Dextrométhorphane et quinidine : interactions médicamenteuses

…such as propranolol Cyclopropane or halogenated hydrocarbon anesthetics, such as halothane Antihistamines Thyroid hormones Diuretics Cardiac glycosides, such as digitalis glycosides Quinidine Drugs potentiating hypokalemic effects of epinephrine • Potassium depleting diuretics • Corticosteroids • Theophylline Epinephrine should not be used to counteract circulatory… (notice Adrénaline, Interactions médicamenteuses)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Serotonin syndrome: Use of NUEDEXTA with selective serotonin reuptake inhibitor (SSRIs) or tricyclic antidepressants increases the risk. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Serotonin syndrome: Use of NUEDEXTA with selective serotonin reuptake inhibitor (SSRIs) or tricyclic antidepressants increases the risk. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Serotonin Syndrome: Increased risk when co-administered with serotonergic agents (e.g., SSRIs, SNRIs, triptans), but also during overdosage situations. (notice Amphétamine, Mises en garde et précautions)

Serotonin Syndrome: Increased risk when coadministered with serotonergic agents (e.g., selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), triptans), but also during overdosage situations. (notice Amphétamine et dexamfétamine, Mises en garde et précautions)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

The use of SAPHRIS should be avoided in combination with other drugs known to prolong QTc including Class 1A antiarrhythmics (e.g., quinidine, procainamide) or Class 3 antiarrhythmics (e.g., amiodarone, sotalol), antipsychotic medications (e.g., ziprasidone, chlorpromazine, thioridazine), and antibiotics (e.g., gatifloxacin, moxifloxacin). (notice Asénapine, Mises en garde et précautions)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

…bradyarrhythmias or uncompensated heart failure • patients on drugs known to prolong the QT interval • patients with ongoing proarrhythmic conditions such as uncorrected hypokalemia or hypomagnesemia, clinically significant bradycardia, and in patients receiving Class IA (quinidine, procainamide) or Class III (dofetilide, amiodarone, sotalol) antiarrhythmic agents. (notice Azithromycine, Mises en garde et précautions)

• Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (notice Belladone et opium, Interactions médicamenteuses)

Use with an MAOI or within 14 days of stopping an MAOI. (notice Dextrométhorphane et quinidine, Contre-indications)

Serotonergic Drugs : Concomitant use may result in serotonin syndrome. (notice Buprénorphine, Interactions médicamenteuses)

Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (notice Buprénorphine et naloxone, Interactions médicamenteuses)

Serotonin syndrome: Use of NUEDEXTA with selective serotonin reuptake inhibitor (SSRIs) or tricyclic antidepressants increases the risk. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Serotonin Syndrome The development of a potentially life-threatening serotonin syndrome has been reported with SNRIs SSRIs, and other serotonergic drugs, including buspirone, alone but particularly with concomitant use of other serotonergic drugs (including triptans), with drugs that impair metabolism of serotonin (in particular, MAOIs, including reversible MAOIs… (notice Buspirone, Mises en garde)

Examples paroxetine, fluoxetine, bupropion, quinidine Benzodiazepines and other Central Nervous System (CNS) Depressants Clinical Impact: Due to additive pharmacologic effect, the concomitant use of benzodiazepines or other CNS depressants including alcohol, increases the risk of respiratory depression, profound sedation, coma, and death. (notice Butalbital, aspirine, caféine et codéine, Interactions médicamenteuses)

Examples: paroxetine, fluoxetine, bupropion, quinidine Benzodiazepines and Other Central Nervous System (CNS) Depressants Clinical Impact: Due to additive pharmacologic effect, the concomitant use of benzodiazepines or other CNS depressants, including alcohol, can increase the risk of hypotension, respiratory depression, profound sedation, coma, and death. (notice Butalbital, paracétamol, caféine et codéine, Interactions médicamenteuses)

…medical attention if they ‎experience symptoms of hyperalgesia, including worsening pain, increased ‎sensitivity to pain, or new pain [see WARNINGS ; ADVERSE REACTIONS ].‎ Serotonin Syndrome Inform patients that butorphanol tartrate could cause a rare but potentially life-threatening condition resulting from concomitant administration of serotonergic drugs. (notice Butorphanol, Précautions)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

…syndrome, uncorrected electrolyte imbalance, such as hypokalemia or hypomagnesemia and cardiac disease, such as heart failure, myocardial infarction, or bradycardia), and patients receiving Class IA antiarrhythmic agents (quinidine, procainamide), or Class III antiarrhythmic agents (amiodarone, sotalol), tricyclic antidepressants, macrolides, and antipsychotics. (notice Ciprofloxacine, Mises en garde et précautions)

Serotonin syndrome: Use of NUEDEXTA with selective serotonin reuptake inhibitor (SSRIs) or tricyclic antidepressants increases the risk. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Serotonin syndrome: Use of NUEDEXTA with selective serotonin reuptake inhibitor (SSRIs) or tricyclic antidepressants increases the risk. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Interactions with Drugs Affecting Cytochrome P450 Isoenzymes The effects of concomitant use or discontinuation of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors with codeine are complex. (notice Codéine, Mise en garde encadrée)

If serotonin syndrome symptoms occur with the use of other serotonergic drugs, immediately discontinue TONMYA. (notice Cyclobenzaprine, Interactions médicamenteuses)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

The dose of desipramine can then be adjusted based on clinical response; however, a dose above 40 mg/day is not recommended. (notice Dextrométhorphane et quinidine, Interactions médicamenteuses)

Serotonin syndrome: Use of NUEDEXTA with selective serotonin reuptake inhibitor (SSRIs) or tricyclic antidepressants increases the risk. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Serotonin Syndrome Serotonin syndrome, a potentially life-threatening reaction, may occur when amphetamines are used in combination with other drugs that affect the serotonergic neurotransmitter systems such as monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), triptans,… (notice Dexamfétamine, Mises en garde)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Concomitant Antiarrhythmic Therapy The concomitant use of Norpace or Norpace CR with other Type 1A antiarrhythmic agents (such as quinidine or procainamide), Type 1C antiarrhythmics (such as encainide, flecainide or propafenone), and/or propranolol should be reserved for patients with life-threatening arrhythmias who are demonstrably unresponsive to single-agent… (notice Disopyramide, Mises en garde)

