Vibegron interactions

Vibegron (Gemtesa), a beta-adrenergic agonist has 173 documented interactions across the FDA labels and fact sheets we index: 36 major, 111 moderate, 26 minor, and 0 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.

Interactions from the label

Major interactions (36)

  • Albuterolbeta-adrenergic agonistMajor

    Do Not Exceed Recommended Dose Fatalities have been reported in association with excessive use of inhaled sympathomimetic drugs in patients with asthma. (Albuterol label, Warnings and precautions)

  • Arformoterolbeta-adrenergic agonistMajor

    Excessive Use of Arformoterol Tartrate Inhalation Solution and Use with Other Long-Acting Beta2-Agonists Fatalities have been reported in association with excessive use of inhaled sympathomimetic drugs. (Arformoterol label, Warnings and precautions)

  • AtazanavirantiretroviralMajor

    Inhaled beta agonist: salmeterol ↑ salmeterol Coadministration of salmeterol with REYATAZ is not recommended. (Atazanavir label, Drug interactions)

  • BenzphetamineCNS stimulantMajor

    CONTRAINDICATIONS Benzphetamine Hydrochloride Tablets are contraindicated in patients with advanced arteriosclerosis, symptomatic cardiovascular disease, moderate to severe hypertension, hyperthyroidism, known hypersensitivity or idiosyncrasy to sympathomimetic amines, and glaucoma. (Benzphetamine label, Contraindications)

  • Budesonide and formoterolcorticosteroidMajor

    Use with additional long-acting beta 2 -agonist: Do not use in combination because of risk of overdose. (Budesonide and formoterol label, Warnings and precautions)

  • Chloroprocainelocal anestheticMajor

    Vasopressors should not be used in the presence of ergot-type oxytocic drugs, since a severe persistent hypertension may occur. (Chloroprocaine label, Warnings)

  • Cocainelocal anestheticMajor

    Known Hypersensitivity or Idiosyncrasy to the Sympathomimetic Amines NUMBRINO is contraindicated in patients with a known history of hypersensitivity to cocaine or to the components of the nasal solution. (Cocaine label, Warnings and precautions)

  • DarunavirantiretroviralMajor

    Inhaled beta agonist : salmeterol ↑ salmeterol Co-administration of salmeterol and PREZISTA/ritonavir is not recommended. (Darunavir label, Drug interactions)

  • Darunavir and cobicistatantiretroviralMajor

    Inhaled beta agonist: salmeterol ↑ salmeterol Co-administration with salmeterol is not recommended and may result in increased risk of cardiovascular adverse events associated with salmeterol, including QT prolongation, palpitations, and sinus tachycardia. (Darunavir and cobicistat label, Drug interactions)

  • DextroamphetamineCNS stimulantMajor

    CONTRAINDICATIONS Advanced arteriosclerosis, symptomatic cardiovascular disease, moderate to severe hypertension, hyperthyroidism, known hypersensitivity or idiosyncrasy to the sympathomimetic amines, glaucoma. (Dextroamphetamine label, Contraindications)

  • DiethylpropionCNS stimulantMajor

    CONTRAINDICATIONS Pulmonary hypertension, advanced arteriosclerosis, hyperthyroidism, known hypersensitivity or idiosyncrasy to the sympathomimetic amines, glaucoma, severe hypertension (See PRECAUTIONS ). (Diethylpropion label, Contraindications)

  • DronabinolcannabinoidMajor

    Avoid concomitant use of other drugs that are also associated with similar cardiac effects (e.g., amphetamines, other sympathomimetic agents, atropine, amoxapine, scopolamine, antihistamines, other anticholinergic agents, amitriptyline, desipramine, other tricyclic antidepressants). (Dronabinol label, Warnings and precautions)

  • Inhaled Beta Agonist: salmeterol ↑ salmeterol Coadministration of salmeterol and GENVOYA is not recommended. (Elvitegravir, cobicistat, emtricitabine, and tenofovir label, Drug interactions)

