Amlodipine and atorvastatin interactions

Literature reports suggest that oral calcium antagonists may be used in combination with beta-adrenergic blocking agents when heart function is normal, but should be avoided in patients with impaired cardiac function. (Betaxolol label, Drug interactions)

• Calcium Channel Blockers: Avoid concomitant use with Calcium Chloride Injection. (Calcium chloride label, Drug interactions)

In situations where the concomitant use of clarithromycin tablets with atorvastatin or pravastatin cannot be avoided, atorvastatin dose should not exceed 20 mg daily and pravastatin dose should not exceed 40 mg daily. (Clarithromycin label, Warnings and precautions)

Use CLOZARIL cautiously in patients with cardiovascular or cerebrovascular disease or conditions predisposing to hypotension (e.g., dehydration, use of antihypertensive medications) [see Dosage and Administration ( 2.2 , 2.6 ), Warnings and Precautions ( 5.2 )]. (Clozapine label, Boxed warning)

Concomitant use of cyclosporine, gemfibrozil, tipranavir plus ritonavir or glecaprevir plus pibrentasvir with amlodipine and atorvastatin tablets are not recommended. (Amlodipine and atorvastatin label, Warnings and precautions)

The concomitant use of RYANODEX and calcium channel blockers is not recommended during the treatment of malignant hyperthermia. (Dantrolene label, Drug interactions)

Lipid Modifying Agents: HMG-CoA reductase inhibitors : lovastatin, simvastatin ↑ lovastatin ↑ simvastatin Co-administration is contraindicated due to potential for serious reactions such as myopathy including rhabdomyolysis. atorvastatin, pravastatin, rosuvastatin ↑ HMG-CoA reductase inhibitors Co-administration of PREZISTA/ritonavir with HMG-Co A reductase inhibitors… (Darunavir label, Drug interactions)

Dosage recommendations with atorvastatin or rosuvastatin are as follows: atorvastatin dosage should not exceed 20 mg/day rosuvastatin dosage should not exceed 20 mg/day Other lipid modifying agents: lomitapide ↑ lomitapide Co-administration is contraindicated due to potential for markedly increased transaminases associated with increased plasma concentrations… (Darunavir and cobicistat label, Drug interactions)

• Statins: Avoid simvastatin doses greater than 10 mg daily. (Dronedarone label, Drug interactions)

Lipid-modifying Agents: HMG-CoA Reductase Inhibitors: lovastatin simvastatin ↑ lovastatin ↑ simvastatin Coadministration with lovastatin or simvastatin is contraindicated due to potential for serious reactions such as myopathy including rhabdomyolysis. atorvastatin ↑ atorvastatin Initiate atorvastatin with the lowest starting dose of atorvastatin and titrate… (Elvitegravir, cobicistat, emtricitabine, and tenofovir label, Drug interactions)

…of active abnormal bleeding within the previous 30 days Severe hypertension (systolic blood pressure >200 mm Hg or diastolic blood pressure >110 mm Hg) not adequately controlled on antihypertensive therapy Major surgery within the preceding 6 weeks History of stroke within 30 days or any history of hemorrhagic stroke Current or planned administration of another… (Eptifibatide label, Contraindications)

Do not use erythromycin concomitantly with HMG CoA reductase inhibitors (statins) that are extensively metabolized by CYP 3A4 (lovastatin or simvastatin), due to the increased risk of myopathy, including rhabdomyolysis (see PRECAUTIONS - Drug Interactions ). (Erythromycin label, Contraindications)

IV administration of cardiodepressant calcium-channel antagonists (e.g., verapamil) and BREVIBLOC in close proximity (i.e., while cardiac effects from the other are still present); fatal cardiac arrests have occurred in patients receiving BREVIBLOC and intravenous verapamil. (Esmolol label, Contraindications)

When used in combination with a statin, fenofibrate, or other LDL-C lowering therapy, ZETIA is contraindicated in patients for whom a statin, fenofibrate, or other LDL-C lowering therapy are contraindicated. (Ezetimibe label, Contraindications)

Table 2: Oral drugs that can be administered concomitantly with Ferric Citrate Tablets Amlodipine Aspirin Atorvastatin Calcitriol Clopidogrel Digoxin Diltiazem Doxercalciferol Enalapril Fluvastatin Glimepiride Levofloxacin Losartan Metoprolol Pravastatin Propranolol Sitagliptin Warfarin Oral drugs that have to be separated from Ferric Citrate Tablets and meals… (Ferric citrate label, Drug interactions)

Concomitant use of cyclosporine, gemfibrozil, tipranavir plus ritonavir or glecaprevir plus pibrentasvir with amlodipine and atorvastatin tablets are not recommended. (Amlodipine and atorvastatin label, Warnings and precautions)

Concomitant intake of large quantities, more than 1.2 liters daily, of grapefruit juice is not recommended in patients taking amlodipine and atorvastatin tablets [see Drug Interactions (7.3) ]. (Amlodipine and atorvastatin label, Warnings and precautions)

Calcium Channel Blockers Felodipine Nisoldipine Contraindicated during and 2 weeks after TOLSURA treatment. (Itraconazole label, Drug interactions)

Myopathy Coadministration of CYP3A4 metabolized HMG-CoA reductase inhibitors such as simvastatin, and lovastatin is contraindicated with ketoconazole tablets (see PRECAUTIONS: Drug Interactions ). (Ketoconazole label, Contraindications)

IV administration of non-dihydropyridine calcium-channel antagonists (e.g., verapamil) Hypersensitivity reactions, including anaphylaxis, to labetalol Bronchial asthma ( 4 ) (Labetalol label, Contraindications)

Coadministration of ledipasvir and sofosbuvir with rosuvastatin is not recommended. atorvastatin ↑ atorvastatin Coadministration of ledipasvir and sofosbuvir with atorvastatin may be associated with increased risk of myopathy, including rhabdomyolysis. (Ledipasvir and sofosbuvir label, Drug interactions)

Concomitant use of cyclosporine, gemfibrozil, tipranavir plus ritonavir or glecaprevir plus pibrentasvir with amlodipine and atorvastatin tablets are not recommended. (Amlodipine and atorvastatin label, Warnings and precautions)

Other Antihypertensive Drugs When metolazone tablets, USP, are used with other antihypertensive drugs, particular care must be taken to avoid excessive reduction of blood pressure, especially during initial therapy. (Metolazone label, Warnings)

Minoxidil should be reserved for hypertensive patients who do not respond adequately to maximum therapeutic doses of a diuretic and two other antihypertensive agents. (Minoxidil label, Boxed warning)

Concomitant use of cyclosporine, gemfibrozil, tipranavir plus ritonavir or glecaprevir plus pibrentasvir with amlodipine and atorvastatin tablets are not recommended. (Amlodipine and atorvastatin label, Warnings and precautions)

Prevention or Management Atorvastatin, Lovastatin, Simvastatin Concomitant use with posaconazole is contraindicated. (Posaconazole label, Drug interactions)

Concomitant use of cyclosporine, gemfibrozil, tipranavir plus ritonavir or glecaprevir plus pibrentasvir with amlodipine and atorvastatin tablets are not recommended. (Amlodipine and atorvastatin label, Warnings and precautions)