Use with Drugs that Prolong QT Interval and Antiarrhythmic Agents The use of dofetilide in conjunction with other drugs that prolong the QT interval has not been studied and is not recommended. (notice Dofétilide, Mises en garde)

Serotonin syndrome: Use of NUEDEXTA with selective serotonin reuptake inhibitor (SSRIs) or tricyclic antidepressants increases the risk. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Serotonin syndrome: Use of NUEDEXTA with selective serotonin reuptake inhibitor (SSRIs) or tricyclic antidepressants increases the risk. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Concomitant use of COMPLERA with drugs with a known risk to prolong the QTc interval of the electrocardiogram may increase the risk of Torsade de Pointes. (notice Emtricitabine, rilpivirine et ténofovir, Mises en garde et précautions)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Serotonin syndrome: Use of NUEDEXTA with selective serotonin reuptake inhibitor (SSRIs) or tricyclic antidepressants increases the risk. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

• Serotonin Syndrome : Potentially life-threatening condition could result from concomitant serotonergic drug administration. (notice Fentanyl, Mises en garde et précautions)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Serotonin syndrome: Use of NUEDEXTA with selective serotonin reuptake inhibitor (SSRIs) or tricyclic antidepressants increases the risk. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Serotonin syndrome: Use of NUEDEXTA with selective serotonin reuptake inhibitor (SSRIs) or tricyclic antidepressants increases the risk. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

(See DOSAGE and ADMINISTRATION. ) Because of the risk of QT prolongation and the potential for torsades de pointes, the use of FOSCAVIR should be avoided in combination with agents known to prolong the QT interval including Class IA (e.g., quinidine or procainamide) or Class III (e.g., dofetilide, amiodarone, sotalol) antiarrhythmic agents, phenothiazines, tricyclic… (notice Foscarnet, Interactions médicamenteuses)

Avoid co-administration of CONTEPO with drugs known to prolong the QT interval. (notice Fosfomycine, Interactions médicamenteuses)

Patients should be monitored for the emergence of serotonin syndrome, especially with concomitant use of granisetron and other serotonergic drugs. (notice Granisétron, Mises en garde et précautions)

Example: lactulose Serotonergic Drugs : Concomitant use may result in serotonin syndrome. (notice Hydrocodone, Interactions médicamenteuses)

Serotonergic drugs : Concomitant use may result in serotonin syndrome. (notice Hydrocodone et chlorphénamine, Interactions médicamenteuses)

Serotonergic Drugs : Concomitant use may result in serotonin syndrome. (notice Hydrocodone et homatropine, Interactions médicamenteuses)

S er otonin Syndrome Inform patients that opioids could cause a rare but potentially life-threatening condition resulting from concomitant administration of serotonergic drugs. (notice Hydrocodone et ibuprofène, Précautions)

Serotonin Syndrome Inform patients that hydrocodone bitartrate and acetaminophen tablets could cause a rare but potentially life-threatening condition resulting from concomitant administration of serotonergic drugs. (notice Hydrocodone et paracétamol, Précautions)

• Serotonergic Drugs : Concomitant use may result in serotonin syndrome. (notice Hydromorphone, Interactions médicamenteuses)

Therefore, PLAQUENIL is not recommended in patients taking other drugs that have the potential to prolong the QT interval. (notice Hydroxychloroquine, Mises en garde et précautions)

Avoid the use of FANAPT in combination with any other drugs that prolong the QT interval [see Warnings and Precautions (5.3) ] . (notice Ilopéridone, Interactions médicamenteuses)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Serotonin syndrome: Use of NUEDEXTA with selective serotonin reuptake inhibitor (SSRIs) or tricyclic antidepressants increases the risk. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Use with an MAOI or within 14 days of stopping an MAOI. (notice Dextrométhorphane et quinidine, Contre-indications)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Bradycardia may increase the risk of QT prolongation which may lead to severe ventricular arrhythmias, including torsade de pointes, especially in patients with risk factors such as use of QTc prolonging drugs [see Adverse Reactions ( 6.2 )] . (notice Ivabradine, Mises en garde et précautions)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Since it cannot be excluded that Lanreotide Injection may have this effect, avoid other drugs mainly metabolized by CYP3A4 and which have a low therapeutic index (e.g., quinidine, terfenadine). (notice Lanréotide, Interactions médicamenteuses)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Levofloxacin should be avoided in patients with known prolongation of the QT interval, patients with uncorrected hypokalemia, and patients receiving Class IA (quinidine, procainamide), or Class III (amiodarone, sotalol) antiarrhythmic agents. (notice Lévofloxacine, Mises en garde et précautions)

Serotonin syndrome: Use of NUEDEXTA with selective serotonin reuptake inhibitor (SSRIs) or tricyclic antidepressants increases the risk. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Serotonin Syndrome Inform patients that opioids could cause a rare but potentially life-threatening condition resulting from concomitant administration of serotonergic drugs. (notice Lévorphanol, Précautions)

Use with an MAOI or within 14 days of stopping an MAOI. (notice Dextrométhorphane et quinidine, Contre-indications)

Serotonin Syndrome: Increased risk when co-administered with serotonergic agents (e.g., SSRIs, SNRIs, triptans), but also during overdosage situations. (notice Lisdexamfétamine, Mises en garde et précautions)

If concomitant use of lithium with other serotonergic drugs is clinically warranted, inform patients of the increased risk for serotonin syndrome and monitor for symptoms. (notice Lithium, Mises en garde et précautions)

