5 Interactions found for:
Drug Interactions
No drug interactions were found for selected drugs: Eliquis, Metoprolol Succinate ER.
This does not necessarily mean no interactions exist. Always consult your healthcare provider.
Drug and Food Interactions
Moderate
Metoprolol Succinate Er
+ Food
The following applies to the ingredients: Metoprolol (found in Metoprolol Succinate Er)
ADJUST DOSING INTERVAL: The bioavailability of metoprolol may be enhanced by food.
MANAGEMENT: Patients may be instructed to take metoprolol at the same time each day, preferably with or immediately following meals.
References
- "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals PROD (2001):
- Darcy PF "Nutrient-drug interactions." Adverse Drug React Toxicol Rev 14 (1995): 233-54
The following applies to the ingredients: Metoprolol (found in Metoprolol Succinate Er)
ADJUST DOSING INTERVAL: Concurrent administration with calcium salts may decrease the oral bioavailability of atenolol and possibly other beta-blockers. The exact mechanism of interaction is unknown. In six healthy subjects, calcium 500 mg (as lactate, carbonate, and gluconate) reduced the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of atenolol (100 mg) by 51% and 32%, respectively. The elimination half-life increased by 44%. Twelve hours after the combination, beta-blocking activity (as indicated by inhibition of exercise tachycardia) was reduced compared to that with atenolol alone. However, during a 4-week treatment in six hypertensive patients, there was no difference in blood pressure values between treatments. The investigators suggest that prolongation of the elimination half-life induced by calcium coadministration may have led to atenolol cumulation during long-term dosing, which compensated for the reduced bioavailability.
MANAGEMENT: It may help to separate the administration times of beta-blockers and calcium products by at least 2 hours. Patients should be monitored for potentially diminished beta-blocking effects following the addition of calcium therapy.
References
- Kirch W, Schafer-Korting M, Axthelm T, Kohler H, Mutschler E "Interaction of atenolol with furosemide and calcium and aluminum salts." Clin Pharmacol Ther 30 (1981): 429-35
Drug and Pregnancy Interactions
Major
Metoprolol Succinate Er
+ Pregnancy
The following applies to the ingredients: Metoprolol (found in Metoprolol Succinate Er)
US: This drug should be used during pregnancy only if clearly needed.
AU and UK: Use is not recommended unless benefit outweighs risk; if used during pregnancy, administer the lowest possible dose and discontinue at least 2 to 3 days prior to expected delivery, if possible.
AU TGA pregnancy category: C
US FDA pregnancy category: C
Animal studies have revealed increased postimplantation loss, fetolethality, and decreased neonatal survival. There are no controlled data in human pregnancy.
AU TGA pregnancy category C: Drugs which, owing to their pharmacological effects, have caused or may be suspected of causing, harmful effects on the human fetus or neonate without causing malformations. These effects may be reversible. Accompanying texts should be consulted for further details.
US FDA pregnancy category C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
References
- "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals PROD (2001):
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
Major
Eliquis
+ Pregnancy
The following applies to the ingredients: Apixaban (found in Eliquis)
Use is not recommended.
AU TGA pregnancy category: C
US FDA pregnancy category: Not assigned.
Risk Summary: Insufficient data exists to inform drug-associated risks of major birth defects, miscarriage, or adverse developmental outcomes.
Comments:
-Treatment can cause uterine bleeding, that may require gynecological surgical intervention.
-Treatment can cause placental hemorrhage and subsequent fetal loss.
-This drug may increase the risk of bleeding in the fetus and neonate.
-Females of reproductive potential that require anticoagulation should discuss pregnancy planning options with their healthcare provider.
Animal studies have failed to reveal evidence of adverse developmental effects. There are no controlled data in human pregnancy.
Use of this drug during labor or delivery in women receiving neuraxial anesthesia may result in epidural or spinal hematomas.
AU TGA pregnancy category C: Drugs which, owing to their pharmacological effects, have caused or may be suspected of causing, harmful effects on the human fetus or neonate without causing malformations. These effects may be reversible. Accompanying texts should be consulted for further details.
US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out.
References
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
- "Product Information. Eliquis (apixaban)." Bristol-Myers Squibb Canada Inc (2012):
Drug and Breastfeeding Interactions
Major
Metoprolol Succinate Er
+ Breastfeeding
The following applies to the ingredients: Metoprolol (found in Metoprolol Succinate Er)
AU and UK: Use is not recommended unless benefit outweighs risk.
US: This drug has been used without apparent harmful effects; caution is recommended.
Excreted into human milk: Yes (in small amounts)
Comments: This drug has been used without apparent harmful effects in the nursing infant.
An infant consuming 1 L of breast milk a day would receive a dose of less than 1 mg of drug.
References
- "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals PROD (2001):
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
Major
Eliquis
+ Breastfeeding
The following applies to the ingredients: Apixaban (found in Eliquis)
A decision should be made to discontinue breast-feeding or discontinue the drug, taking into account the importance of the drug to the mother.
Excreted into human milk: Unknown
Excreted into animal milk: Yes
The effects in the nursing infant are unknown.
Animal studies in lactation did not result in death of offspring. The drug was excreted in the milk of the animal model at a high milk to plasma ratio, possibly due to active transport.
References
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
- "Product Information. Eliquis (apixaban)." Bristol-Myers Squibb Canada Inc (2012):
Therapeutic Duplication Warnings
No warnings were found for your selected drugs.Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
Switch to: Consumer Interactions
| Drug Interaction Classification | |
|---|---|
These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication. |
|
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
| Unknown | No interaction information available. |
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