  • Fluticasone and salmeterolcorticosteroidMajor

    When LABA are used in fixed-dose combination with ICS, data from large clinical trials do not show a significant increase in the risk of serious asthma-related events (hospitalizations, intubations, death) compared with ICS alone [see Serious Asthma-Related Events with Inhaled Corticosteroid/Long-acting Beta 2 -adrenergic Agonists] . (Fluticasone and salmeterol label, Warnings and precautions)

  • Formoterolbeta-adrenergic agonistMajor

    The increased risk of asthma-related death is considered a class effect of the long-acting beta 2 -adrenergic agonists, including formoterol fumarate inhalation solution. (Formoterol label, Warnings and precautions)

  • FosamprenavirantiretroviralMajor

    Inhaled beta-agonist: Salmeterol ↑ Salmeterol Concurrent administration of salmeterol with fosamprenavir calcium is not recommended. (Fosamprenavir label, Drug interactions)

  • Imipraminetricyclic antidepressantMajor

    Avoid the use of preparations, such as decongestants and local anesthetics, that contain any sympathomimetic amine (e.g., epinephrine, norepinephrine), since it has been reported that tricyclic antidepressants can potentiate the effects of catecholamines. (Imipramine label, Drug interactions)

  • Ipratropium and albuterolanticholinergicMajor

    DO NOT EXCEED RECOMMENDED DOSE Fatalities have been reported in association with excessive use of inhaled products containing sympathomimetic amines and with the home use of nebulizers. (Ipratropium and albuterol label, Warnings)

  • Levalbuterolbeta-adrenergic agonistMajor

    Do Not Exceed Recommended Dose Fatalities have been reported in association with excessive use of inhaled sympathomimetic drugs in patients with asthma. (Levalbuterol label, Warnings and precautions)

  • Levothyroxine and liothyroninethyroid hormoneMajor

    Larger doses may produce serious or even life-threatening manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects. (Levothyroxine and liothyronine label, Boxed warning)

  • Liothyroninethyroid hormoneMajor

    • Larger doses may produce serious or even life-threatening manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects [see Adverse Reactions (6) , Drug Interactions (7.7) , and Overdosage (10) ] . (Liothyronine label, Boxed warning)

  • Mepivacainelocal anestheticMajor

    Mepivacaine with epinephrine or other vasopressors should not be used concomitantly with ergot-type oxytocic drugs, because a severe persistent hypertension may occur. (Mepivacaine label, Warnings)

  • PhendimetrazineCNS stimulantMajor

    …hypertension) • During or within 14 days following the administration of monoamine oxidase inhibitors • Hyperthyroidism • Glaucoma • Agitated states • History of drug abuse • Pregnancy (see PRECAUTIONS, Pregnancy ) • Nursing • Use in combination with other anorectic agents or CNS stimulants • Known hypersensitivity or idiosyncratic reactions to sympathomimetics (Phendimetrazine label, Contraindications)

  • PhenelzineMAO inhibitorMajor

    The potentiation of sympathomimetic substances and related compounds by MAO inhibitors may result in hypertensive crises (see WARNINGS ). (Phenelzine label, Contraindications)

  • PhentermineCNS stimulantMajor

    …states • History of drug abuse • Pregnancy [ see Use in Specific Populations () ] • Nursing [ see Use in Specific Populations ( 8.3 ) ] • Known hypersensitivity, or idiosyncrasy to the sympathomimetic amines • History of cardiovascular disease (e.g., coronary artery disease, stroke, arrhythmias, congestive heart failure, uncontrolled hypertension) () • During or within… (Phentermine label, Contraindications)

  • Phentermine and topiramateCNS stimulantMajor

    …(8.1) ] With glaucoma [see Warnings and Precautions (5.3) ] With hyperthyroidism Taking or within 14 days of stopping a monoamine oxidase inhibitors [see Drug Interactions (7) ] With known hypersensitivity to phentermine, topiramate or any of the excipients in phentermine and topiramate extended-release capsules, or idiosyncrasy to the sympathomimetic amines. (Phentermine and topiramate label, Contraindications)