Avoid loperamide hydrochloride capsules in: • combination with others drugs or herbal products that are known to prolong the QT interval, including Class 1A (e.g., quinidine, procainamide) or Class III (e.g., amiodarone, sotalol) antiarrhythmics, antipsychotics (e.g., chlorpromazine, haloperidol, thioridazine, ziprasidone), antibiotics (e.g., moxifloxacin), or… (notice Lopéramide, Mises en garde)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Concomitant use with quinidine, quinine, or mefloquine. (notice Dextrométhorphane et quinidine, Contre-indications)

Serotonin syndrome has resulted from concomitant use of metaxalone (within the recommended dosage range) and other serotonergic drugs [see Warnings and Precautions (5.1) ]. (notice Métaxalone, Interactions médicamenteuses)

Interactions with Drugs Affecting Cytochrome P450 Isoenzymes The concomitant use of METHADOSE with all cytochrome P450 3A4, 2B6, 2C19, 2C9 or 2D6 inhibitors may result in an increase in methadone plasma concentrations, which could cause potentially fatal respiratory depression. (notice Méthadone, Mise en garde encadrée)

Serotonin Syndrome: Increased risk when coadministered with serotonergic agents (e.g., SSRIs, SNRIs, triptans), but also during overdosage situations. (notice Méthamphétamine, Mises en garde et précautions)

CYP2D6 Inhibitors Monitor patients closely when the combination use of CYP2D6 inhibitor and metoprolol cannot be avoided. (notice Métoprolol, Interactions médicamenteuses)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

L'association du millepertuis avec des antidépresseurs et d'autres médicaments sérotoninergiques augmente le risque de syndrome sérotoninergique. (NCCIH, St. John's Wort)

• Serotonin Syndrome : Increased risk when co-administered with other serotonergic agents, but also when taken alone. (notice Milnacipran, Mises en garde et précautions)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Serotonin syndrome: Use of NUEDEXTA with selective serotonin reuptake inhibitor (SSRIs) or tricyclic antidepressants increases the risk. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

• Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (notice Morphine, Interactions médicamenteuses)

The drug should be avoided in patients with known prolongation of the QT interval, patients with uncorrected hypokalemia and patients receiving Class IA (for example, quinidine, procainamide) or Class III (for example, amiodarone, sotalol) antiarrhythmic agents, due to the lack of clinical experience with the drug in these patient populations. (notice Moxifloxacine, Mises en garde et précautions)

Serotonin syndrome: Use of NUEDEXTA with selective serotonin reuptake inhibitor (SSRIs) or tricyclic antidepressants increases the risk. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Serotonin syndrome: Use of NUEDEXTA with selective serotonin reuptake inhibitor (SSRIs) or tricyclic antidepressants increases the risk. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Ofloxacin should be avoided in patients with known prolongation of the QT interval, patients with uncorrected hypokalemia, and patients receiving Class IA (quinidine, procainamide), or Class III (amiodarone, sotalol) antiarrhythmic agents. (notice Ofloxacine, Précautions)

Serotonin syndrome: Use of NUEDEXTA with selective serotonin reuptake inhibitor (SSRIs) or tricyclic antidepressants increases the risk. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Serotonergic Drugs : Concomitant use may result in serotonin syndrome. (notice Olicéridine, Interactions médicamenteuses)

Patients should be monitored for the emergence of serotonin syndrome, especially with concomitant use of Ondansetron Injection and other serotonergic drugs. (notice Ondansétron, Mises en garde et précautions)

Avoid coadministration of oxaliplatin injection with medicinal products with a known potential to prolong the QT interval. (notice Oxaliplatine, Interactions médicamenteuses)

Serotonergic Drug s: Concomitant use may result in serotonin syndrome. (notice Oxycodone, Interactions médicamenteuses)

Serotonergic Drugs : Concomitant use may result in serotonin syndrome. (notice Oxymorphone, Interactions médicamenteuses)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Patients should be monitored for the emergence of serotonin syndrome, especially with concomitant use of POSFREA and other serotonergic drugs. (notice Palonosétron, Mises en garde et précautions)

Interactions with Drugs Affecting Cytochrome P450 Isoenzymes The effects of concomitant use or discontinuation of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors with codeine are complex. (notice Paracétamol et codéine, Mise en garde encadrée)

The dose of paroxetine can then be adjusted based on clinical response; however, dosage above 35 mg/day is not recommended. (notice Dextrométhorphane et quinidine, Interactions médicamenteuses)

Avoid coadministration of VOTRIENT with drugs known to prolong the QT/QTc interval. (notice Pazopanib, Interactions médicamenteuses)

Serotonin Syndrome Inform patients that opioids could cause a rare but potentially life-threatening condition resulting from concomitant administration of serotonergic drugs. (notice Pentazocine et naloxone, Précautions)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Use with an MAOI or within 14 days of stopping an MAOI. (notice Dextrométhorphane et quinidine, Contre-indications)

Drugs that Prolong the QT Interval : Avoid concomitant use. (notice Phénobarbital, Interactions médicamenteuses)

…use of NUPLAZID should be avoided in patients with known QT prolongation or in combination with other drugs known to prolong QT interval including Class 1A antiarrhythmics (e.g., quinidine, procainamide) or Class 3 antiarrhythmics (e.g., amiodarone, sotalol), certain antipsychotic medications (e.g., ziprasidone, chlorpromazine, thioridazine), and certain antibiotics… (notice Pimavansérine, Mises en garde et précautions)

Concomitant use with drugs that both prolong QT interval and are metabolized by CYP2D6 (e.g., thioridazine or pimozide). (notice Dextrométhorphane et quinidine, Contre-indications)

The use of WAKIX should be avoided in patients with known QT prolongation or in combination with other drugs known to prolong the QT interval [see Drug Interactions ( 7.1 )]. (notice Pitolisant, Mises en garde et précautions)

Class Ia (e.g., quinidine, procainamide) and Class III (e.g., amiodarone, sotalol) anti-arrhythmic drugs have been associated with cases of Torsades de Pointes in patients with bradycardia. (notice Ponésimod, Interactions médicamenteuses)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Interactions with Drugs Affecting Cytochrome P450 Isoenzymes The effects of concomitant use or discontinuation of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors with codeine are complex, requiring careful consideration of the effects on the parent drug, codeine, and the active metabolite, morphine. (notice Prométhazine et codéine, Mise en garde encadrée)

