Alprostadil interactions

• Benzyl alcohol: Serious and fatal adverse reactions can occur in neonates and low birth weight infants treated with benzyl alcohol-preserved formulations in infusion solutions, including CAVERJECT. (Alprostadil label, Warnings and precautions)

…fatal, anaphylactic reactions to NSAIDs have been reported in such patients [see Warnings and Precautions (5.8 , 5.9) ] • Known hypersensitivity (e.g., anaphylactic reactions and serious skin reactions) to diclofenac sodium and misoprostol, other prostaglandins, or any components of the drug product [see Warnings and Precautions (5.8 , 5.10) ] • Pregnancy ( 4 ) (Diclofenac and misoprostol label, Contraindications)

Ketorolac tromethamine is contraindicated in labor and delivery because, through its prostaglandin synthesis inhibitory effect, it may adversely affect fetal circulation and inhibit uterine contractions, thus increasing the risk of uterine hemorrhage. (Ketorolac label, Contraindications)

The combined use of two or more prostaglandins, or prostaglandin analogs including XELPROS is not recommended. (Latanoprost label, Drug interactions)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Acetaminophen and ibuprofen label, Warnings and precautions)

Hypotension Adenosine injection is a potent peripheral vasodilator and can induce significant hypotension. (Adenosine label, Warnings and precautions)

Nonetheless, caution, as with any other peripheral vasodilator, should be exercised when administering amlodipine, particularly in patients with severe aortic stenosis. (Amlodipine and valsartan label, Warnings and precautions)

• Injection site bleeding may occur in patients taking anticoagulants, such as warfarin or heparin. (Alprostadil label, Warnings and precautions)

• Injection site bleeding may occur in patients taking anticoagulants, such as warfarin or heparin. (Alprostadil label, Warnings and precautions)

Concomitant use of prostaglandin synthase inhibiting drugs, e.g., indomethacin, may decrease the hypotensive effects of beta-blockers. (Atenolol label, Drug interactions)

Concomitant use of prostaglandin synthase inhibiting drugs, e.g., indomethacin, may decrease the hypotensive effects of beta-blockers. (Atenolol and chlorthalidone label, Drug interactions)

When vasodilators are used in combination, an additive effect on blood pressure may be anticipated. (Avanafil label, Warnings and precautions)

• Injection site bleeding may occur in patients taking anticoagulants, such as warfarin or heparin. (Alprostadil label, Warnings and precautions)

Valvular Stenosis There is concern, on theoretical grounds, that patients with aortic stenosis might be at particular risk of decreased coronary perfusion when treated with vasodilators because they do not develop as much afterload reduction as others. (Captopril label, Precautions)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Celecoxib label, Warnings and precautions)

• Injection site bleeding may occur in patients taking anticoagulants, such as warfarin or heparin. (Alprostadil label, Warnings and precautions)

• Co-administration with Other Vasodilators or Negative Chronotropic Agents : Use with caution due to additive pharmacodynamic effects. (Dexmedetomidine label, Warnings and precautions)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Diclofenac label, Warnings and precautions)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Diflunisal label, Warnings)

• Injection site bleeding may occur in patients taking anticoagulants, such as warfarin or heparin. (Alprostadil label, Warnings and precautions)

• Injection site bleeding may occur in patients taking anticoagulants, such as warfarin or heparin. (Alprostadil label, Warnings and precautions)

Additional reductions in blood pressure may occur when VELETRI is administered with diuretics, antihypertensive agents, or other vasodilators. (Epoprostenol label, Drug interactions)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Etodolac label, Warnings)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Fenoprofen label, Warnings and precautions)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Flurbiprofen label, Warnings and precautions)

• Injection site bleeding may occur in patients taking anticoagulants, such as warfarin or heparin. (Alprostadil label, Warnings and precautions)

Indomethacin Coadministration of indomethacin may reduce the natriuretic and antihypertensive effects of furosemide in some patients by inhibiting prostaglandin synthesis. (Furosemide label, Drug interactions)

• Injection site bleeding may occur in patients taking anticoagulants, such as warfarin or heparin. (Alprostadil label, Warnings and precautions)

Renal Toxicity and Hyperkalemia Renal Toxicity Long-term administration of NSAIDs has resulted in renal papillary necrosis and other renal injury.Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Hydrocodone and ibuprofen label, Warnings)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Ibuprofen label, Warnings and precautions)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Ibuprofen and famotidine label, Warnings and precautions)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Indomethacin label, Warnings and precautions)