…↑ pitavastatin Coadministration with VOSEVI may increase the concentration of pitavastatin and is not recommended, due to an increased risk of myopathy, including rhabdomyolysis. atorvastatin fluvastatin lovastatin simvastatin ↑ atorvastatin ↑ fluvastatin ↑ lovastatin ↑ simvastatin Coadministration with VOSEVI may increase the concentrations of atorvastatin,… (Sofosbuvir and velpatasvir label, Drug interactions)

…coadministration of an alpha-blocker and CIALIS for the treatment of BPH has not been adequately studied, and due to the potential vasodilatory effects of combined use resulting in blood pressure lowering, the combination of CIALIS and alpha-blockers is not recommended for the treatment of BPH. [see Dosage and Administration ( 2.7 ), Drug Interactions ( 7.1 ),… (Tadalafil label, Warnings and precautions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

• Hypertension : Patients taking some antihypertensive medications may have impaired response to these therapies when taking NSAIDs. (Acetaminophen and ibuprofen label, Warnings and precautions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

Patients who consume substantial quantities of alcohol and/or have a history of liver disease may be at increased risk for hepatic injury [see Use in Specific Populations (8.7) ] . (Amlodipine and atorvastatin label, Warnings and precautions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

Postural hypotension/syncope: Care should be taken in patients with symptomatic hypotension or who have had a hypotensive response to other medications or are concomitantly treated with antihypertensive medication or nitrates ( 5.1 ) (Alfuzosin label, Warnings and precautions)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Amlodipine and atorvastatin label, Drug interactions)

• Myopathy and Rhabdomyolysis: Risk factors include age 65 years or greater, uncontrolled hypothyroidism, renal impairment, concomitant use with certain other drugs, and higher amlodipine and atorvastatin dosage. (Amlodipine and atorvastatin label, Warnings and precautions)

• Myopathy and Rhabdomyolysis: Risk factors include age 65 years or greater, uncontrolled hypothyroidism, renal impairment, concomitant use with certain other drugs, and higher amlodipine and atorvastatin dosage. (Amlodipine and atorvastatin label, Warnings and precautions)

• Myopathy and Rhabdomyolysis: Risk factors include age 65 years or greater, uncontrolled hypothyroidism, renal impairment, concomitant use with certain other drugs, and higher amlodipine and atorvastatin dosage. (Amlodipine and atorvastatin label, Warnings and precautions)

• Myopathy and Rhabdomyolysis: Risk factors include age 65 years or greater, uncontrolled hypothyroidism, renal impairment, concomitant use with certain other drugs, and higher amlodipine and atorvastatin dosage. (Amlodipine and atorvastatin label, Warnings and precautions)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Amlodipine and atorvastatin label, Drug interactions)

Antihypertensive Drugs Due to its alpha-adrenergic antagonism, aripiprazole has the potential to enhance the effect of certain antihypertensive agents. (Aripiprazole label, Drug interactions)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine and atorvastatin label, Drug interactions)

Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (elderly patients, patients with dehydration, hypovolemia, concomitant treatment with antihypertensive medications, patients with known cardiovascular disease (history of myocardial infarction or ischemic heart disease, heart failure, or conduction abnormalities), and patients… (Asenapine label, Warnings and precautions)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Amlodipine and atorvastatin label, Drug interactions)

(See DOSAGE AND ADMINISTRATION . ) Concomitant Use of Calcium Channel Blockers Bradycardia and heart block can occur and the left ventricular end diastolic pressure can rise when beta-blockers are administered with verapamil or diltiazem. (Atenolol label, Warnings)

Because of its relative beta 1 -selectivity, however, atenolol and chlorthalidone may be used with caution in patients with bronchospastic disease who do not respond to or cannot tolerate, other antihypertensive treatment. (Atenolol and chlorthalidone label, Warnings)

Antihypertensive Drugs Prevention or Management Increase the frequency of monitoring blood pressure and adjust atomoxetine oral solution dosage as clinically appropriate. (Atomoxetine label, Drug interactions)

• Myopathy and Rhabdomyolysis: Risk factors include age 65 years or greater, uncontrolled hypothyroidism, renal impairment, concomitant use with certain other drugs, and higher amlodipine and atorvastatin dosage. (Amlodipine and atorvastatin label, Warnings and precautions)

CYP3A4 Substrate When administered with avanafil 200 mg, amlodipine (5 mg daily) increased the C max and AUC of avanafil by approximately 22% and 70%, respectively. (Avanafil label, Drug interactions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

Amlodipine and atorvastatin tablets dosage modifications are recommended for patients taking certain anti-viral, azole antifungals, or macrolide antibiotic medications [see Dosage and Administration (2) ] . (Amlodipine and atorvastatin label, Warnings and precautions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

Drug Interactions that may Decrease Exposure to Atorvastatin Rifampin Clinical Impact: Concomitant administration of atorvastatin with rifampin, an inducer of cytochrome P450 3A4 and inhibitor of OATP1B1, can lead to variable reductions in plasma concentrations of atorvastatin. (Amlodipine and atorvastatin label, Drug interactions)

The thiazide component of Lotensin HCT may potentiate the action of other antihypertensive drugs, especially ganglionic or peripheral adrenergic-blocking drugs. (Benazepril and hydrochlorothiazide label, Warnings)

Amphetamines may decrease the hypotensive effect of antihypertensives. (Benzphetamine label, Drug interactions)

HMG-CoA Reductase Inhibitors: lovastatin simvastatin ↑ lovastatin ↑ simvastatin Initiate lovastatin and simvastatin with the lowest starting dose and titrate carefully while monitoring for safety (e.g., myopathy). (Bictegravir, emtricitabine, and tenofovir alafenamide label, Drug interactions)

Because of its relative beta 1 -selectivity, however, BISOPROLOL FUMARATE may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol label, Warnings)

Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

Hypotension: Use caution when treating patients taking antihypertensives, with a history of syncope, or with dehydration. (Bortezomib label, Warnings and precautions)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine and atorvastatin label, Drug interactions)

Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, concomitant treatment with antihypertensive medication), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Brexpiprazole label, Warnings and precautions)

Antihypertensives/Cardiac Glycosides Because brimonidine tartrate ophthalmic solution 0.1% and 0.15% may reduce blood pressure, caution in using drugs such as antihypertensives and/or cardiac glycosides with brimonidine tartrate ophthalmic solution 0.1% and 0.15% is advised. (Brimonidine label, Drug interactions)

Oral or intravenous calcium antagonists may cause atrioventricular conduction disturbances, left ventricular failure, and hypotension. (Brimonidine and timolol label, Drug interactions)

Use caution in patients taking antihypertensive medications. (Bromocriptine label, Warnings and precautions)

Central Nervous System (CNS) depressants Antihistamines have additive effects with alcohol and other CNS depressants (hypnotics, sedatives, tranquilizers, antianxiety agents, etc.). Antihypertensive drugs Sympathomimetic may reduce the effects of antihypertensive drugs. (Brompheniramine, pseudoephedrine, and dextromethorphan label, Drug interactions)

Antihypertensives Bumetanide may potentiate the effect of various antihypertensive drugs, necessitating a reduction in the dosage of these drugs. (Bumetanide label, Drug interactions)

Calcium Channel Blockers : Administration of calcium may reduce the response. (Calcium gluconate label, Drug interactions)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine and atorvastatin label, Drug interactions)

Symptomatic postural hypotension has occurred when carbidopa, given with levodopa or carbidopa-levodopa combination products, was added to the treatment of a patient receiving antihypertensive drugs. (Carbidopa label, Drug interactions)