  • PromethazineantihistamineMajor

    Epinephrine Because of the potential for Promethazine to reverse epinephrine's vasopressor effect, epinephrine should NOT be used to treat hypotension associated with Promethazine Syrup overdose. (Promethazine label, Drug interactions)

  • Epinephrine – Because of the potential for promethazine to reverse epinephrine’s vasopressor effect, epinephrine should NOT be used to treat hypotension associated with Promethazine Hydrochloride and Dextromethorphan Hydrobromide Oral Solution overdose. (Promethazine and dextromethorphan label, Drug interactions)

  • Vasopressors and resuscitation equipment should be immediately available in case of a severe reaction to protamine. (Protamine label, Boxed warning)

  • RibavirinantiviralMajor

    IF INITIATION OF AEROSOLIZED RIBAVIRIN FOR INHALATION SOLUTION, USP TREATMENT APPEARS TO PRODUCE SUDDEN DETERIORATION OF RESPIRATORY FUNCTION, TREATMENT SHOULD BE STOPPED AND REINSTITUTED ONLY WITH EXTREME CAUTION, CONTINUOUS MONITORING AND CONSIDERATION OF CONCOMITANT ADMINISTRATION OF BRONCHODILATORS (SEE WARNINGS ). (Ribavirin label, Boxed warning)

  • RoflumilastPDE4 inhibitorMajor

    Treatment of Acute Bronchospasm DALIRESP is not a bronchodilator and should not be used for the relief of acute bronchospasm. (Roflumilast label, Warnings and precautions)

  • Salmeterolbeta-adrenergic agonistMajor

    WARNING: ASTHMA-RELATED DEATH Long-acting beta 2 -adrenergic agonists (LABA), such as salmeterol, the active ingredient in SEREVENT DISKUS, as monotherapy (without inhaled corticosteroids [ICS]) increase the risk of asthma-related death. (Salmeterol label, Boxed warning)

  • Terbutalinebeta-adrenergic agonistMajor

    Hypersensitivity Terbutaline sulfate is contraindicated in patients known to be hypersensitive to sympathomimetic amines or any component of this drug product. (Terbutaline label, Contraindications)

  • Tizanidinemuscle relaxantMajor

    Hypotension: monitor for signs and symptoms of hypotension, in particular in patients receiving concurrent antihypertensives; Zanaflex should not be used with other α 2 -adrenergic agonists ( 5.1 , 7.7 ) (Tizanidine label, Warnings and precautions)

  • TranylcypromineMAO inhibitorMajor

    …(SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) tricyclic antidepressants other antidepressants, such as amoxapine, bupropion, maprotiline, nefazodone, trazodone, vilazodone, vortioxetine amphetamines and methylphenidates medicines that can raise blood pressure (sympathomimetic medicine), such as pseudoephedrine, phenylephrine and ephedrine. (Tranylcypromine label, Boxed warning)

  • Umeclidinium and vilanterolanticholinergicMajor

    • use of a long-acting beta 2 -adrenergic agonist (LABA), including vilanterol, one of the active ingredients in Umeclidinium and Vilanterol ELLIPTA, without an inhaled corticosteroid (ICS), in patients with asthma [see Warnings and Precautions ( 5.1 )] . (Umeclidinium and vilanterol label, Contraindications)

Moderate interactions (111)

  • AclidiniumanticholinergicModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • Alogliptin and metforminDPP-4 inhibitorModerate

    Examples: Thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blocking drugs and isoniazid Alogliptin Cytochrome (CYP) P450, CYP-Substrates or Inhibitors Clinical Impact: Insulin Secretagogues and Insulin Insulin and insulin secretagogues… (Alogliptin and metformin label, Drug interactions)

  • AmantadineanticholinergicModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • AmiodaroneantiarrhythmicModerate

    • Hypotension: Slow the infusion; as needed, add vasopressor drugs, positive inotropic agents, and volume expansion. (Amiodarone label, Warnings and precautions)