Avoid the use of propafenone with Class IA and III antiarrhythmic agents (including quinidine and amiodarone). (notice Propafénone, Mises en garde et précautions)

Serotonin syndrome: Use of NUEDEXTA with selective serotonin reuptake inhibitor (SSRIs) or tricyclic antidepressants increases the risk. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Thrombocytopenia and Other Hypersensitivity Reactions Quinidine can cause immune-mediated thrombocytopenia that can be severe or fatal. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Concomitant use with quinidine, quinine, or mefloquine. (notice Dextrométhorphane et quinidine, Contre-indications)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Use with an MAOI or within 14 days of stopping an MAOI. (notice Dextrométhorphane et quinidine, Contre-indications)

• Serotonin Syndrome : Potentially life-threatening condition could result from concomitant serotonergic drug administration. (notice Rémifentanil, Mises en garde et précautions)

…exposure Progestins Anticonvulsants Phenytoin Administered with rifampin 450 mg daily Decrease exposure Antiarrhythmics Disopyramide Decrease exposure Mexiletine Decrease exposure Quinidine Decrease exposure Propafenone Decrease AUC by 50%-67% Tocainide Decrease exposure Antiestrogens Tamoxifen Decrease AUC by 86% Toremifene Decrease steady state concentrations… (notice Rifampicine, Interactions médicamenteuses)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Use with an MAOI or within 14 days of stopping an MAOI. (notice Dextrométhorphane et quinidine, Contre-indications)

Serotonin syndrome: Use of NUEDEXTA with selective serotonin reuptake inhibitor (SSRIs) or tricyclic antidepressants increases the risk. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Class Ia antiarrhythmic drugs, such as disopyramide, quinidine, and procainamide, and other Class III drugs (for example, amiodarone) are not recommended as concomitant therapy, because of their potential for additive QTc prolongation [see Warnings and Precautions ( 5.1 )]. (notice Sotalol, Interactions médicamenteuses)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Certain conditions may increase the risk for torsade de pointes or sudden death such as (1) bradycardia; (2) hypokalemia or hypomagnesemia; (3) concomitant use of other drugs that prolong the QTc interval; and (4) presence of congenital prolongation of the QT interval [see Warnings and Precautions ( 5.8 ), Clinical Pharmacology (12.2) ]. (notice Tétrabénazine, Interactions médicamenteuses)

Concomitant use with drugs that both prolong QT interval and are metabolized by CYP2D6 (e.g., thioridazine or pimozide). (notice Dextrométhorphane et quinidine, Contre-indications)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

The effects of concomitant use or discontinuation of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors with tramadol are complex. (notice Tramadol, Mise en garde encadrée)

Interactions with Drugs Affecting Cytochrome P450 Isoenzymes The effects of concomitant use or discontinuation of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors with tramadol are complex. (notice Tramadol et paracétamol, Mise en garde encadrée)

Use with an MAOI or within 14 days of stopping an MAOI. (notice Dextrométhorphane et quinidine, Contre-indications)

Serotonin syndrome: Use of NUEDEXTA with selective serotonin reuptake inhibitor (SSRIs) or tricyclic antidepressants increases the risk. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Serotonin syndrome: Use of NUEDEXTA with selective serotonin reuptake inhibitor (SSRIs) or tricyclic antidepressants increases the risk. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Patients taking Class 1A (for example. quinidine, procainamide) or Class III (for example, amiodarone, sotalol) antiarrhythmic medications or those with congenital QT prolongation, should avoid using vardenafil hydrochloride tablets. (notice Vardénafil, Mises en garde et précautions)

Serotonin syndrome: Use of NUEDEXTA with selective serotonin reuptake inhibitor (SSRIs) or tricyclic antidepressants increases the risk. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Avoid concomitant use of VEPPANU with strong CYP3A inhibitors or drugs known to prolong the QTc interval. (notice Vepdégestrant, Mises en garde et précautions)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Serotonin syndrome: Use of NUEDEXTA with selective serotonin reuptake inhibitor (SSRIs) or tricyclic antidepressants increases the risk. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

QT Prolongation: Monitor ECG if concomitant use of drugs that prolong QT interval cannot be avoided or if concomitant CYP3A4 inhibitors used. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Serotonin syndrome: Use of NUEDEXTA with selective serotonin reuptake inhibitor (SSRIs) or tricyclic antidepressants increases the risk. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Therefore, ziprasidone should not be given with: • dofetilide, sotalol, quinidine, other Class Ia and III anti-arrhythmics, mesoridazine, thioridazine, chlorpromazine, droperidol, pimozide, sparfloxacin, gatifloxacin, moxifloxacin, halofantrine, mefloquine, pentamidine, arsenic trioxide, levomethadyl acetate, dolasetron mesylate, probucol or tacrolimus. (notice Ziprasidone, Contre-indications)

Acetazolamide reduces urinary excretion of quinidine and may enhance its effect. (notice Acétazolamide, Interactions médicamenteuses)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Effect of P-glycoprotein (P-gp) Inhibitors and Inducers Concomitant taking of P-gp inhibitors (including but not limited to ritonavir, cyclosporine A, ketoconazole, itraconazole, erythromycin, verapamil, quinidine, tacrolimus, nelfinavir, saquinavir, and amiodarone) with GILOTRIF can increase exposure to afatinib [see Clinical Pharmacology (12.3) ]. (notice Afatinib, Interactions médicamenteuses)

Alcohol As with any other CNS drug, caution should be used when NUEDEXTA is taken in combination with other centrally acting drugs and alcohol. (notice Dextrométhorphane et quinidine, Interactions médicamenteuses)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

MAO inhibitors, tricyclic antidepressants and drugs that prolong the QTc interval may potentiate effect on the cardiovascular system. (notice Arformotérol, Interactions médicamenteuses)