Antihypertensive drugs: May cause symptomatic postural hypotension. (Carbidopa and levodopa label, Drug interactions)

Antihypertensive Agents Symptomatic postural hypotension has occurred when carbidopa/levodopa was added to the treatment of patients receiving antihypertensive drugs. (Carbidopa, levodopa, and entacapone label, Drug interactions)

Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, and concomitant treatment with antihypertensive medications), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Cariprazine label, Warnings and precautions)

COREG may be used with caution, however, in patients who do not respond to, or cannot tolerate, other antihypertensive agents. (Carvedilol label, Warnings and precautions)

Intervention: During concomitant use of VYSCOXA with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [ see Warnings and Precautions (5.6) ]. (Celecoxib label, Drug interactions)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Amlodipine and atorvastatin label, Drug interactions)

Thiazides may add to or potentiate the action of other antihypertensive drugs. (Chlorothiazide label, Warnings)

Effect of chlorthalidone on other drugs Chlorthalidone may add to or potentiate the action of other antihypertensive drugs. (Chlorthalidone label, Drug interactions)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Amlodipine and atorvastatin label, Drug interactions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine and atorvastatin label, Drug interactions)

Drugs that affect sinus node function or AV node conduction (e.g., digitalis, calcium channel blockers, beta blockers) Clinical Implication Concomitant use of drugs that affect sinus node function or AV node conduction with clonidine potentiate bradycardia and risk of AV block [see Warnings and Precautions (5.1) ]. (Clonidine label, Drug interactions)

Amlodipine and atorvastatin tablets dosage modifications are recommended for patients taking certain anti-viral, azole antifungals, or macrolide antibiotic medications [see Dosage and Administration (2) ] . (Amlodipine and atorvastatin label, Warnings and precautions)

Cases of myopathy/rhabdomyolysis have been reported with atorvastatin co-administered with lipid modifying doses (> 1 gram/day) of niacin, fibrates, colchicine, and ledipasvir plus sofosbuvir [see Adverse Reactions (6.1) ] . (Amlodipine and atorvastatin label, Warnings and precautions)

• Oral Contraceptives: May increase plasma levels of norethindrone and ethinyl estradiol; consider this effect when selecting an oral contraceptive ( 7.5 ). (Amlodipine and atorvastatin label, Drug interactions)

• Oral Contraceptives: May increase plasma levels of norethindrone and ethinyl estradiol; consider this effect when selecting an oral contraceptive ( 7.5 ). (Amlodipine and atorvastatin label, Drug interactions)

…concomitant use of TONMYA with: MAO inhibitors may be life-threatening [see Contraindications (4) ] , Alcohol, barbiturates, and other CNS depressants may increase the risk of adverse reactions associated with these drugs, Tramadol may increase the seizure risk, Guanethidine or other similar acting drugs may block the antihypertensive action of these drugs. (Cyclobenzaprine label, Drug interactions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

The risk of myopathy and rhabdomyolysis is increased by concomitant administration of danazol with statins such as simvastatin, atorvastatin and lovastatin. (Danazol label, Drug interactions)

In patients who receive Daptomycin for Injection, CPK levels should be monitored weekly, and more frequently in patients who received recent prior or concomitant therapy with an HMG-CoA reductase inhibitor or in whom elevations in CPK occur during treatment with Daptomycin for Injection. (Daptomycin label, Warnings and precautions)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine and atorvastatin label, Drug interactions)

• Oral Contraceptives: May increase plasma levels of norethindrone and ethinyl estradiol; consider this effect when selecting an oral contraceptive ( 7.5 ). (Amlodipine and atorvastatin label, Drug interactions)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine and atorvastatin label, Drug interactions)

• Antihypertensive Drugs: Monitor blood pressure. (Dexmethylphenidate label, Drug interactions)

Intervention: During concomitant use of ZIPSOR with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [ see Warnings and Precautions ( 5.6 ) ]. (Diclofenac label, Drug interactions)

Intervention: During concomitant use of diclofenac sodium/misoprostol with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions (5.7) ] . (Diclofenac and misoprostol label, Drug interactions)

The pressor effects of diethylpropion and those of other drugs may be additive when the drugs are used concomitantly; conversely, diethylpropion may interfere with antihypertensive drugs (i.e., guanethidine, a-methyldopa). (Diethylpropion label, Drug interactions)

• Digoxin: May increase digoxin plasma levels; monitor patients appropriately ( 7.5 ). (Amlodipine and atorvastatin label, Drug interactions)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Amlodipine and atorvastatin label, Drug interactions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

Concomitant medications were grouped as ACE inhibitors, oral anticoagulants, calcium channel blockers, beta blockers, cardiac glycosides, inducers of CYP3A4, substrates and inhibitors of CYP3A4, substrates and inhibitors of P-glycoprotein, nitrates, sulphonylureas, loop diuretics, potassium sparing diuretics, thiazide diuretics, substrates and inhibitors of tubular… (Dofetilide label, Drug interactions)

Oral or intravenous calcium antagonists may cause atrioventricular conduction disturbances, left ventricular failure, and hypotension. (Dorzolamide and timolol label, Drug interactions)

Possible pharmacodynamic interactions can occur between droperidol and potentially arrhythmogenic agents such as class I or III antiarrhythmics, antihistamines that prolong the QT interval, antimalarials, calcium channel blockers, neuroleptics that prolong the QT interval, and antidepressants. (Droperidol label, Drug interactions)

• Oral Contraceptives: May increase plasma levels of norethindrone and ethinyl estradiol; consider this effect when selecting an oral contraceptive ( 7.5 ). (Amlodipine and atorvastatin label, Drug interactions)

The risk of BP decreases may be greater in patients taking concomitant medications that induce orthostatic hypotension (such as antihypertensives) or are potent CYP1A2 inhibitors [see Drug Interactions ( 7.1 )] and in patients taking duloxetine delayed-release capsules at doses above 60 mg daily. (Duloxetine label, Warnings and precautions)

Calcium Channel Antagonists Coadministration of verapamil or diltiazem decreases dutasteride clearance and leads to increased exposure to dutasteride. (Dutasteride label, Drug interactions)

Calcium Channel Antagonists Dutasteride Coadministration of verapamil or diltiazem decreases dutasteride clearance and leads to increased exposure to dutasteride. (Dutasteride and tamsulosin label, Drug interactions)

Amlodipine and atorvastatin tablets dosage modifications are recommended for patients taking certain anti-viral, azole antifungals, or macrolide antibiotic medications [see Dosage and Administration (2) ] . (Amlodipine and atorvastatin label, Warnings and precautions)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Amlodipine and atorvastatin label, Drug interactions)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Amlodipine and atorvastatin label, Drug interactions)

Concomitant use of TRIKAFTA may increase exposures of medicinal products that are substrates of these transporters, such as statins, glyburide, nateglinide and repaglinide. (Elexacaftor, tezacaftor, and ivacaftor label, Drug interactions)

Drug Interactions that may Decrease Exposure to Atorvastatin Rifampin Clinical Impact: Concomitant administration of atorvastatin with rifampin, an inducer of cytochrome P450 3A4 and inhibitor of OATP1B1, can lead to variable reductions in plasma concentrations of atorvastatin. (Amlodipine and atorvastatin label, Drug interactions)

Epinephrine may antagonize the neuronal blockade produced by guanethidine resulting in decreased antihypertensive effect and requiring increased dosage of the latter. (Epinephrine label, Drug interactions)

