Interaction between Clonidine and Doxepin
Major
Synergy
| ID | DDInter412 and DDInter593 |
| Interaction |
Potentially life-threatening elevations in blood pressure have been observed when tricyclic antidepressants (TCAs) and clonidine have been administered concomitantly. The mechanism is postulated to be enhancement of the pressor response by the TCA. Reports are available for clomipramine, desipramine and imipramine.
abdominal distension
abdominal pain
agoraphobia
Amnesia
Anorexia
Anxiety
Aching joints
asthenia
asthma
Blepharospasm
More
|
| Management | It is recommended that this combination be avoided. If no alternatives exist and this combination must be used, blood pressure should be monitored closely, especially during the first few weeks of therapy. When clonidine, the TCA, or the combination is discontinued, gradual withdrawal is recommended to prevent abrupt blood pressure fluctuations. Patients should be advised to seek medical help if they develop potential symptoms of a hypertensive crisis such as nausea, vomiting, sweating, flushing, dizziness, stiff neck, headache or palpitations. |
| References | |
| Alternative for Clonidine |
S01E
Levobunolol (ophthalmic)
Brinzolamide (ophthalmic)
Epinephrine (topical)
Neostigmine
Tafluprost (ophthalmic)
Dipivefrin (ophthalmic)
Dorzolamide (ophthalmic)
Bimatoprost
Epinephrine (ophthalmic)
Latanoprostene bunod (ophthalmic)
Brimonidine
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| Alternative for Doxepin |
N06A
D04A Oxybuprocaine (ophthalmic)
Diphenhydramine (topical)
Tetracaine (ophthalmic)
Cinchocaine (topical)
Tetracaine (topical)
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|
Potential Metabolism Interactions
Substrate-Substrate Interaction：If more than one drug is metabolized by the same CYP, it is possible that its metabolism is inhibited because of the competition between the drugs. That means, it can be useful to lower the dosage of the drugs in the drug-cocktail because they remain longer in the organism than in monotherapy.
Inhibitor-Inhibitor Interaction：Combining two or more inhibitors of one CYP, should be compensated by lowering the dosage of these drugs because the metabolism is reduced and the drugs remain longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.
Inhibitor-Substrate Interaction：Combining drugs that have inhibitory effect and are substrates of one particular CYP, should be compensated by lowering the dosage. They rest longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.