CYP2D6 inhibitors and CYP3A4 Inhibitors : See full prescribing information for ABILIFY MAINTENA dosage modifications when used concomitantly with CYP2D6 inhibitors and/or CYP3A4 inhibitors for greater than 14 days ( 7.1 ) (notice Aripiprazole, Interactions médicamenteuses)

Strong CYP2D6 Inhibitors Prevention or Management With concomitant use of atomoxetine oral solution and a strong CYP2D6 inhibitor 1 , increase the titration interval [see Dosage and Administration (2.5) and Clinical Pharmacology (12.3) ] . (notice Atomoxétine, Interactions médicamenteuses)

Drug Interactions Drugs which may enhance the neuromuscular blocking action of atracurium include: enflurane; isoflurane; halothane; certain antibiotics, especially the aminoglycosides and polymyxins; lithium; magnesium salts; procainamide; and quinidine. (notice Atracurium, Interactions médicamenteuses)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Strong CYP2D6 REXULTI may be administered without dosage adjustment in patients with MDD when administered with strong CYP2D6 inhibitors (e.g., paroxetine, fluoxetine). or CYP3A4 inhibitors Administer half of recommended dosage. (notice Brexpiprazole, Interactions médicamenteuses)

CYP2D6 inhibitors may potentiate systemic beta-blockade. (notice Brimonidine et timolol, Interactions médicamenteuses)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

CYP2D6 Inhibitors and Poor Metabolizers Interactions of carvedilol with potent inhibitors of CYP2D6 isoenzyme (such as quinidine, fluoxetine, paroxetine, and propafenone) have not been studied, but these drugs would be expected to increase blood levels of the R(+) enantiomer of carvedilol [see Clinical Pharmacology (12.3) ]. (notice Carvédilol, Interactions médicamenteuses)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

QT Interval Prolongation and V entricular A rr h ythmia Decreases in serum calcium can also prolong the QT interval, potentially resulting in ventricular arrhythmia. (notice Cinacalcet, Mises en garde et précautions)

Potentiation of Neuromuscular Blockade Certain drugs may enhance the neuromuscular blocking action of Cisatracurium Besylate Injection including inhalational anesthetics, antibiotics, magnesium salts, lithium, local anesthetics, procainamide and quinidine [see Drug Interactions ( 7.1 )] . (notice Cisatracurium, Mises en garde et précautions)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

The use of the P-gp inhibitors verapamil, amiodarone, quinidine, clarithromycin, and ticagrelor does not require a dosage adjustment of PRADAXA. (notice Dabigatran, Interactions médicamenteuses)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

…ergotamine, everolimus, felodipine, fentanyl, hormonal contraceptive agents, indinavir, fluticasone, lopinavir, lovastatin, lurasidone, maraviroc, midazolam, nisoldipine, pimozide, quetiapine, quinidine, saquinavir, sildenafil, simvastatin, sirolimus, tacrolimus, tolvaptan, tipranavir, triazolam, ticagrelor, and vardenafil) [see Clinical Pharmacology (12.3)] . (notice Déférasirox, Interactions médicamenteuses)

Carefully monitor cardiac rhythm when administering SUPRANE to susceptible patients (e.g., patients with congenital Long QT Syndrome or patients taking drugs that can prolong the QT interval). (notice Desflurane, Mises en garde et précautions)

Concomitant use of strong CYP2D6 inhibitors: Maximum recommended dose of AUSTEDO XR or AUSTEDO is 36 mg per day ( 2.3 , 7.1 ) (notice Deutétrabénazine, Interactions médicamenteuses)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Digoxin: Increased digoxin substrate plasma concentration may occur. (notice Dextrométhorphane et quinidine, Interactions médicamenteuses)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

CYP2D6 inhibitors may potentiate systemic beta-blockade. (notice Dorzolamide et timolol, Interactions médicamenteuses)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

…cardiac disease, 3) treatment with Class I and Class III antiarrhythmics, 4) treatment with monoamine oxidase inhibitors (MAOI's), 5) concomitant treatment with other drug products known to prolong the QT interval (see PRECAUTIONS, Drug Interactions ), and 6) electrolyte imbalance, in particular hypokalemia and hypomagnesemia, or concomitant treatment with drugs… (notice Dropéridol, Mises en garde)

Use caution in combination with moderate CYP3A4 inhibitors (e.g., erythromycin) or strong (e.g., paroxetine) or moderate CYP2D6 inhibitors, a combination of both CYP3A4 and CYP2D6 inhibitors, or known poor metabolizers of CYP2D6. (notice Dutastéride et tamsulosine, Mises en garde et précautions)

QT Prolongation: Monitor for prolonged QT intervals in patients with congestive heart failure, bradyarrhythmias, drugs known to prolong the QT interval, and electrolyte abnormalities. (notice Éribuline, Mises en garde et précautions)

The serum digoxin concentrations should be monitored and used for titration of the digoxin dose to obtain the desired clinical effect. amiodarone bepridil disopyramide flecainide lidocaine (systemic) mexiletine propafenone quinidine ↓ antiarrhythmics Concentrations of these antiarrhythmics may be decreased when co-administered with Etravirine. (notice Étravirine, Interactions médicamenteuses)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

(See DOSAGE AND ADMINISTRATION ) Drugs that inhibit cytochrome P450IID6, such as quinidine , might increase the plasma concentrations of flecainide in patients that are on chronic flecainide therapy; especially if these patients are extensive metabolizers. (notice Flécaïnide, Interactions médicamenteuses)

…Antidepressants, QTc Prolonging Drugs Formoterol, as with other beta 2 -agonists, should be administered with extreme caution to patients being treated with monoamine oxidase inhibitors, tricyclic antidepressants, or drugs known to prolong the QTc interval because the effect of adrenergic agonists on the cardiovascular system may be potentiated by these agents. (notice Formotérol, Interactions médicamenteuses)