The administration of other potassium-sparing antihypertensives with NSAIDs has been shown to reduce the antihypertensive effect in some patients and result in severe hyperkalemia in patients with impaired renal function. (Eplerenone label, Drug interactions)

Following initiation and titration of Epogen, approximately 25% of patients on dialysis required initiation of or increases in antihypertensive therapy; hypertensive encephalopathy and seizures have been reported in patients with CKD receiving Epogen. (Epoetin alfa 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)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine and atorvastatin label, Drug interactions)

• Oral Contraceptives: May increase plasma levels of norethindrone and ethinyl estradiol; consider this effect when selecting an oral contraceptive ( 7.5 ). (Amlodipine and atorvastatin label, Drug interactions)

• Oral Contraceptives: May increase plasma levels of norethindrone and ethinyl estradiol; consider this effect when selecting an oral contraceptive ( 7.5 ). (Amlodipine and atorvastatin label, Drug interactions)

• Oral Contraceptives: May increase plasma levels of norethindrone and ethinyl estradiol; consider this effect when selecting an oral contraceptive ( 7.5 ). (Amlodipine and atorvastatin label, Drug interactions)

• Oral Contraceptives: May increase plasma levels of norethindrone and ethinyl estradiol; consider this effect when selecting an oral contraceptive ( 7.5 ). (Amlodipine and atorvastatin label, Drug interactions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

• Oral Contraceptives: May increase plasma levels of norethindrone and ethinyl estradiol; consider this effect when selecting an oral contraceptive ( 7.5 ). (Amlodipine and atorvastatin label, Drug interactions)

• Oral Contraceptives: May increase plasma levels of norethindrone and ethinyl estradiol; consider this effect when selecting an oral contraceptive ( 7.5 ). (Amlodipine and atorvastatin label, Drug interactions)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine and atorvastatin label, Drug interactions)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Amlodipine and atorvastatin label, Drug interactions)

VYTORIN dosage modifications are recommended for patients taking lomitapide, verapamil, diltiazem, dronedarone, amiodarone, amlodipine or ranolazine [see Dosage and Administration (2.5) ] . (Ezetimibe and simvastatin label, Warnings and precautions)

Cases of myopathy/rhabdomyolysis have been reported with atorvastatin co-administered with lipid modifying doses (> 1 gram/day) of niacin, fibrates, colchicine, and ledipasvir plus sofosbuvir [see Adverse Reactions (6.1) ] . (Amlodipine and atorvastatin label, Warnings and precautions)

Cases of myopathy/rhabdomyolysis have been reported with atorvastatin co-administered with lipid modifying doses (> 1 gram/day) of niacin, fibrates, colchicine, and ledipasvir plus sofosbuvir [see Adverse Reactions (6.1) ] . (Amlodipine and atorvastatin label, Warnings and precautions)

Intervention: During concomitant use of FENOPROFEN CALCIUM with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [ see Warnings and Precautions ( 5.6 ) ]. (Fenoprofen label, Drug interactions)

Amlodipine and atorvastatin tablets dosage modifications are recommended for patients taking certain anti-viral, azole antifungals, or macrolide antibiotic medications [see Dosage and Administration (2) ] . (Amlodipine and atorvastatin label, Warnings and precautions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

Amlodipine and atorvastatin tablets dosage modifications are recommended for patients taking certain anti-viral, azole antifungals, or macrolide antibiotic medications [see Dosage and Administration (2) ] . (Amlodipine and atorvastatin label, Warnings and precautions)

Intervention: During concomitant use of flurbiprofen with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [ see Warnings and Precautions (5) ]. (Flurbiprofen label, Drug interactions)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Amlodipine and atorvastatin label, Drug interactions)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Amlodipine and atorvastatin label, Drug interactions)

The thiazide component of fosinopril sodium and hydrochlorothiazide may potentiate the action of other antihypertensive drugs, especially ganglionic or peripheral adrenergic-blocking drugs. (Fosinopril and hydrochlorothiazide label, Warnings)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine and atorvastatin label, Drug interactions)

• Oral Contraceptives: May increase plasma levels of norethindrone and ethinyl estradiol; consider this effect when selecting an oral contraceptive ( 7.5 ). (Amlodipine and atorvastatin label, Drug interactions)

Monitor for changes in blood pressure and adjust the dose of other antihypertensive drugs if needed. (Furosemide label, Drug interactions)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine and atorvastatin label, Drug interactions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

During concomitant use of hydrocodone bitartrate and ibuprofen tablets with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects (see WARNINGS: Renal Toxicity and Hyperkalemia ). (Hydrocodone and ibuprofen label, Drug interactions)

Intervention: During concomitant use of CALDOLOR with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [ see Warnings and Precautions ( 5.6 ) ]. (Ibuprofen label, Drug interactions)

Intervention: During concomitant use of ibuprofen and famotidine tablet with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions ( 5.7 )] . (Ibuprofen and famotidine label, Drug interactions)

In a double-blind, placebo-controlled trial of 8,179 statin-treated subjects with established cardiovascular disease (CVD) or diabetes plus an additional risk factor for CVD, adjudicated atrial fibrillation or atrial flutter requiring hospitalization for 24 or more hours occurred in 127 (3%) patients treated with VASCEPA compared to 84 (2%) patients receiving… (Icosapent ethyl label, Warnings and precautions)

Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, and concomitant treatment with antihypertensive medications), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Iloperidone label, Warnings and precautions)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Amlodipine and atorvastatin label, Drug interactions)

Drug Interactions Other Antihypertensives: Indapamide may add to or potentiate the action of other antihypertensive drugs. (Indapamide label, Drug interactions)

Monitor patients to assure diuretic efficacy including antihypertensive effects ( 7 ) (Indomethacin label, Drug interactions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

Calcium Antagonists FORANE may lead to marked hypotension in patients treated with calcium antagonists. (Isoflurane label, Drug interactions)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Amlodipine and atorvastatin label, Drug interactions)

Marked symptomatic orthostatic hypotension has been reported when calcium channel blockers and organic nitrates were used in combination. (Isosorbide mononitrate label, Drug interactions)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Amlodipine and atorvastatin label, Drug interactions)

VIMPAT should also be used with caution in patients on concomitant medications that affect cardiac conduction, including sodium channel blockers, beta-blockers, calcium channel blockers, potassium channel blockers, and medications that prolong the PR interval [see Drug Interactions (7.2) ] . (Lacosamide label, Warnings and precautions)

Examples of relevant classes of compounds where antacids have been demonstrated to reduce bioavailability include antibiotics (such as quinolones, ampicillin, and tetracyclines), thyroid hormones, ACE inhibitors, statin lipid regulators, and anti-malarials. (Lanthanum label, Drug interactions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Amlodipine and atorvastatin label, Drug interactions)

• Oral Contraceptives: May increase plasma levels of norethindrone and ethinyl estradiol; consider this effect when selecting an oral contraceptive ( 7.5 ). (Amlodipine and atorvastatin label, Drug interactions)

• Oral Contraceptives: May increase plasma levels of norethindrone and ethinyl estradiol; consider this effect when selecting an oral contraceptive ( 7.5 ). (Amlodipine and atorvastatin label, Drug interactions)

When a diuretic is added to the therapy of a patient receiving lisinopril, an additional antihypertensive effect is usually observed (see DOSAGE AND ADMINISTRATION ). (Lisinopril and hydrochlorothiazide label, Drug interactions)

