Isradipine

Severe hypotension has been reported during fentanyl anesthesia with concomitant use of beta blockers and calcium channel blockers, though not observed with isradipine specifically.

Exaggerated hypotensive response is possible with concomitant use. Monitor vital signs frequently; supportive care and/or discontinuation may be required.

An exaggerated hypotensive response is possible with concomitant use of magnesium sulfate and dihydropyridine calcium channel blockers.

Rifampicin reduces isradipine levels to below detectable limits, markedly reducing or abolishing therapeutic effects through increased metabolism and clearance.

Cimetidine increases isradipine mean peak plasma concentrations by 36% and AUC by 50%. Careful monitoring and downward dose adjustment may be required.

Fluconazole has potential to increase systemic exposure of isradipine. Frequent monitoring for adverse effects recommended.

Calcium channel blockers: Diltiazem, felodipine, nifedipine, nicardipine, nimodipine, verapamil, amlodipine, nisoldipine, isradipine ↑ Calcium channel blockers Use with caution.

Concomitant administration does not affect renal, nonrenal, or total body clearance of digoxin.

Concomitant administration does not alter pharmacokinetics of either drug; isradipine provides additional antihypertensive effect with no unexpected adverse effects.

Isradipine has been safely coadministered with nitroglycerin with no reported adverse effects.

Propranolol: In a single dose study in normal volunteers, coadministration of propranolol had a small effect on the rate but no effect on the extent of isradipine bioavailability. Significant increases in AUC (27%) and C max (58%) and decreases in t max (23%) of propranolol were noted in this study. propranolol to healthy volunteers under steady-state conditions had no relevant effect on either drug’s bioavailability.

No clinically relevant pharmacokinetic or pharmacodynamic interaction observed between isradipine and racemic warfarin; plasma protein binding not altered.

albuterol, systemic and inhaled amoxicillin ampicillin, with or without sulbactam atenolol azithromycin caffeine, dietary ingestion cefaclor co-trimoxazole (trimethoprim and sulfamethoxazole) diltiazem dirithromycin enflurane famotidine felodipine finasteride hydrocortisone isoflurane isoniazid isradipine influenza vaccine ketoconazole lomefloxacin mebendazole medroxyprogesterone methylprednisolone metronidazole metoprolol nadolol nifedipine nizatidine norfloxacin ofloxacin omeprazole prednisone, prednisolone ranitidine rifabutin roxithromycin sorbitol (purgative doses do not inhibit theophylline absorption) sucralfate terbutaline, systemic terfenadine tetracycline tocainide The Effect of Other Drugs on Theophylline Serum Concentration Measurements: Most serum theophylline assays in clinical use are immunoassays which are specific for theophylline.

Drugs that have been documented not to interact with theophylline or drugs that produce no clinically significant interaction with theophylline.* albuterol, systemic and inhaled mebendazole amoxicillin medroxyprogesterone ampicillin, with or without methylprednisolone sulbactam metronidazole atenolol metoprolol azithromycin nadolol caffeine, dietary ingestion nifedipine cefaclor nizatidine co-trimoxazole (trimethoprim and sulfamethoxazole) norfloxacin ofloxacin diltiazem omeprazole dirithromycin prednisone, prednisolone enflurane ranitidine famotidine rifabutin felodipine roxithromycin finasteride Sorbitol (purgative doses do not inhibit hydrocortisone theophylline absorption) isoflurane sucralfate isoniazid terbutaline, systemic isradipine terfenadine influenza vaccine tetracycline ketoconazole tocainide lomefloxacin * Refer to PRECAUTIONS, Drug Interactions for information regarding table.

albuterol, systemic and inhaled mebendazole amoxicillin medroxyprogesterone ampicillin, with or without sulbactam methylprednisolone atenolol metronidazole azithromycin metoprolol caffeine, dietary ingestion nadolol cefaclor nifedipine co-trimoxazole (trimethoprim and sulfamethoxazole) nizatidine diltiazem norfloxacin dirithromycin ofloxacin enflurane omeprazole famotidine prednisone, prednisolone felodipine ranitidine finasteride rifabutin hydrocortisone roxithromycin isoflurane Sorbitol (purgative doses do not inhibit theophylline absorption) isoniazid sucralfate isradipine terbutaline, systemic influenza vaccine terfenadine ketoconazole tetracycline lomefloxacin tocainide