Other Corticosteroids, doxycycline, estrogens, furosemide, oral contraceptives, paroxetine, quinidine, rifampin, sertraline, theophylline, and vitamin D Drugs whose level is decreased by phenytoin Anticoagulants Apixaban, dabigatran, edoxaban, rivaroxaban Antiepileptic drugs The effect of phenytoin on phenobarbital, valproic acid and sodium valproate serum levels… (notice Fosphénytoïne, Interactions médicamenteuses)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Effect on QT/QTc Interval: Androgen deprivation therapy may prolong the QT interval. (notice Goséréline, Mises en garde et précautions)

The haloperidol plasma concentrations increased when a CYP3A4 and/or CYP2D6 inhibitor was coadministered with haloperidol. (notice Halopéridol, Interactions médicamenteuses)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Monitor QT interval when administering FORANE to susceptible patients (e.g., patients with congenital Long QT Syndrome or patients taking drugs that can prolong the QT interval). (notice Isoflurane, Mises en garde et précautions)

TYKERB may prolong the QT interval in some patients. (notice Lapatinib, Mises en garde et précautions)

Effect on QT/QTc Interval: Androgen deprivation therapy may prolong the QT interval. (notice Leuproréline, Mises en garde et précautions)

Risk of QT Prolongation : Lofexidine tablets prolong the QT interval. (notice Lofexidine, Mises en garde et précautions)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Use with Other N-methyl-D-aspartate (NMDA) Antagonists The combined use of memantine hydrochloride with other NMDA antagonists (amantadine, ketamine, and dextromethorphan) has not been systematically evaluated and such use should be approached with caution. (notice Mémantine, Interactions médicamenteuses)

Use of Memantine with Other N-methyl-D-aspartate (NMDA) Antagonists The combined use of memantine hydrochloride with other NMDA antagonists (amantadine, ketamine, and dextromethorphan) has not been systematically evaluated and such use should be approached with caution. (notice Mémantine et donépézil, Interactions médicamenteuses)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Examples quinidine, bupropion, fluoxetine, and paroxetine Monoamine Oxidase Inhibitors Clinical Impact Increased risk of hypertension [see Warnings and Precautions ( 5.5 )] . (notice Métoclopramide, Interactions médicamenteuses)

CYP2D6 inhibitors: Increased metoprolol concentration. (notice Métoprolol et hydrochlorothiazide, Interactions médicamenteuses)

Drugs that Prolong the QT Interval QT prolongation has been reported, particularly when metronidazole was administered with drugs with the potential for prolonging the QT interval. (notice Métronidazole, Interactions médicamenteuses)

Serotonergic Drugs The concomitant use of opioids with other drugs that affect the serotonergic neurotransmitter system, such as selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), triptans, 5-HT3 receptor antagonists, drugs that effect the serotonin neurotransmitter system… (notice Nalbuphine, Interactions médicamenteuses)

P-glycoprotein (P-gp) Inhibitors (e.g., amiodarone, captopril, cyclosporine, quercetin, quinidine, verapamil) Clinical Impact Increase in plasma naldemedine concentrations [see Clinical Pharmacology (12.3) ] Intervention Monitor for potential naldemedine-related adverse reactions [see Adverse Reactions (6.1) ] . (notice Naldémédine, Interactions médicamenteuses)

•Weak CYP3A4 inhibitors (e.g., quinidine, cimetidine) •Clinically significant increases in naloxegol concentrations are not expected. (notice Naloxégol, Interactions médicamenteuses)

Use with CYP2D6 Inhibitors Nebivolol exposure increases with inhibition of CYP2D6 [see Drug Interactions ( 7 ) ] . (notice Nébivolol, Mises en garde et précautions)

Co-administration of multiple doses of quinidine sulfate, 200 mg t.i.d., and nifedipine, 20 mg t.i.d., increased C max and AUC of nifedipine in healthy volunteers by factors of 2.30 and 1.37, respectively. (notice Nifédipine, Interactions médicamenteuses)

Quinidine at 648 mg bid decreased the bioavailability (AUC) of nisoldipine by 26%, but not the peak concentration. (notice Nisoldipine, Interactions médicamenteuses)

Drugs Metabolized by CYP 450 Enzymes: concomitant use with other drugs mainly metabolized by CYP3A4 that have a narrow therapeutic index (e.g., quinidine) should be used with caution and increased monitoring may be required (‎ 7 ). (notice Octréotide, Interactions médicamenteuses)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

…combination with other drugs that are known to prolong QTc including Class 1A (e.g., quinidine, procainamide) or Class III (e.g., amiodarone, sotalol) antiarrhythmic medications, antipsychotic medications (e.g., chlorpromazine, thioridazine), antibiotics (e.g., gatifloxacin, moxifloxacin), or any other class of medications known to prolong the QTc interval. (notice Palipéridone, Mises en garde et précautions)

Drugs that Prolong QT: Use with caution in patients who are at significant risk of developing QTc prolongation. (notice Pasiréotide, Interactions médicamenteuses)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

CYP3A4 Substrates with narrow therapeutic index (e.g., alfentanil, quinidine, cyclosporine) : Glycerol phenylbutyrate may decrease exposure; monitor for decreased efficacy of the narrow therapeutic index drug ( 7.3 ) (notice Phénylbutyrate de glycérol, Interactions médicamenteuses)

…decreased PT/INR responses have been reported when phenytoin is coadministered with warfarin Other Corticosteroids, doxycycline, estrogens, furosemide, oral contraceptives, paroxetine, quinidine, rifampin, sertraline, theophylline, and vitamin D Drugs whose level is decreased by phenytoin Anticoagulants Apixaban, dabigatran, edoxaban, rivaroxaban Antiepileptic drugs… (notice Phénytoïne, Interactions médicamenteuses)

QT Interval Prolonging Drugs The pharmacodynamic interaction potential to prolong the QT interval of the electrocardiogram between Primaquine phosphate Tablets and other drugs that effect cardiac conduction is unknown. (notice Primaquine, Interactions médicamenteuses)