  • Amitriptylinetricyclic antidepressantModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • Amoxapinetricyclic antidepressantModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • AmphetamineCNS stimulantModerate

    Tricyclic Antidepressants Clinical Impact May enhance the activity of tricyclic or sympathomimetic agents causing striking and sustained increases in the concentration of d- amphetamine in the brain; cardiovascular effects can be potentiated. (Amphetamine label, Drug interactions)

  • Tricyclic Antidepressants Clinical Impact May enhance the activity of tricyclic or sympathomimetic agents causing striking and sustained increases in the concentration of d-amphetamine in the brain; cardiovascular effects can be potentiated. (Amphetamine and dextroamphetamine label, Drug interactions)

  • Atenololbeta blockerModerate

    Since beta 1 selectivity is not absolute, the lowest possible dose of TENORMIN should be used with therapy initiated at 50 mg and a beta 2 -stimulating agent (bronchodilator) should be made available. (Atenolol label, Warnings)

  • Atenolol and chlorthalidonebeta blockerModerate

    Since beta 1 -selectivity is not absolute, the lowest possible dose of atenolol and chlorthalidone should be used and a beta 2 -stimulating agent (bronchodilator) should be made available. (Atenolol and chlorthalidone label, Warnings)

  • Atomoxetinenorepinephrine reuptake inhibitorModerate

    Albuterol (or other beta 2 agonists): Increase the frequency of monitoring blood pressure and heart rate. (Atomoxetine label, Drug interactions)

  • AtropineanticholinergicModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • Atropine and pralidoximeanticholinergicModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • AztreonamantibioticModerate

    Reduction of 15% or more in forced expiratory volume in 1 second (FEV 1 ) immediately following administration of study medication after pretreatment with a bronchodilator was observed in 3% of patients treated with CAYSTON. (Aztreonam label, Warnings and precautions)

  • Belladonna and opiumopioidModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • BenztropineanticholinergicModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • Betaxololbeta blockerModerate

    Since β 1 -selectivity is not absolute and is inversely related to dose, the lowest possible dose of betaxolol should be used (5 to 10 mg once daily) and a bronchodilator should be made available. (Betaxolol label, Warnings)

  • BortezomibModerate

    Management of orthostatic/postural hypotension may include adjustment of antihypertensive medications, hydration, and administration of mineralocorticoids and/or sympathomimetics. (Bortezomib label, Warnings and precautions)

  • Brimonidine and timololalpha-adrenergic agonistModerate

    If necessary during surgery, the effects of beta-adrenergic blocking agents may be reversed by sufficient doses of adrenergic agonists. (Brimonidine and timolol label, Warnings and precautions)

  • Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • BudesonidecorticosteroidModerate

    Patients should be instructed to contact their physician immediately if episodes of asthma not responsive to their usual doses of bronchodilators occur during the course of treatment with PULMICORT FLEXHALER. (Budesonide label, Warnings and precautions)

  • Candesartanangiotensin II receptor blocker (ARB)Moderate

    Very rarely, hypotension may be severe such that it may warrant the use of intravenous fluids and/or vasopressors. (Candesartan label, Warnings and precautions)

  • CarbinoxamineantihistamineModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • Chlordiazepoxide and clidiniumbenzodiazepineModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • ChlorpheniramineantihistamineModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • ChlorpromazineantipsychoticModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • CiclesonidecorticosteroidModerate

    Patients should be instructed to contact their physician immediately if episodes of asthma not responsive to their usual doses of bronchodilators occur during the course of treatment with ALVESCO. (Ciclesonide label, Warnings and precautions)

  • ClemastineantihistamineModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • Clomipraminetricyclic antidepressantModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • ClozapineantipsychoticModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • Cyclobenzaprinemuscle relaxantModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • CyclopentolateanticholinergicModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • CyproheptadineantihistamineModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • DarifenacinanticholinergicModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • Desipraminetricyclic antidepressantModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • DexchlorpheniramineantihistamineModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • DicyclomineanticholinergicModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • Digoxindigitalis glycosideModerate

