug should be discontinued.
-Poorly controlled diabetes during pregnancy increases maternal and fetal risks for adverse outcomes.
Rat studies have shown adverse renal changes when this drug was administered during the period of renal development corresponding to late second and third trimesters of human development. Renal pelvic and tubule dilations, not fully reversible (within a 1 month recovery period), were observed at all doses studied including the lowest which provided an exposure 15-times the 10 mg clinical dose. There are no adequate well-controlled studies in pregnant women.
Clinical considerations: The estimated background risk of major birth defects is 6% to 10% in women with pre-gestational diabetes with a HbA1c greater than 7% and has been reported to be as high as 20% to 25% in women with HbA1c greater than 10%. Poorly controlled diabetes during pregnancy increases maternal risks for diabetic ketoacidosis, preeclampsia, spontaneous abortions, preterm delivery, and delivery complications; and fetal risks for for major birth defects, stillbirth, and macrosomia related morbidity. Insulin is generally recommended as the drug of choice during pregnancy.
AU TGA pregnancy category D: Drugs which have caused, are suspected to have caused or may be expected to cause, an increased incidence of human fetal malformations or irreversible damage. These drugs may also have adverse pharmacological effects. Accompanying texts should be consulted for further details
US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out.
References
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
- "Product Information. Farxiga (dapagliflozin)." Bristol-Myers Squibb (2014):
Drug and Breastfeeding Interactions
Major
Amlodipine
+ Breastfeeding
The following applies to the ingredients: Amlodipine
Professional Content
Use is not recommended and a decision should be made to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother (AU, US)
Use is contraindicated (UK)
Excreted into human milk: Yes
Comments:
-The effects in the nursing infant are unknown.
-Infants exposed to this drug should be closely monitored.
References
- "Product Information. Norvasc (amlodipine)." Pfizer U.S. Pharmaceuticals PROD (2002):
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
- United States National Library of Medicine "Toxnet. Toxicology Data Network. http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT" (2013):
Major
Farxiga
+ Breastfeeding
The following applies to the ingredients: Dapagliflozin (found in Farxiga)
Professional Content
Not recommended
Excreted into human milk: Unknown
Excreted into animal milk: Yes
Comment: This drug is not recommended while breastfeeding due to the potential for serious adverse reactions in breastfed infants.
This drug has been found in rat milk at a milk to plasma ratio of 0.49 which means this drug and its metabolites are transferred into milk at a concentration that is approximately 50% of that in maternal plasma. Although, it is unknown if this drug is excreted into human milk, there is potential for serious harm to the developing kidney if the breastfed infant is exposed. Human kidney maturation occurs during the first 2 years of life. Juvenile rats directly exposed to this drug have shown renal pelvic and tubular dilations during maturation. The long-term functional consequences of these effects are unknown. Additionally,decreased weight gain has been associated with lactational exposure in juvenile rats.
References
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
- "Product Information. Farxiga (dapagliflozin)." Bristol-Myers Squibb (2014):
Therapeutic Duplication Warnings
No warnings were found for your selected drugs.Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
Switch to: Professional Interactions
| Drug Interaction Classification | |
|---|---|
These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication. |
|
| 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 interaction information available. |
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