Concurrent Other Antiarrhythmic Agents Concurrent use of PA with other Group 1A antiarrhythmic agents such as quinidine or disopyramide may produce enhanced prolongation of conduction or depression of contractility and hypotension, especially in patients with cardiac decompensation. (notice Procaïnamide, Mises en garde)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Impact of Other Drugs on Propranolol CYP2D6, CYP1A2 and CYP2C19 Inhibitors: CYP2D6 inhibitors (e.g. bupropion, fluoxetine, paroxetine, quinidine), CYP1A2 inhibitors (e.g., ciprofloxacin, enoxamine, fluvoxamine) and CYP2C19 inhibitors (e.g., fluconazole, fluvoxamine, ticlopidine) increase exposure to propranolol when co-administered with INNOPRAN XL. (notice Propranolol, Interactions médicamenteuses)

…Class 1A antiarrythmics (e.g., quinidine, procainamide) or Class III antiarrythmics (e.g., amiodarone, sotalol), antipsychotic medications (e.g., ziprasidone, chlorpromazine, thioridazine), antibiotics (e.g., gatifloxacin, moxifloxacin), or any other class of medications known to prolong the QTc interval (e.g., pentamidine, levomethadyl acetate, methadone). (notice Quétiapine, Mises en garde et précautions)

Table 4: Drug Interactions with PRIFTIN: Dosage Adjustment May be Necessary Drug Class Examples of Drugs Within Class Antiarrhythmics Disopyramide, mexiletine, quinidine, tocainide Antibiotics Chloramphenicol, clarithromycin, dapsone, doxycycline; Fluoroquinolones (such as ciprofloxacin) Oral Anticoagulants Warfarin Anticonvulsants Phenytoin Antimalarials Quinine… (notice Rifapentine, Interactions médicamenteuses)

In healthy subjects, 75 mg once daily and 300 mg once daily (3 times and 12 times the dose in EDURANT) have been shown to prolong the QTc interval of the electrocardiogram. (notice Rilpivirine, Mises en garde et précautions)

P-gp Inhibitors Concomitant administration of NURTEC ODT with potent inhibitors of P-gp (e.g., amiodarone, cyclosporine, lapatinib, quinidine, ranolazine) may result in increased exposure of rimegepant. (notice Rimégépant, Interactions médicamenteuses)

Fluoxetine and Paroxetine Fluoxetine (20 mg once daily) and paroxetine (20 mg once daily), CYP 2D6 inhibitors, have been shown to increase the plasma concentration of risperidone 2.5–2.8 fold and 3–9 fold respectively. (notice Rispéridone, Interactions médicamenteuses)

Certain inhalation anesthetics, particularly enflurane and isoflurane, antibiotics, magnesium salts, lithium, local anesthetics, procainamide, and quinidine have been shown to increase the duration of neuromuscular block and decrease infusion requirements of neuromuscular blocking agents [see Drug Interactions ( 7.3 )] . (notice Rocuronium, Mises en garde et précautions)

Exposure to dextromethorphan, a CYP2D6 substrate, following a single dose of rolapitant increased about 3-fold on Days 8 and Day 22. (notice Rolapitant, Mises en garde et précautions)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Caution should be exercised when administering sevoflurane to susceptible patients (e.g., patients with congenital Long QT Syndrome or patients taking drugs that can prolong the QT interval). (notice Sévoflurane, Mises en garde)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Monitor electrolytes and electrocardiograms in patients with congestive heart failure, bradyarrhythmias, drugs known to prolong the QT interval, including Class Ia and III antiarrhythmics. (notice Sorafénib, Mises en garde et précautions)

Drugs that Prolong the QT interval QT prolongation has been reported with metronidazole, a component of bismuth subcitrate potassium, metronidazole and tetracycline hydrochloride, particularly when administered with drugs with the potential for prolonging the QT interval. (notice Sous-citrate de bismuth, métronidazole et tétracycline, Mises en garde et précautions)

Drug Interactions Some studies have shown that simultaneous sucralfate administration in healthy volunteers reduced the extent of absorption (bioavailability) of single doses of the following: cimetidine, digoxin, fluoroquinolone antibiotics, ketoconazole, l-thyroxine, phenytoin, quinidine, ranitidine, tetracycline, and theophylline. (notice Sucralfate, Interactions médicamenteuses)

Drugs that Prolong QT Interval SUTENT is associated with QTc interval prolongation [see Warnings and Precautions (5.3) , Clinical Pharmacology (12.2) ] . (notice Sunitinib, Interactions médicamenteuses)

Drugs that May Enhance the Neuromuscular Blocking Action of Succinylcholine : promazine, oxytocin, aprotinin, certain non-penicillin antibiotics, quinidine, β-adrenergic blockers, procainamide, lidocaine, trimethaphan, lithium carbonate, magnesium salts, quinine, chloroquine, isoflurane, desflurane, metoclopramide, terbutaline, and drugs that reduce plasma cholinesterase… (notice Suxaméthonium, Interactions médicamenteuses)

Use with caution in combination with moderate inhibitors of CYP3A4, with strong or moderate inhibitors of CYP2D6, in patients known to be CYP2D6 poor metabolizers, or in combination with other cytochrome P450 inhibitors. (notice Tamsulosine, Mises en garde et précautions)

In studies in healthy subjects characterized as extensive metabolizers of dextromethorphan (antitussive drug and CYP2D6 probe substrate), terbinafine increases the dextromethorphan/ dextrorphan metabolite ratio in urine by 16- to 97-fold on average. (notice Terbinafine, Interactions médicamenteuses)

Potentiated systemic beta-blockade (e.g., decreased heart rate) has been reported during combined treatment with quinidine and timolol. (notice Timolol, Interactions médicamenteuses)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Agents generally accepted to prolong QT interval include Class 1A (e.g., quinidine, procainamide, disopyramide) and Class III (e.g., amiodarone, sotalol, ibutilide, dofetilide) antiarrhythmics; certain antipsychotics (e.g., thioridazine, haloperidol); certain antidepressants (e.g., venlafaxine, amitriptyline); certain antibiotics (e.g., erythromycin, clarithromycin,… (notice Torémifène, Interactions médicamenteuses)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Effect on QT/QTc Interval: Androgen deprivation therapy may prolong the QT interval. (notice Triptoréline, Mises en garde et précautions)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Use of BCRP and/or P-gp only inhibitors (e.g., quinidine, carvedilol, eltrombopag, curcumin) may increase the exposure of ubrogepant [ s ee Clinical Pharmacology ( 12.3 ) ] . (notice Ubrogépant, Interactions médicamenteuses)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