Calcium Channel Blocking Agents (CCB) Clinical Impact: Concomitant use may increase the risk of neurologic adverse reactions in the form of ataxia, tremors, nausea, vomiting, diarrhea and/or tinnitus. (Lithium label, Drug interactions)

Weak CYP3A4 Inhibitors Weak CYP3A4 inhibitors (such as alprazolam, amiodarone, amlodipine, atorvastatin, bicalutamide, cilostazol, cimetidine, cyclosporine, fluoxetine, fluvoxamine, ginkgo, goldenseal, isoniazid, lapatinib, nilotinib, pazopanib, ranitidine, ranolazine, ticagrelor, zileuton) can increase lomitapide exposure approximately 2-fold [see Clinical Pharmacology… (Lomitapide label, Drug interactions)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine and atorvastatin label, Drug interactions)

However, another HMG-CoA reductase inhibitor has been found to produce a less than two-second increase in prothrombin time in healthy volunteers receiving low doses of warfarin. (Lovastatin label, Drug interactions)

Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, and concomitant treatment with antihypertensive drugs), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and patients… (Lumateperone label, Warnings and precautions)

Patients at increased risk of these adverse reactions or at increased risk of developing complications from hypotension include those with dehydration, hypovolemia, treatment with antihypertensive medication, history of cardiovascular disease (e.g., heart failure, myocardial infarction, ischemia, or conduction abnormalities), history of cerebrovascular disease,… (Lurasidone label, Warnings and precautions)

The action of Mecamylamine HCl may be potentiated by anesthesia, other antihypertensive drugs and alcohol. (Mecamylamine label, Drug interactions)

• Oral Contraceptives: May increase plasma levels of norethindrone and ethinyl estradiol; consider this effect when selecting an oral contraceptive ( 7.5 ). (Amlodipine and atorvastatin label, Drug interactions)

Intervention: During concomitant use of mefenamic acid with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions ( 5.6 )] . (Mefenamic acid label, Drug interactions)

Other Drugs that Prolong the QTc Interval Coadministration of other drugs known to alter cardiac conduction (e.g., anti-arrhythmic or beta-adrenergic blocking agents, calcium channel blockers, antihistamines or H 1 -blocking agents, tricyclic antidepressants and phenothiazines) might also contribute to a prolongation of the QTc interval. (Mefloquine label, Drug interactions)

• Oral Contraceptives: May increase plasma levels of norethindrone and ethinyl estradiol; consider this effect when selecting an oral contraceptive ( 7.5 ). (Amlodipine and atorvastatin label, Drug interactions)

Intervention: During concomitant use of QAMZOVA with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [ see Warnings and Precautions ( 5.6 ) ]. (Meloxicam label, Drug interactions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

Examples: Drugs known to have potential to prolong QT interval: Class I and III antiarrhythmics, some neuroleptics and tricyclic antidepressants, and calcium channel blockers. (Methadone label, Drug interactions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

Antihypertensive Drugs: Monitor blood pressure. (Methylphenidate label, Drug interactions)

Digitalis, Clonidine, and Calcium Channel Blockers: Digitalis glycosides, clonidine, diltiazem and verapamil slow atrioventricular conduction and decrease heart rate. (Metoprolol and hydrochlorothiazide label, Drug interactions)

Amlodipine and atorvastatin tablets dosage modifications are recommended for patients taking certain anti-viral, azole antifungals, or macrolide antibiotic medications [see Dosage and Administration (2) ] . (Amlodipine and atorvastatin label, Warnings and precautions)

• Oral Contraceptives: May increase plasma levels of norethindrone and ethinyl estradiol; consider this effect when selecting an oral contraceptive ( 7.5 ). (Amlodipine and atorvastatin label, Drug interactions)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Amlodipine and atorvastatin label, Drug interactions)

REMERON/REMERONSolTab should be used with caution in patients with known cardiovascular or cerebrovascular disease that could be exacerbated by hypotension (history of myocardial infarction, angina, or ischemic stroke) and conditions that would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medication). (Mirtazapine label, Warnings and precautions)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine and atorvastatin label, Drug interactions)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine and atorvastatin label, Drug interactions)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine and atorvastatin label, Drug interactions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine and atorvastatin label, Drug interactions)

( 5.3 Hepatotoxicity) Hypertension: Patients taking some antihypertensive medications may have impaired response to these therapies when taking NSAIDs. (Naproxen label, Warnings and precautions)

Intervention : During concomitant use of naproxen and esomeprazole magnesium delayed-release tablets with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see Warnings and Precautions (5.6) ]. (Naproxen and esomeprazole label, Drug interactions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

Non-dihydropyridine Calcium Channel Blockers Because of significant negative inotropic and chronotropic effects in patients treated with β-blockers and calcium channel blockers of the verapamil and diltiazem type, monitor the ECG and blood pressure in patients treated concomitantly with these agents. (Nebivolol label, Warnings and precautions)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Amlodipine and atorvastatin label, Drug interactions)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine and atorvastatin label, Drug interactions)

Cases of myopathy/rhabdomyolysis have been reported with atorvastatin co-administered with lipid modifying doses (> 1 gram/day) of niacin, fibrates, colchicine, and ledipasvir plus sofosbuvir [see Adverse Reactions (6.1) ] . (Amlodipine and atorvastatin label, Warnings and precautions)

Blood Pressure Lowering Drugs Nimodipine may increase the blood pressure lowering effect of concomitantly administered anti-hypertensives such as diuretics, beta-blockers, ACE inhibitors, angiotensin receptor blockers, other calcium channel blockers, α-adrenergic blockers, PDE5 inhibitors, and α-methyldopa. (Nimodipine label, Drug interactions)

Antihypertensives: Possible additive hypotensive effects. (Nitroglycerin label, Drug interactions)

• Oral Contraceptives: May increase plasma levels of norethindrone and ethinyl estradiol; consider this effect when selecting an oral contraceptive ( 7.5 ). (Amlodipine and atorvastatin label, Drug interactions)

• Oral Contraceptives: May increase plasma levels of norethindrone and ethinyl estradiol; consider this effect when selecting an oral contraceptive ( 7.5 ). (Amlodipine and atorvastatin label, Drug interactions)

• Oral Contraceptives: May increase plasma levels of norethindrone and ethinyl estradiol; consider this effect when selecting an oral contraceptive ( 7.5 ). (Amlodipine and atorvastatin label, Drug interactions)

• Oral Contraceptives: May increase plasma levels of norethindrone and ethinyl estradiol; consider this effect when selecting an oral contraceptive ( 7.5 ). (Amlodipine and atorvastatin label, Drug interactions)

• Oral Contraceptives: May increase plasma levels of norethindrone and ethinyl estradiol; consider this effect when selecting an oral contraceptive ( 7.5 ). (Amlodipine and atorvastatin label, Drug interactions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

Beta Blocker and Calcium Channel Blockers : dose adjustment of beta blockers or calcium channel blockers may be necessary (‎ 7 ). (Octreotide label, Drug interactions)

…of myocardial infarction or ischemia, heart failure, or conduction abnormalities), cerebrovascular disease, and conditions which would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medications) where the occurrence of syncope, or hypotension and/or bradycardia might put the patient at increased medical risk. (Olanzapine label, Warnings and precautions)

