Thioridazine Carbamazepine

CYP2C19 CYP2D6 diazepam, imipramine, 5-mephenytoin, omeprazol, proguanil, propranolol codeine, debrisoquine, dextromethorphan, flecainide, paroxetine, perphenazine, thioridazine carbamazepine, rifampicin cimetidine, felbamate fluoxetine, paroxetine, quinidine... 

Codeine, dextromethorphan, haloperidol, thioridazine, perphenazine, nortriptyline, desipramine, fluoxetine, norfluoxetine, TCAs (hydroxylation), beta-blockers such as timolol and metoprolol, type 1C antiarrhythmics encainide, flecainide TCAs (desmethylation), triazolam, alprazolam, midazolam, carbamazepine, terfenadine, quinidine, lidocaine, erythromycin, cyclosporin... 

Zaleplon (Sonata) [C IV] [Sedotive/Hypnotic] Uses Insomnia Action A nonbenzodiazepine sedative/hypnotic, a pyrazolopyrimidine Dose 5-20 mg hs PRN -1- w/ renal/hepatic insuff, elderly Caution [C, /-] w/ mental/ psychological conditions Contra Component allergy Disp Caps SE HA, edema, amnesia, somnolence, photosens Interactions t CNS depression W/ CNS d es-sants, imipramine, thioridazine, EtOH X effects W/ carbamazepine, phenobarbital, phenytoin, rifampin EMS Concurrent EtOH can t adverse CNS effects OD May cause profound CNS depression symptomatic and supportive Zanamivir (Relenza) [Antiviral/Neuramidase Inhibitor] Uses Influenza A (including HlNl swine flu) B Action X Viral neuraminidase Dose Adults Feds > 7 y.2 inhal (10 mg) bid for 5 d initiate w/in 48 h of Sxs Caution [C, M] Contra Pulm Dz Disp Powder for inhal SE Bron-chospasm, HA, GI upset EMS Does not reduce risk of transmitting virus monitor for bronchospasm or other severe resp events OD May cause resp problems s5rmptomatic and supportive... 

Solution of thioridazine hydrochloride is incompatible with carbamazepine suspensions. Cessation of therapy or drug reduction with troopiclone may cause dependence and withdrawal symptoms. Patients taking this drug should avoid operating machinery or industrial work and driving.168... 

Carbamazepine Carbamazepine suspension is incompatible with thioridazine hydrochloride solution, since it produces visual incompatibility in the form of a rubbery orange mass. Carbamazepine should be diluted before nasogastric administration.189 Carbamazepine may be stored in silica gel sachets and must be protected from humidity for effective stability.190... 

Based on published data in humans, concomitant medications were classified as potential inhibitors (cimetidine, fluoxetine, levopromazine, paroxetine, and thioridazine) or inducers of haloperidol metabolism (carbamazepine, phenobarbital, and phenytoin). 

A 68-year-old man with a 5-year history of Alzheimer s disease was treated with thioridazine 25 mg tds because of violent outbursts (12). His other drugs, temazepam 10-30 mg at night, carbamazepine 100 mg bd for neuropathic pain, and droperidol 5-10 mg as required, were unaltered. Five days later, he was found dead, having been in his usual condition 2 hours before. Post-mortem examination showed stenosis of the coronary arteries, but no coronary thrombosis, myocardial infarction, or other significant pathology. The certified cause of death was cardiac dysrhythmia due to ischemic heart disease. Thioridazine was considered as a possible contributing factor. 

Interactions. Several types of drug interfere with lithium excretion by the renal tubules, causing the plasma concentration to rise. These include diuretics (thiazides more than loop type), ACE inhibitors and angiotensin-11 antagonists, and nonsteroidal anti-inflammatory analgesics. Theophylline and sodium-containing antacids reduce plasma lithium concentration. The effects can be important because lithium has such a low therapeutic ratio. Diltiazem, verapamil, carbamazepine and pheny-toin may cause neurotoxicity without affecting the plasma lithium. Concomitant use of thioridazine should be avoided as ventricular arrhythmias may result. 

The postmortem blood concentration of carbamazepine has been reported in a case of suicide attributed to mixed drug toxicity with carbamazepine, lamotrigine, paroxetine, and thioridazine (86). It was 76 pmol/l. 