    Concomitant use of GEMTESA increases digoxin maximal concentrations (C max ) and systemic exposure as assessed by area under the concentration-time curve (AUC) [see Clinical Pharmacology ( 12.3 )] . (Vibegron label, Drug interactions)

  • DimenhydrinateantihistamineModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • DiphenhydramineantihistamineModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • DisopyramideantiarrhythmicModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • Dorzolamide and timololcarbonic anhydrase inhibitorModerate

    If necessary during surgery, the effects of beta-adrenergic blocking agents may be reversed by sufficient doses of adrenergic agonists. (Dorzolamide and timolol label, Warnings and precautions)

  • DoxapramModerate

    Drug Interactions Administration of doxapram to patients who are receiving sympathomimetic or monoamine oxidase inhibiting drugs may result in an additive pressor effect (see PRECAUTIONS, General ). (Doxapram label, Drug interactions)

  • Doxepintricyclic antidepressantModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • DoxylamineantihistamineModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • Doxylamine and pyridoxineantihistamineModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • EphedrinesympathomimeticModerate

    • Pr e ssor Effect with Concomitant Oxytocic Drugs : Pressor effect of sympathomimetic pressor amines is potentiated (5.1) (Ephedrine label, Warnings and precautions)

  • Esmololbeta blockerModerate

    Sympathomimetic drugs: Dose adjustment needed (7) (Esmolol label, Drug interactions)

  • FesoterodineanticholinergicModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • FlavoxateanticholinergicModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • FluticasonecorticosteroidModerate

    Lung function (mean forced expiratory volume in 1 second [FEV 1 ] or morning peak expiratory flow [AM PEF]), beta-agonist use, and asthma symptoms should be carefully monitored during withdrawal of oral corticosteroids. (Fluticasone label, Warnings and precautions)

  • GlimepiridesulfonylureaModerate

    …somatropin, protease inhibitors, atypical antipsychotic medications (e.g., olanzapine and clozapine), barbiturates, diazoxide, laxatives, rifampin, thiazides and other diuretics, corticosteroids, phenothiazines, thyroid hormones, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics (e.g., epinephrine, albuterol, terbutaline), and isoniazid. (Glimepiride label, Drug interactions)

  • GlipizidesulfonylureaModerate

    …olanzapine and clozapine), 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), thyroid hormones, phenytoin, nicotinic acid, and calcium channel blocking drugs. (Glipizide label, Drug interactions)

  • GlycopyrrolateanticholinergicModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • HydroxyzineantihistamineModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • HyoscyamineanticholinergicModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • Insulin aspartinsulinModerate

    …Insulin Aspart Drugs: Atypical antipsychotics (e.g., olanzapine and clozapine), 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 thyroid hormones. (Insulin aspart label, Drug interactions)

  • Insulin degludecinsulinModerate

    …Insulin Degludec Drugs: Atypical antipsychotics (e.g., olanzapine and clozapine), 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 thyroid hormones. (Insulin degludec label, Drug interactions)

  • Insulin detemirinsulinModerate

    …Effect of LEVEMIR Drugs: Atypical antipsychotics (e.g., olanzapine and clozapine), 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 thyroid hormones. (Insulin detemir label, Drug interactions)

  • Insulin glargineinsulinModerate

    …Glargine-yfgn Drugs: Atypical antipsychotics (e.g., olanzapine and clozapine), 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 thyroid hormones. (Insulin glargine label, Drug interactions)

  • Insulin lisproinsulinModerate

    …Effect of LYUMJEV Drugs: Atypical antipsychotics (e.g., olanzapine and clozapine), 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 thyroid hormones. (Insulin lispro label, Drug interactions)

  • IpratropiumanticholinergicModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • KetamineCNS depressantModerate