…and fluoxetine capsules should be used with particular caution in patients with known cardiovascular disease (history of myocardial infarction or ischemia, heart failure, or conduction abnormalities), cerebrovascular disease, or conditions that would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medications). (Olanzapine and fluoxetine label, Warnings and precautions)

• Myopathy and Rhabdomyolysis: Risk factors include age 65 years or greater, uncontrolled hypothyroidism, renal impairment, concomitant use with certain other drugs, and higher amlodipine and atorvastatin dosage. (Amlodipine and atorvastatin label, Warnings and precautions)

Intervention: During concomitant use of OXAPROZIN CAPSULES with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [see WARNINGS AND PRECAUTIONS (5.6) ]. (Oxaprozin label, Drug interactions)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine and atorvastatin label, Drug interactions)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Amlodipine and atorvastatin label, Drug interactions)

Use ERZOFRI with caution in patients with known cardiovascular disease (e.g., heart failure, history of myocardial infarction or ischemia, conduction abnormalities), cerebrovascular disease, or conditions that predispose the patient to hypotension (e.g., dehydration, hypovolemia, and treatment with antihypertensive medications). (Paliperidone label, Warnings and precautions)

Adjustments in the dose of drugs known to slow the heart rate (e.g., beta-blockers, calcium channel blockers) and correction of electrolyte disturbances may be necessary when initiating or during the course of SIGNIFOR LAR treatment. (Pasireotide label, Warnings and precautions)

Monitor blood pressure as clinically indicated and initiate and adjust antihypertensive therapy as appropriate. (Pazopanib label, Warnings and precautions)

Small decreases in blood pressure have been observed in some patients treated with pentoxifylline extended-release tablets; periodic systemic blood pressure monitoring is recommended for patients receiving concomitant antihypertensive therapy. (Pentoxifylline label, Drug interactions)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Amlodipine and atorvastatin label, Drug interactions)

…hydrochloride desipramine hydrochloride imipramine hydrochloride doxepin carbamazepine cyclobenzaprine HCl amoxapine maprotiline HCl trimipramine maleate protriptyline HCl mirtazapine Phenelzine sulfate should be used with caution in combination with antihypertensive drugs, including thiazide diuretics and β-blockers, since exaggerated hypotensive effects may result. (Phenelzine label, Warnings)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine and atorvastatin label, Drug interactions)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine and atorvastatin label, Drug interactions)

Antagonistic Effects (decrease in BIORPHEN blood pressure effect) can occur with α-adrenergic antagonists, phosphodiesterase Type 5 inhibitors, mixed α- and β-receptor antagonists, calcium channel blockers, benzodiazepines and ACE inhibitors, centrally acting sympatholytic agents. (Phenylephrine label, Drug interactions)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine and atorvastatin label, Drug interactions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

Monitor patients to assure diuretic efficacy including antihypertensive effects (7) (Piroxicam label, Drug interactions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

Syncopal episodes have usually occurred within 30 to 90 minutes of the initial dose of the drug; occasionally, they have been reported in association with rapid dosage increases or the introduction of another antihypertensive drug into the regimen of a patient taking high doses of prazosin hydrochloride capsules. (Prazosin label, Warnings)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine and atorvastatin label, Drug interactions)

Cases of myopathy/rhabdomyolysis have been reported with atorvastatin co-administered with lipid modifying doses (> 1 gram/day) of niacin, fibrates, colchicine, and ledipasvir plus sofosbuvir [see Adverse Reactions (6.1) ] . (Amlodipine and atorvastatin label, Warnings and precautions)

• Oral Contraceptives: May increase plasma levels of norethindrone and ethinyl estradiol; consider this effect when selecting an oral contraceptive ( 7.5 ). (Amlodipine and atorvastatin label, Drug interactions)

The concomitant use of beta-adrenergic blockers and non-dihydropyridine calcium channel blockers (e.g., verapamil and diltiazem), digoxin or clonidine increases the risk of significant bradycardia. (Propranolol label, Warnings and precautions)

Quetiapine should be used with particular caution in patients with known cardiovascular disease (history of myocardial infarction or ischemic heart disease, heart failure, or conduction abnormalities), cerebrovascular disease, or conditions which would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medications). (Quetiapine label, Warnings and precautions)

The thiazide component of quinapril and hydrochlorothiazide tablets may potentiate the action of other antihypertensive drugs, especially ganglionic or peripheral adrenergic- blocking drugs. (Quinapril and hydrochlorothiazide label, Warnings)

Atorvastatin (CYP3A4 Substrate) Rhabdomyolysis with acute renal failure secondary to myoglobinuria was reported in a patient taking atorvastatin administered with a single dose of quinine. (Quinine label, Drug interactions)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Amlodipine and atorvastatin label, Drug interactions)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine and atorvastatin label, Drug interactions)

• Rifampin: May reduce atorvastatin plasma concentrations. (Amlodipine and atorvastatin label, Drug interactions)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine and atorvastatin label, Drug interactions)

Consider the potential for symptomatic hypotension or ischemia in patients with hypovolemia, severe left ventricular outflow obstruction, resting hypotension, autonomic dysfunction, or concomitant treatment with antihypertensives or strong CYP and P-gp/BCRP inhibitors [see Drug Interactions (7.2) and Clinical Pharmacology (12.3) ] . (Riociguat label, Warnings and precautions)

Clinically significant hypotension has been observed with concomitant use of oral RISPERDAL and antihypertensive medication. (Risperidone label, Warnings and precautions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

Calcium antagonists Sevoflurane may lead to marked hypotension in patients treated with calcium antagonists. (Sevoflurane label, Drug interactions)

Sildenafil Monitor for hypotension when sildenafil is co-administered with amlodipine [see Clinical Pharmacology (12.2) ] . (Amlodipine and atorvastatin label, Drug interactions)

However, patients in the Phase 3 clinical studies taking concomitant antihypertensive medications with silodosin capsules did not experience a significant increase in the incidence of syncope, dizziness, or orthostasis. (Silodosin label, Warnings and precautions)

ZOCOR dosage modifications are recommended for patients taking lomitapide, verapamil, diltiazem, dronedarone, amiodarone, amlodipine or ranolazine [see Dosage and Administration (2.5) ] . (Simvastatin label, Warnings and precautions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

However, there was an increase in systemic exposure to weak acids such as furosemide and atorvastatin, and a decrease in systemic exposure to weak bases such as dabigatran when co-administered with LOKELMA, as shown in Figure 2. (Sodium zirconium cyclosilicate label, Drug interactions)

Consider temporary or permanent discontinuation for severe or persistent hypertension despite antihypertensive therapy. (Sorafenib label, Warnings and precautions)

Thiazides may add to or potentiate the action of other antihypertensive drugs. (Spironolactone and hydrochlorothiazide label, Warnings)

Monitor patients to assure diuretic efficacy including antihypertensive effects. (Sumatriptan and naproxen label, Drug interactions)

Initiate and/or adjust antihypertensive therapy as appropriate. (Sunitinib label, Warnings and precautions)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Amlodipine and atorvastatin label, Drug interactions)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine and atorvastatin label, Drug interactions)

Frequent monitoring of trough blood levels of cyclosporine and tacrolimus is recommended and adjust the dose when appropriate [see Clinical Pharmacology (12.3) ] . (Amlodipine and atorvastatin label, Drug interactions)