Anticholinergic effects of quinidine: Monitor for worsening in myasthenia gravis and other sensitive conditions. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

For patients who are CYP2D6 poor metabolizers or are taking a strong CYP2D6 inhibitor, dose reduction may be necessary. (notice Valbénazine, Mises en garde et précautions)

CYP2D6 Substrates Clinical Impact Viloxazine is a weak inhibitor of CYP2D6, and increases the exposure of CYP2D6 substrates when coadministered [see Clinical Pharmacology (12.3) ] . (notice Viloxazine, Interactions médicamenteuses)

Digoxin Quinidine is an inhibitor of P-glycoprotein. (notice Dextrométhorphane et quinidine, Interactions médicamenteuses)

CYP2D6 substrates Clinical Impact: In vitro studies indicate that celecoxib, although not a substrate, is an inhibitor of CYP2D6. (notice Célécoxib, Interactions médicamenteuses)

Drugs which inhibit CYP2D6 and CYP3A3/4 also inhibit the metabolism of cevimeline. (notice Céviméline, Interactions médicamenteuses)

The selective serotonin reuptake inhibitors sertraline (weak CYP3A4 inducer) and fluoxetine (CYP2D6 inhibitor), and the anti-epileptic drug felbamate (CYP2C19 inhibitor and CYP3A4 inducer) do not affect the pharmacokinetics of clonazepam. (notice Clonazépam, Interactions médicamenteuses)

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. (notice Éphédrine, Interactions médicamenteuses)

Digoxin Quinidine is an inhibitor of P-glycoprotein. (notice Dextrométhorphane et quinidine, Interactions médicamenteuses)

Digoxin Quinidine is an inhibitor of P-glycoprotein. (notice Dextrométhorphane et quinidine, Interactions médicamenteuses)

A variety of antiarrhythmics such as quinidine or propranolol were also added, sometimes with improved control of ventricular ectopy. (notice Mexilétine, Interactions médicamenteuses)

…for Drug Interaction: It appears possible, although there is no supporting experimental evidence, that the high renal clearance of desglymidodrine (a base) is due to active tubular secretion by the base-secreting system also responsible for the secretion of such drugs as metformin, cimetidine, ranitidine, procainamide, triamterene, flecainide, and quinidine. (notice Midodrine, Précautions)

…untoward clinical manifestations have been observed in limited experience with patients in whom milrinone was used concurrently with the following drugs: digitalis glycosides; lidocaine, quinidine; hydralazine, prazosin; isosorbide dinitrate, nitroglycerin; chlorthalidone, furosemide, hydrochlorothiazide, spironolactone; captopril; heparin, warfarin, diazepam, insulin;… (notice Milrinone, Interactions médicamenteuses)

Digoxin Quinidine is an inhibitor of P-glycoprotein. (notice Dextrométhorphane et quinidine, Interactions médicamenteuses)

In Vitro Interaction The plasma protein binding of nicardipine was not altered when therapeutic concentrations of furosemide, propranolol, dipyridamole, warfarin, quinidine, or naproxen were added to human plasma in vitro. (notice Nicardipine, Interactions médicamenteuses)

Digoxin Quinidine is an inhibitor of P-glycoprotein. (notice Dextrométhorphane et quinidine, Interactions médicamenteuses)

Serotonergic Drugs Clinical Impact: The concomitant use of opioids with other drugs that affect the serotonergic neurotransmitter system has resulted in serotonin syndrome [see Adverse Reaction ( 6.2)]. (notice Oxycodone et paracétamol, Interactions médicamenteuses)

Strong and moderate CYP3A inhibitors include, but are not limited to, atazanavir, clarithromycin, indinavir, itraconazole, ketoconazole, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, amprenavir, aprepitant, diltiazem, erythromycin, fluconazole, fosamprenavir, grapefruit juice, and verapamil. (notice Dextrométhorphane et quinidine, Mises en garde et précautions)

The safety and efficacy of combination therapy with phentermine and any other drug products for weight loss including prescribed drugs, over-the-counter preparations, and herbal products, or serotonergic agents such as selective serotonin reuptake inhibitors (e.g., fluoxetine, sertraline, fluvoxamine, paroxetine), have not been established. (notice Phentermine, Mises en garde et précautions)

…tolazamide, and tolbutamide; (3) tranquilizers and sedatives–chlordiazepoxide, diazepam, and phenobarbital; (4) antigout–allopurinol, colchicine, and probenecid; (5) antiarrhythmics–procainamide, propranolol (see WARNINGS however), and quinidine; and (6) analgesics, antipyretics and anti-inflammatories–propoxyphene, aspirin, indomethacin, and phenylbutazone. (notice Prazosine, Interactions médicamenteuses)

Digoxin Quinidine is an inhibitor of P-glycoprotein. (notice Dextrométhorphane et quinidine, Interactions médicamenteuses)

Strong Inhibitors of CYP2D6 The impact on the efficacy of tamoxifen with co-administration of strong CYP2D6 inhibitors (e.g., paroxetine) is not well established. (notice Tamoxifène, Interactions médicamenteuses)

Other Experience concerning injection of quinidine during recovery from use of other muscle relaxants suggests that recurrent paralysis may occur. (notice Vécuronium, Précautions)

Digoxin Quinidine is an inhibitor of P-glycoprotein. (notice Dextrométhorphane et quinidine, Interactions médicamenteuses)

Drugs Metabolized by Cytochrome P450 Isozymes In healthy subjects, a subcutaneous dose of 0.3 mg/kg of RELISTOR did not significantly affect the metabolism of dextromethorphan, a CYP2D6 substrate. (notice Méthylnaltrexone, Interactions médicamenteuses)