    Sympathomimetics and Vasopressin : Sympathomimetics and vasopressin may enhance the sympathomimetic effects of ketamine [see Drug Interactions ( 7.2 )] . (Ketamine label, Warnings and precautions)

  • Levothyroxinethyroid hormoneModerate

    Sympathomimetics Concurrent use may of sympathomimetics and levothyroxine may increase the effects of sympathomimetics or thyroid hormone. (Levothyroxine label, Drug interactions)

  • Lidocainelocal anestheticModerate

    Concurrent administration of vasopressor drugs (for the treatment of hypotension related to obstetric blocks) and ergot-type oxytocic drugs may cause severe, persistent hypertension or cerebrovascular accidents. (Lidocaine label, Drug interactions)

  • LinezolidantibioticModerate

    …administered to patients with uncontrolled hypertension, pheochromocytoma, thyrotoxicosis and/or patients taking any of the following types of medications: directly and indirectly acting sympathomimetic agents (e.g., pseudoephedrine), vasopressive agents (e.g., epinephrine, norepinephrine), dopaminergic agents (e.g., dopamine, dobutamine) [ see Drug Interactions (7)… (Linezolid label, Warnings and precautions)

  • LisdexamfetamineCNS stimulantModerate

    Tricyclic Antidepressants Clinical Impact May enhance the activity of tricyclic or sympathomimetic agents causing striking and sustained increases in the concentration of d-amphetamine in the brain; cardiovascular effects can be potentiated. (Lisdexamfetamine label, Drug interactions)

  • MargetuximabModerate

    Interrupt MARGENZA infusion in patients experiencing dyspnea or clinically significant hypotension and intervene with medical therapy which may include epinephrine, corticosteroids, diphenhydramine, bronchodilators and oxygen. (Margetuximab label, Warnings and precautions)

  • MeclizineantihistamineModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • MethamphetamineCNS stimulantModerate

    Tricyclic Antidepressants Clinical Impact: May enhance the activity of tricyclic or sympathomimetic agents causing sustained increases in the concentration of d-amphetamine in the brain; cardiovascular effects can be potentiated. (Methamphetamine label, Drug interactions)

  • MethscopolamineanticholinergicModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • MethyldopaantihypertensiveModerate

    If hypotension does occur during anesthesia, it usually can be controlled by vasopressors. (Methyldopa label, Drug interactions)

  • Metolazonethiazide diureticModerate

    Sympathomimetics Metolazone may decrease arterial responsiveness to norepinephrine, but this diminution is not sufficient to preclude effectiveness of the pressor agent for therapeutic use. (Metolazone label, Drug interactions)

  • Metoprololbeta blockerModerate

    Bronchodilators, including beta 2 -agonists, should be readily available or administered concomitantly [see Dosage and Administration (2) ]. (Metoprolol label, Warnings and precautions)

  • Because beta1-selectivity is not absolute, use the lowest possible dose of metoprolol tartrate and have bronchodilators (e.g., beta 2 -agonists) readily available or administered concomitantly . (Metoprolol and hydrochlorothiazide label, Warnings and precautions)

  • MometasonecorticosteroidModerate

    Lung function (FEV 1 or PEF), beta-agonist use, and asthma symptoms should be carefully monitored during withdrawal of oral or other systemic corticosteroids. (Mometasone label, Warnings and precautions)

  • NateglinidemeglitinideModerate

    Drugs and Herbals That May Reduce the Blood-Glucose-Lowering Effect of Nateglinide and Increase Susceptibility to Hyperglycemia Drugs: Thiazides, corticosteroids, thyroid products, sympathomimetics, somatropin, somatostatin analogues (e.g., lanreotide, octreotide), and CYP inducers (e.g., rifampin, phenytoin and St John's Wort). (Nateglinide label, Drug interactions)

  • Nortriptylinetricyclic antidepressantModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • OlanzapineantipsychoticModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • Olanzapine and fluoxetineantipsychoticModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • Orphenadrinemuscle relaxantModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • OxybutyninanticholinergicModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • ParoxetineSSRIModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • PhenylephrinedecongestantModerate

    Pressor Effect with Concomitant Oxytocic Drugs Oxytocic drugs potentiate the increasing blood pressure effect of sympathomimetic pressor amines including BIORPHEN [see Drug Interactions (7.1) ] , with the potential for hemorrhagic stroke. (Phenylephrine label, Warnings and precautions)

  • Pioglitazone and glimepiridethiazolidinedioneModerate

    …somatropin, protease inhibitors, atypical antipsychotic medications (e.g., olanzapine and clozapine), barbiturates, diazoxide, laxatives, rifampin, thiazides and other diuretics, corticosteroids, phenothiazines, thyroid hormones, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics (e.g., epinephrine, albuterol, terbutaline), and isoniazid. (Pioglitazone and glimepiride label, Drug interactions)

  • ProchlorperazineantipsychoticModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • Propranololbeta blockerModerate

    Pharmacodynamic Drug-Drug Interactions Adrenergic Agonists: Beta-blockers may antagonize the antihypertensive effects of clonidine, and rebound hypertension may result if clonidine is withdrawn abruptly. (Propranolol label, Drug interactions)

  • Protriptylinetricyclic antidepressantModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • RasagilineMAO inhibitorModerate

    Hypertensive crisis has been reported in patients taking the recommended dose of rasagiline and sympathomimetic medications. (Rasagiline label, Drug interactions)

  • RitonavirantiretroviralModerate

    Bronchodilator: theophylline ↓ theophylline Increased dosage of theophylline may be required; therapeutic monitoring should be considered. (Ritonavir label, Drug interactions)

  • ScopolamineanticholinergicModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • SelegilineMAO inhibitorModerate

    Uncontrolled hypertension has been reported when taking the recommended dose of swallowed selegiline and a sympathomimetic medication (ephedrine). (Selegiline label, Warnings and precautions)

  • SolifenacinanticholinergicModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • Sotalolbeta blockerModerate

    Beta-2-Receptor Stimulants Beta-agonists such as albuterol, terbutaline and isoproterenol may have to be administered in increased dosages when used concomitantly with sotalol. (Sotalol label, Drug interactions)

  • SugammadexModerate

    The most commonly described clinical features in reports of anaphylaxis were dermatologic symptoms (including urticaria, rash, erythema, flushing and skin eruption); and clinically important hypotension often requiring the use of vasopressors for circulatory support. (Sugammadex label, Warnings and precautions)

  • Circulatory Shock Circulatory shock with fever, severe hypotension, and confusion requiring intravenous fluid resuscitation and vasopressors has occurred within minutes to hours of re-challenge with trimethoprim-sulfamethoxazole products in patients with history of recent (days to weeks) exposure to sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Warnings)

  • ThioridazineantipsychoticModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • Timololbeta blockerModerate

    If necessary during surgery, the effects of beta-adrenergic blocking agents may be reversed by sufficient doses of adrenergic agonists. (Timolol label, Warnings and precautions)

  • TiotropiumanticholinergicModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • TolcaponeModerate

    Drugs That Increase Catecholamines: Tolcapone did not influence the effect of ephedrine, an indirect sympathomimetic, on hemodynamic parameters or plasma catecholamine levels, either at rest or during exercise. (Tolcapone label, Drug interactions)

  • TolterodineanticholinergicModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • TrastuzumabModerate

    Interrupt TRAZIMERA infusion in all patients experiencing dyspnea, clinically significant hypotension, and intervention of medical therapy administered (which may include epinephrine, corticosteroids, diphenhydramine, bronchodilators, and oxygen). (Trastuzumab label, Warnings and precautions)

  • TrihexyphenidylanticholinergicModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • Trimipraminetricyclic antidepressantModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • TrospiumanticholinergicModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • UmeclidiniumanticholinergicModerate

    Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)