• Myopathy and Rhabdomyolysis: Risk factors include age 65 years or greater, uncontrolled hypothyroidism, renal impairment, concomitant use with certain other drugs, and higher amlodipine and atorvastatin dosage. (Amlodipine and atorvastatin label, Warnings and precautions)

Monitor patients for signs and symptoms of angioedema when temsirolimus is given concomitantly with angiotensin converting enzyme (ACE) inhibitors (e.g., ramipril) or calcium channel blockers (CCB) (e.g., amlodipine). (Temsirolimus label, Drug interactions)

Risk of Hypotension with Concomitant Use of Other Antihypertensive Agents and Phospodiesterase Type 5 Inhibitors (PDE5-I): Concomitant administration of TEZRULY with antihypertensives or phosphodiesterase-5 (PDE-5) inhibitors can result in additive blood pressure lowering effects and symptomatic hypotension (5.3). (Terazosin label, Warnings and precautions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

In patients with hypertension on antihypertensive therapy, TLANDO increased the mean systolic/diastolic BP by 4.8/1.6 mm Hg from baseline. [see Adverse Reactions ( 6.1 )] . (Testosterone label, Warnings and precautions)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Amlodipine and atorvastatin label, Drug interactions)

Oral or intravenous calcium antagonists may cause atrioventricular conduction disturbances, left ventricular failure, and hypotension. (Timolol label, Drug interactions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

Blood pressure should be closely monitored when amlodipine is co-administered with CYP3A inducers. (Amlodipine and atorvastatin label, Drug interactions)

Concomitant use with an antihypertensive may require a reduction in the dose of the antihypertensive drug. (Trazodone label, Warnings and precautions)

Thiazides may add to or potentiate the action of other antihypertensive drugs. (Triamterene and hydrochlorothiazide label, Drug interactions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Amlodipine and atorvastatin label, Drug interactions)

Vardenafil hydrochloride tablets can potentiate the hypotensive effects of nitrates, alpha- blockers, and antihypertensives. (Vardenafil label, Drug interactions)

Metoprolol: Possibly reduced blood-pressure lowering effect despite increased metoprolol plasma levels. (Venlafaxine label, Drug interactions)

Impact of Other Drugs on Amlodipine CYP3A Inhibitors Co-administration with CYP3A inhibitors (moderate and strong) results in increased systemic exposure to amlodipine and may require dose reduction. (Amlodipine and atorvastatin label, Drug interactions)

Amlodipine and atorvastatin tablets dosage modifications are recommended for patients taking certain anti-viral, azole antifungals, or macrolide antibiotic medications [see Dosage and Administration (2) ] . (Amlodipine and atorvastatin label, Warnings and precautions)

…ticlopidine, verapamil, zileuton montelukast, moricizine, omeprazole, phenobarbital, phenytoin, cigarette smoking CYP3A4 alprazolam, amiodarone, amlodipine, amprenavir, aprepitant, atorvastatin, atazanavir, bicalutamide, cilostazol, cimetidine, ciprofloxacin, clarithromycin, conivaptan, cyclosporine, darunavir/ritonavir, diltiazem, erythromycin, fluconazole, fluoxetine,… (Warfarin label, Drug interactions)

Ziprasidone should be used with particular caution in patients with known cardiovascular disease (history of myocardial infarction or ischemic heart disease, heart failure or conduction abnormalities), cerebrovascular disease, or conditions which would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medications). (Ziprasidone label, Warnings and precautions)

Effects of Adenosine on Other Drugs Adenosine injection has been given with other cardioactive drugs (such as beta adrenergic blocking agents, cardiac glycosides, and calcium channel blockers) without apparent adverse interactions, but its effectiveness with these agents has not been systematically evaluated. (Adenosine label, Drug interactions)

Atorvastatin was used in 48% (73/152) of patients with CTCL. (Bexarotene label, Warnings and precautions)

In such cases, butorphanol should be discontinued and the hypertension treated with antihypertensive drugs. (Butorphanol label, Warnings)

Most epidemiologic studies examining fetal abnormalities after exposure to antihypertensive use in the first trimester have not distinguished drugs affecting the renin-angiotensin system from other antihypertensive agents. (Candesartan and hydrochlorothiazide label, Warnings)

Most epidemiologic studies examining fetal abnormalities after exposure to antihypertensive use in the first trimester have not distinguished drugs affecting the renin-angiotensin system from other antihypertensive agents. (Captopril label, Warnings)

Chlorpromazine may counteract the antihypertensive effect of guanethidine and related compounds. (Chlorpromazine label, Warnings)

…malignant hyperthermia in patients with known or suspected susceptibility based on genetic factors or family history, including those with certain inherited ryanodine receptor (RYR1) or dihydropyridine receptor (CACNA1S) variants. [see Contraindications (4), Clinical Pharmacology (12.5)] Signs consistent with malignant hyperthermia may include hyperthermia, hypoxia,… (Desflurane label, Warnings and precautions)

This drug is capable of blocking the antihypertensive effect of guanethidine and similarly acting compounds. (Desipramine label, Warnings)

Antihypertensives Amphetamines may antagonize the hypotensive effects of antihypertensives. (Dextroamphetamine label, Drug interactions)

Drug Interactions ACE-inhibitors and Angiotensin II Anagonists Reports suggest that NSAIDs may diminish the antihypertensive effect of ACE-inhibitors and angiotensin II antagonists. (Diflunisal label, Drug interactions)

Most epidemiologic studies examining fetal abnormalities after exposure to antihypertensive use in the first trimester have not distinguished drugs affecting the renin-angiotensin system from other antihypertensive agents. (Enalapril and hydrochlorothiazide label, Warnings)

Examples: α-adrenergic antagonists, β-adrenergic receptor antagonists, reserpine, quinidine, mephentermine Other Drug Interactions G u anethidine C linical Impact: Ephedrine may inhibit the neuron blockage produced by guanethidine, resulting in loss of antihypertensive effectiveness. (Ephedrine label, Drug interactions)

Drug Interactions ACE-inhibitors Reports suggest that NSAIDs may diminish the antihypertensive effect of ACE-inhibitors. (Etodolac label, Drug interactions)

…acid, α-blockers, angiotensin-converting enzyme (ACE) inhibitors, analgesics, anti-convulsants, beta-adrenergic blocking agents, diuretics, calcium channel blockers, cardiac nitrates, HMG-CoA reductase inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs), benzodiazepines, H 2 antagonists and quinolone anti-infectives without evidence of clinically significant… (Finasteride label, Drug interactions)

Most epidemiologic studies examining fetal abnormalities after exposure to antihypertensive use in the first trimester have not distinguished drugs affecting the renin-angiotensin system from other antihypertensive agents. (Fosinopril label, Warnings)

Examples: Thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Glyburide and metformin label, Drug interactions)

When other potent parenteral antihypertensive drugs, such as diazoxide, are used in combination with hydralazine, patients should be continuously observed for several hours for any excessive fall in blood pressure. (Hydralazine label, Drug interactions)

ACE Inhibitors FIRAZYR is a bradykinin B2 receptor antagonist and thereby has the potential to have a pharmacodynamic interaction with ACE inhibitors where FIRAZYR may attenuate the antihypertensive effect of ACE inhibitors. (Icatibant label, Drug interactions)

In a study in hypertensive patients, addition of isradipine to existing hydrochlorothiazide therapy did not result in any unexpected adverse effects, and isradipine had an additional antihypertensive effect. (Isradipine label, Drug interactions)