Sulfonamides, penicillins, diclofenac, oxyphenbutazone, piroxicam, phenytoin, carbamazepine (Same as for erythema multiforme) penicillamine, captopril, piroxicam, penicillins, rifampicin Frusemide, penicillamine, penicillin, PUVA therapy Immunosuppressants, mexiletine, thioridazine, penicillamine, moduretic , atenolol, quinacrine... 

Antidepressants mirtazapine, nefazodone, sertraline Neuroleptics thioridazine, haloperidol, clozapine, quetiapine, risperidone, sertindole, ziprasidone Mood stabilizers carbamazepine, gabapentin, lamotrigine... 

Extracted allobarbital, azinphos, barbital, brallobarbitone, bromazepam, butethal, caffeine, carbamazepine, ceirbaryl, cephaloridine, chloramphenicol, cblordiazepoxide, chlorothiazide, chlorvinphos, clothiapine, cocaine, coomassie blue, desipramine, diazepam, diphenhydramine, dipipanone, ethylbromphos, flufenamic acid, formothion, griseofiilvin, indomethacin, lidocaine, lorazepam, malatbion, medazepam, midazolam, oxazepam, par-aoxon, penicillin G, pentobarbital, prazepam, propoxyphene, prothiophos, quinine, salicylic acid, secobarbital, strychnine, sulfamethoxazole, theophylline, thiopental, thioridazine, trimethoprim... 

Also analyzed acebutolol, acepromazine, acetaminophen, acetazolamide, acetophenazine, albuterol, amitriptyline, amobarbital, amoxapine, antipsrrine, atenolol, atropine, azata-dine, baclofen, benzocaine, bromocriptine, brompheniramine, brotizolam, bupivacaine, buspirone, butabarbital, butalbital, caffeine, carbamazepine, cetirizine, chlorqyclizine, chlordiazepoxide, chlormezanone, chloroquine, chlorpheniramine, chlorpromazine, chlorpropamide, chlorprothixene, chlorthalidone, chlorzoxazone, cimetidine, cisapride, clomipramine, clonazepam, clonidine, clozapine, cocaine, codeine, colchicine, qyclizine, (yclo-benzaprine, dantrolene, desipramine, diazepam, diclofenac, diflunisal, diltiazem, diphenhydramine, diphenidol, dipheno late, dipyridamole, disopyramide, dobutamine, doxapram, doxepin, droperidol, encainide, ethidium bromide, ethopropazine, fenoprofen, fentanyl, flavoxate, fluoxetine, fluphenazine, flurazepam, flurbiprofen, fluvoxamine, fii-rosemide, glutethimide, glyburide, guaifenesin, haloperidol, homatropine, hydralazine, hydrochlorothiazide, hydrocodone, hydromorphone, hydro g chloroquine, hydroxyzine, ibuprofen, imipramine, indomethacin, ketoconazole, ketoprofen, ketorolac, labetalol, le-vorphanol, lidocaine, loratadine, lorazepam, lovastatin, loxapine, mazindol, mefenamic acid, meperidine, mephenytoin, mepivacaine, mesoridazine, metaproterenol, methadone, methdilazine, methocarbamol, methotrexate, methotrimeprazine, methoxamine, methyl-dopa, methylphenidate, metoclopramide, metolazone, metoprolol, metronidazole, midazolam, moclobemide, morphine, nadolol, nalbuphine, naloxone, naphazoline, naproxen, nifedipine, nizatidine, norepinephrine, nortriptyline, oxazepam, oxycodone, oxymetazo-line, paroxetine, pemoline, pentazocine, pentobarbital, pentoxifylline, perphenazine, pheniramine, phenobarbital, phenol, phenolphthalein, phentolamine, phenylbutazone, phenyltoloxamine, phenytoin, pimozide, pindolol, piroxicam, pramoxine, prazepam, prazosin, probenecid, procainamide, procaine, prochlorperazine, procyclidine, promazine, promethazine, propafenone, propantheline, propiomazine, propofol, propranolol, protriptyline, quazepam, quinidine, quinine, racemethorphan, ranitidine, remoxipride, risperidone, salicylic acid, scopolamine, secobarbital, sertraline, sotalol, spironolactone, sulfinpyrazone, sulindac, temazepam, terbutaline, terfenadine, tetracaine, theophylline, thiethyl-perazine, thiopental, thioridazine, thiothixene, timolol, tocainide, tolbutamide, tolmetin, trazodone, triamterene, triazolam, trifluoperazine, triflupromazine, trimeprazine, trimethoprim, trimipramine, verapamil, warfarin, xylometazoline, yohimbine, zopiclone... 

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