  • ZanamivirantiviralModerate

    If a decision is made to prescribe RELENZA for such a patient, this should be done only under conditions of careful monitoring of respiratory function, close observation, and appropriate supportive care, including availability of fast‑acting bronchodilators. (Zanamivir label, Warnings and precautions)

Minor mentions (26)

  • AcarboseantidiabeticMinor

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

  • Acebutololbeta blockerMinor

    A bronchodilator, such as theophylline or a β2-stimulant, should be made available in advance with instructions concerning its use. (Acebutolol label, Warnings)

  • BeclomethasonecorticosteroidMinor

    Treat bronchospasm immediately with inhaled, short-acting bronchodilator and discontinue QVAR REDIHALER. (Beclomethasone label, Warnings and precautions)

  • Severe reactions have required intervention with vasopressor agents and supportive measures. (Benzonatate label, Warnings)

  • Discontinue in patients who develop a severe infusion-related reaction and administer appropriate medical therapy (e.g., epinephrine, corticosteroids, intravenous antihistamines, bronchodilators and/or oxygen). (Bevacizumab label, Warnings and precautions)

  • Bisoprololbeta blockerMinor

    A beta 2 agonist (bronchodilator) should be made available. (Bisoprolol label, Warnings)

  • A beta 2 agonist (bronchodilator) should be made available. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Bromocriptinedopamine agonistMinor

    There are postmarketing reports of hypertension and tachycardia when bromocriptine was co-administered with sympathomimetic drugs (e.g., phenylpropanolamine and isometheptene) in postpartum women. (Bromocriptine label, Drug interactions)

  • Dapagliflozin and metforminSGLT2 inhibitorMinor

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

  • Empagliflozin and metforminSGLT2 inhibitorMinor

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

  • Ergotamine and caffeineergot alkaloidMinor

    Use with sympathomimetics (pressor agents) may cause extreme elevation of blood pressure. (Ergotamine and caffeine label, Drug interactions)

  • Glipizide and metforminsulfonylureaMinor

    These drugs include thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blocking drugs, and isoniazid. (Glipizide and metformin label, Precautions)

  • GlyburidesulfonylureaMinor

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

  • Glyburide and metforminsulfonylureaMinor

    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)

  • In a study of patients with asthma whose bronchodilators were temporarily withheld for assessment, bronchoconstriction and wheezing following AFREZZA dosing was reported in 29% (5/17) and 0% (0/13) of patients with and without a diagnosis of asthma, respectively. (Insulin regular (human) label, Warnings and precautions)

  • Labetalolbeta blockerMinor

    Beta blockers antagonize the bronchodilator effect of beta-receptor agonists. (Labetalol label, Drug interactions)

  • Linagliptin and metforminDPP-4 inhibitorMinor

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

  • MetforminbiguanideMinor

    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)

  • PerphenazineantipsychoticMinor

    If a vasopressor is needed, norepinephrine may be used. (Perphenazine label, Warnings)

  • Pioglitazone and metforminthiazolidinedioneMinor

    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)

  • PropofolCNS depressantMinor

    These effects are responsive to discontinuation of DIPRIVAN, intravenous fluid administration, and/or vasopressor therapy. (Propofol label, Warnings and precautions)

  • RepaglinidemeglitinideMinor

    …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 thyroid hormones. (Repaglinide label, Drug interactions)

  • RituximabimmunosuppressantMinor

    Institute medical management (e.g., glucocorticoids, epinephrine, bronchodilators, or oxygen) for infusion-related reactions as needed. (Rituximab label, Warnings and precautions)

  • Saxagliptin and metforminDPP-4 inhibitorMinor

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

  • Sitagliptin and metforminDPP-4 inhibitorMinor

    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)

  • TobramycinaminoglycosideMinor

    In clinical studies, patients receiving TOBI Podhaler continued to take dornase alfa, bronchodilators, inhaled corticosteroids, and macrolides. (Tobramycin label, Drug interactions)

Check Vibegron against everything you take. Add your full list; every pair is checked at once.

Open in the checker

Not medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.