Drug Interactions The vasodilating effects of isosorbide dinitrate may be additive with those of other vasodilators. (Isosorbide dinitrate label, Drug interactions)

The vasodilating effects of isosorbide mononitrate may be additive with those of other vasodilators. (Isosorbide mononitrate label, Drug interactions)

A second form of renal toxicity has been seen in patients with conditions leading to a reduction in renal blood flow or blood volume, where renal prostaglandins have a supportive role in the maintenance of renal blood flow. (Ketoprofen label, Warnings and precautions)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Mefenamic acid label, Warnings and precautions)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Meloxicam label, Warnings and precautions)

Caution should be exercised when methylergonovine maleate is used concurrently with other vasoconstrictors, ergot alkaloids, or prostaglandins. (Methylergonovine label, Drug interactions)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Nabumetone label, Warnings)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Naproxen label, Warnings and precautions)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Naproxen and esomeprazole label, Warnings and precautions)

Nifedipine is a vasodilator, and co-administration of other drugs affecting blood pressure may result in pharmacodynamic interactions. (Nifedipine label, Drug interactions)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Oxaprozin label, Warnings and precautions)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Piroxicam label, Warnings and precautions)

• Injection site bleeding may occur in patients taking anticoagulants, such as warfarin or heparin. (Alprostadil label, Warnings and precautions)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Salsalate label, Warnings)

Blood Pressure Decreases Patients with left ventricular outflow obstruction (e.g., aortic stenosis, idiopathic hypertrophic subaortic stenosis) and those with severely impaired autonomic control of blood pressure can be sensitive to the actions of vasodilators, including SILDENAFIL ORAL FILM. (Sildenafil label, Warnings and precautions)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion.In these patients, administration of a non-steroidal anti-inflammatory drug may cause a dose-dependent reduction in prostaglandin formation and, secondarily, in renal blood flow, which may precipitate overt renal decompensation. (Sulindac label, Warnings)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Sumatriptan and naproxen label, Warnings and precautions)

When vasodilators are used in combination, an additive effect on blood pressure may be anticipated. (Tadalafil label, Warnings and precautions)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (Tolmetin label, Warnings)

When vasodilators are used in combination, an additive effect on blood pressure may be anticipated. (Vardenafil label, Warnings and precautions)

Antihypertensive Agents Verapamil administered concomitantly with oral antihypertensive agents (e.g., vasodilators, angiotensin-converting enzyme inhibitors, diuretics, beta blockers) will usually have an additive effect on lowering blood pressure. (Verapamil label, Drug interactions)

• Injection site bleeding may occur in patients taking anticoagulants, such as warfarin or heparin. (Alprostadil label, Warnings and precautions)

Phosphodiesterase-5 (PDE5) Inhibitors: PDE5-inhibitors are also vasodilators. (Alfuzosin label, Warnings and precautions)

Evidence from animal studies has suggested that certain other prostaglandins have some teratogenic potential. (Carboprost label, Warnings)

Alpha-adrenergic antagonists and PDE-5 inhibitors are both vasodilators that can lower blood pressure. (Dutasteride and tamsulosin label, Warnings and precautions)

Drugs antagonizing pressor effects of epinephrine α-blockers, such as phentolamine Vasodilators, such as nitrates Diuretics Antihypertensives Ergot alkaloids Drugs potentiating pressor effects of epinephrine • Sympathomimetics • β-blockers, such as propranolol • Tricyclic anti-depressants • Monoamine oxidase (MAO) inhibitors • Catechol-O-methyl transferase (COMT)… (Epinephrine label, Drug interactions)

Post injury arterial injection of vasodilators and/or arterial infusion of parenteral fluids are generally regarded to be of no value in altering outcome. (Methohexital label, Warnings)

Nonsteroidal Anti-inflammatory Drugs (NSAIDs) NSAIDs may produce potassium retention by reducing renal synthesis of prostaglandin E and impairing the renin-angiotensin system. (Potassium chloride label, Drug interactions)

Alpha-adrenergic blockers and PDE5 inhibitors are both vasodilators that can lower blood pressure. (Silodosin label, Warnings and precautions)

Alpha-adrenergic blockers and PDE5 inhibitors are both vasodilators that can lower blood pressure. (Tamsulosin label, Warnings and precautions)

Bronchospasm Like other inhaled prostaglandins, Tyvaso may cause acute bronchospasm. (Treprostinil label, Warnings and precautions)