ACE-inhibitors Reports suggest that NSAIDs may diminish the antihypertensive effect of ACE-inhibitors. (Ketoprofen label, Warnings and precautions)

Reports suggest that NSAIDs may diminish the antihypertensive effect of ACE inhibitors and/or angiotensin II receptor antagonists. (Ketorolac label, Drug interactions)

Examples: Thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Metformin label, Drug interactions)

Drug Interactions When methyldopa is used with other antihypertensive drugs, potentiation of antihypertensive effect may occur. (Methyldopa label, Drug interactions)

Because of its relative beta 1 cardio-selectivity, however, Metoprolol Tartrate Tablets may be used in patients with bronchospastic disease who do not respond to, or cannot tolerate, other antihypertensive treatment. (Metoprolol label, Warnings and precautions)

In a large compassionate use program mexiletine has been used concurrently with commonly employed antianginal, antihypertensive, and anticoagulant drugs without observed interactions. (Mexiletine label, Drug interactions)

Most epidemiologic studies examining fetal abnormalities after exposure to antihypertensive use in the first trimester have not distinguished drugs affecting the renin-angiotensin system from other antihypertensive agents. (Moexipril label, Warnings)

Drug Interactions: ACE-inhibitors: Reports suggest that NSAIDs may diminish the antihypertensive effect of ACE-inhibitors. (Nabumetone label, Drug interactions)

Should treatment with any HMG-CoA reductase inhibitor (a lipid lowering agent) be needed to treat lipid elevations, evaluate the potential for a drug-drug interaction before initiating therapy as certain HMG-CoA reductase inhibitors are metabolized by the CYP3A4 pathway [see Drug Interactions ( 7.1 )] . (Nilotinib label, Warnings and precautions)

The blood pressure effect of SULAR tended to be greater in patients on atenolol than in patients on no other antihypertensive therapy. (Nisoldipine label, Drug interactions)

Hypertensive patients, and patients concomitantly receiving other antihypertensive medications, may be more sensitive to the effects of sodium nitroprusside than normal subjects. (Nitroprusside label, Warnings)

The antihypertensive action of guanethidine and similar agents may be blocked. (Nortriptyline label, Warnings)

These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Pioglitazone and metformin label, Drug interactions)

Effient can be administered with aspirin (75 mg to 325 mg per day), heparin, GPIIb/IIIa inhibitors, statins, digoxin, and drugs that elevate gastric pH, including proton pump inhibitors and H 2 blockers [see Clinical Pharmacology (12.3) ] . (Prasugrel label, Drug interactions)

Antihypertensive effects of guanethidine and related compounds may be counteracted when phenothiazines are used concomitantly. (Prochlorperazine label, Precautions)

Protriptyline may block the antihypertensive effect of guanethidine or similarly acting compounds. (Protriptyline label, Warnings)

Most epidemiologic studies examining fetal abnormalities after exposure to antihypertensive use in the first trimester have not distinguished drugs affecting the renin-angiotensin system from other antihypertensive agents. (Quinapril label, Warnings)

Interactions with other dihydropyridine calcium channel blockers have not been reported, but these agents (including felodipine, nicardipine, and nimodipine ) are all dependent upon P450 IIIA4 for metabolism, so similar interactions with quinidine should be anticipated. (Quinidine label, Drug interactions)

Examples: Atypical antipsychotics (e.g., olanzapine and clozapine), calcium channel antagonists, corticosteroids, danazol, diuretics, estrogens, glucagon, isoniazid, niacin, oral contraceptives, phenothiazines, progestogens (e.g., in oral contraceptives), protease inhibitors, somatropin, sympathomimetic agents (e.g., albuterol, epinephrine, terbutaline), and… (Repaglinide label, Drug interactions)

DRUG INTERACTIONS ACE-inhibitors Reports suggest that NSAIDs may diminish the antihypertensive effect of ACE-inhibitors. (Salsalate label, Drug interactions)

Examples: Thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid. (Sitagliptin and metformin label, Drug interactions)

QUELICIN can induce malignant hyperthermia in patients with known or suspected susceptibility based on genetic factors or family history, including those with certain inherited ryanodine receptor (RYR1) or dihydropyridine receptor (CACNA1S) variants. [see Contraindications (4) , Clinical Pharmacology (12.5) ] . (Succinylcholine label, Warnings and precautions)

Drug Interactions ACE-Inhibitors and Angiotensin II Antagonists Reports suggest that NSAIDs may diminish the antihypertensive effect of ACE-inhibitors and angiotensin II antagonists. (Sulindac label, Drug interactions)

There is no information available from adequate drug-drug interaction studies with the following classes of drugs: oral contraceptives, hormone replacement therapies, hypoglycemics, phenytoins, thiazide diuretics, and calcium channel blockers. (Terbinafine label, Drug interactions)

DRUG INTERACTIONS ACE Inhibitors: Reports suggest that NSAIDs may diminish the antihypertensive effect of ACE Inhibitors. (Tolmetin label, Drug interactions)

Most epidemiologic studies examining fetal abnormalities after exposure to antihypertensive use in the first trimester have not distinguished drugs affecting the renin-angiotensin system from other antihypertensive agents. (Trandolapril label, Warnings)

Antihypertensive effects of guanethidine and related compounds may be counteracted when phenothiazines are used concurrently. (Trifluoperazine label, Precautions)

No other formal drug-drug interaction studies between zafirlukast and marketed drugs known to be metabolized by the P450 3A4 (CYP3A4) isoenzyme (e.g., dihydropyridine calcium-channel blockers, cyclosporin, cisapride) have been conducted. (Zafirlukast label, Precautions)

…clinically significant changes in concentration were observed for the following agents when co-administered with doravirine: dolutegravir, lamivudine, TDF, elbasvir and grazoprevir, ledipasvir and sofosbuvir, atorvastatin, an oral contraceptive containing ethinyl estradiol and levonorgestrel, metformin, methadone, and midazolam [see Clinical Pharmacology (12.3) ] . (Doravirine label, Drug interactions)

No clinically significant drug interactions have been observed between RPV and the following medications: acetaminophen, atorvastatin, chlorzoxazone, ethinyl estradiol, ledipasvir/sofosbuvir, norethindrone, sildenafil, simeprevir, sofosbuvir, sofosbuvir/velpatasvir, sofosbuvir/velpatasvir/voxilaprevir, or TDF. (Emtricitabine, rilpivirine, and tenofovir label, Drug interactions)

Calcium channel blocking agents: Coadministration of calcium channel blockers did not have any effect on either the safety or efficacy of ibutilide in the clinical trials. (Ibutilide label, Drug interactions)

Based on these data, ISENTRESS is not expected to affect the pharmacokinetics of drugs that are substrates of these enzymes or P-glycoprotein (e.g., protease inhibitors, NNRTIs, opioid analgesics, statins, azole antifungals, proton pump inhibitors and anti-erectile dysfunction agents). (Raltegravir label, Drug interactions)

…included in Table 6, the interaction between EDURANT and the following drugs was evaluated in clinical studies and no dose adjustment is needed for either drug [see Clinical Pharmacology (12.3) ] : acetaminophen, atorvastatin, chlorzoxazone, cabotegravir, ethinylestradiol, norethindrone, raltegravir, sildenafil, simeprevir and tenofovir disoproxil fumarate. (Rilpivirine label, Drug interactions)