Alprostadil : interactions médicamenteuses

• Benzyl alcohol: Serious and fatal adverse reactions can occur in neonates and low birth weight infants treated with benzyl alcohol-preserved formulations in infusion solutions, including CAVERJECT. (notice Alprostadil, Mises en garde et précautions)

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

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

The combined use of two or more prostaglandins, or prostaglandin analogs including XELPROS is not recommended. (notice Latanoprost, Interactions médicamenteuses)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (notice Acide méfénamique, Mises en garde et précautions)

Hypotension Adenosine injection is a potent peripheral vasodilator and can induce significant hypotension. (notice Adénosine, Mises en garde et précautions)

Nonetheless, caution, as with any other peripheral vasodilator, should be exercised when administering amlodipine, particularly in patients with severe aortic stenosis. (notice Amlodipine et valsartan, Mises en garde et précautions)

• Injection site bleeding may occur in patients taking anticoagulants, such as warfarin or heparin. (notice Alprostadil, Mises en garde et précautions)

• Injection site bleeding may occur in patients taking anticoagulants, such as warfarin or heparin. (notice Alprostadil, Mises en garde et précautions)

Concomitant use of prostaglandin synthase inhibiting drugs, e.g., indomethacin, may decrease the hypotensive effects of beta-blockers. (notice Aténolol, Interactions médicamenteuses)

Concomitant use of prostaglandin synthase inhibiting drugs, e.g., indomethacin, may decrease the hypotensive effects of beta-blockers. (notice Aténolol et chlortalidone, Interactions médicamenteuses)

When vasodilators are used in combination, an additive effect on blood pressure may be anticipated. (notice Avanafil, Mises en garde et précautions)

• Injection site bleeding may occur in patients taking anticoagulants, such as warfarin or heparin. (notice Alprostadil, Mises en garde et précautions)

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

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (notice Célécoxib, Mises en garde et précautions)

• Injection site bleeding may occur in patients taking anticoagulants, such as warfarin or heparin. (notice Alprostadil, Mises en garde et précautions)

• Co-administration with Other Vasodilators or Negative Chronotropic Agents : Use with caution due to additive pharmacodynamic effects. (notice Dexmédétomidine, Mises en garde et précautions)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (notice Diclofénac, Mises en garde et précautions)

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

Drug Interactions The vasodilating effects of isosorbide dinitrate may be additive with those of other vasodilators. (notice Dinitrate d'isosorbide, Interactions médicamenteuses)

• Injection site bleeding may occur in patients taking anticoagulants, such as warfarin or heparin. (notice Alprostadil, Mises en garde et précautions)

• Injection site bleeding may occur in patients taking anticoagulants, such as warfarin or heparin. (notice Alprostadil, Mises en garde et précautions)

Additional reductions in blood pressure may occur when VELETRI is administered with diuretics, antihypertensive agents, or other vasodilators. (notice Époprosténol, Interactions médicamenteuses)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (notice Étodolac, Mises en garde)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (notice Fénoprofène, Mises en garde et précautions)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (notice Flurbiprofène, Mises en garde et précautions)

• Injection site bleeding may occur in patients taking anticoagulants, such as warfarin or heparin. (notice Alprostadil, Mises en garde et précautions)

Indomethacin Coadministration of indomethacin may reduce the natriuretic and antihypertensive effects of furosemide in some patients by inhibiting prostaglandin synthesis. (notice Furosémide, Interactions médicamenteuses)

• Injection site bleeding may occur in patients taking anticoagulants, such as warfarin or heparin. (notice Alprostadil, Mises en garde et précautions)

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

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (notice Ibuprofène, Mises en garde et précautions)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (notice Ibuprofène et famotidine, Mises en garde et précautions)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (notice Indométacine, Mises en garde et précautions)

A second form of renal toxicity has been seen in patients with conditions leading to a reduction in renal blood flow or blood volume, where renal prostaglandins have a supportive role in the maintenance of renal blood flow. (notice Kétoprofène, Mises en garde et précautions)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (notice Méloxicam, Mises en garde et précautions)

Caution should be exercised when methylergonovine maleate is used concurrently with other vasoconstrictors, ergot alkaloids, or prostaglandins. (notice Méthylergométrine, Interactions médicamenteuses)

The vasodilating effects of isosorbide mononitrate may be additive with those of other vasodilators. (notice Mononitrate d'isosorbide, Interactions médicamenteuses)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (notice Nabumétone, Mises en garde)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (notice Naproxène, Mises en garde et précautions)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (notice Naproxène et ésoméprazole, Mises en garde et précautions)

Nifedipine is a vasodilator, and co-administration of other drugs affecting blood pressure may result in pharmacodynamic interactions. (notice Nifédipine, Interactions médicamenteuses)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (notice Oxaprozine, Mises en garde et précautions)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (notice Paracétamol et ibuprofène, Mises en garde et précautions)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (notice Piroxicam, Mises en garde et précautions)

• Injection site bleeding may occur in patients taking anticoagulants, such as warfarin or heparin. (notice Alprostadil, Mises en garde et précautions)

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

Blood Pressure Decreases Patients with left ventricular outflow obstruction (e.g., aortic stenosis, idiopathic hypertrophic subaortic stenosis) and those with severely impaired autonomic control of blood pressure can be sensitive to the actions of vasodilators, including SILDENAFIL ORAL FILM. (notice Sildénafil, Mises en garde et précautions)

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

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (notice Sumatriptan et naproxène, Mises en garde et précautions)

When vasodilators are used in combination, an additive effect on blood pressure may be anticipated. (notice Tadalafil, Mises en garde et précautions)

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. (notice Tolmétine, Mises en garde)

When vasodilators are used in combination, an additive effect on blood pressure may be anticipated. (notice Vardénafil, Mises en garde et précautions)

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

• Injection site bleeding may occur in patients taking anticoagulants, such as warfarin or heparin. (notice Alprostadil, Mises en garde et précautions)

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

Phosphodiesterase-5 (PDE5) Inhibitors: PDE5-inhibitors are also vasodilators. (notice Alfuzosine, Mises en garde et précautions)

Evidence from animal studies has suggested that certain other prostaglandins have some teratogenic potential. (notice Carboprost, Mises en garde)

Nonsteroidal Anti-inflammatory Drugs (NSAIDs) NSAIDs may produce potassium retention by reducing renal synthesis of prostaglandin E and impairing the renin-angiotensin system. (notice Chlorure de potassium, Interactions médicamenteuses)

Alpha-adrenergic antagonists and PDE-5 inhibitors are both vasodilators that can lower blood pressure. (notice Dutastéride et tamsulosine, Mises en garde et précautions)

Post injury arterial injection of vasodilators and/or arterial infusion of parenteral fluids are generally regarded to be of no value in altering outcome. (notice Méthohexital, Mises en garde)

Alpha-adrenergic blockers and PDE5 inhibitors are both vasodilators that can lower blood pressure. (notice Silodosine, Mises en garde et précautions)

Alpha-adrenergic blockers and PDE5 inhibitors are both vasodilators that can lower blood pressure. (notice Tamsulosine, Mises en garde et précautions)

Bronchospasm Like other inhaled prostaglandins, Tyvaso may cause acute bronchospasm. (notice Tréprostinil, Mises en garde et précautions)