7 Interactions found for:
Drug Interactions
Moderate
Lisinopril
+ Januvia
The following applies to the ingredients: Lisinopril and Sitagliptin (found in Januvia)
Using SITagliptin together with lisinopril may cause angioedema, a condition associated with swelling of the face, eyes, lips, tongue, throat, and occasionally also the hands and feet. Each medication alone can also cause angioedema, but the risk may be increased when they are combined. Angioedema can occur with the first dose of medication or after many doses. You should discontinue the medications and seek immediate medical attention if you develop symptoms of angioedema or have difficulty swallowing or breathing. In addition, lisinopril may enhance the effects of SITagliptin and increase the risk of hypoglycemia (low blood sugar). Symptoms of low blood sugar include headache, dizziness, drowsiness, nausea, hunger, tremor, weakness, sweating, and fast or pounding heartbeats. You may need a dose adjustment or more frequent monitoring of your blood sugar if you have been using SITagliptin and are starting treatment with lisinopril. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Drug and Food Interactions
Moderate
Lisinopril
+ Food
The following applies to the ingredients: Lisinopril
It is recommended that if you are taking lisinopril you should be advised to avoid moderately high or high potassium dietary intake. This can cause high levels of potassium in your blood. Do not use salt substitutes or potassium supplements while taking lisinopril, unless your doctor has told you to.
The following applies to the ingredients: Lisinopril
Lisinopril and ethanol may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Moderate
Januvia
+ Food
The following applies to the ingredients: Sitagliptin (found in Januvia)
Alcohol may affect blood glucose levels in patients with diabetes. Both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) may occur, depending on how much and how often you drink. You should avoid using alcohol if your diabetes is not well controlled or if you have high triglycerides, neuropathy (nerve damage), or pancreatitis. Moderate alcohol consumption generally does not affect blood glucose levels if your diabetes is under control. However, it may be best to limit alcohol intake to one drink daily for women and two drinks daily for men (1 drink = 5 oz wine, 12 oz beer, or 1.5 oz distilled spirits) in conjunction with your normal meal plan. Avoid drinking alcohol on an empty stomach or following exercise, as it may increase the risk of hypoglycemia. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Drug and Pregnancy Interactions
Major
Lisinopril
+ Pregnancy
The following applies to the ingredients: Lisinopril
Professional Content
AU: Use is contraindicated.
UK: Use is not recommended during the first trimester and use is contraindicated during the second and third trimesters.
US: This drug should not be used during pregnancy unless there are no alternatives and the benefit outweighs the risk to the fetus.
AU TGA pregnancy category: D
US FDA pregnancy category: Not assigned
Risk Summary: Use of drugs that act on the renin angiotensin system (RAS) during the second and third trimesters of pregnancy increases fetal and neonatal morbidity and death.
Comments:
-Adequate methods of contraception should be encouraged.
-Advise pregnant women and females of reproductive potential of the potential risk to a fetus.
Animal studies have revealed evidence of fetotoxicity. In humans, exposure to angiotensin-converting enzyme (ACE) inhibitors during the second and third trimesters has revealed evidence of fetal and neonatal toxicity and fetolethality. There are no controlled data in human pregnancy.
AU TGA pregnancy category D: Drugs which have caused, are suspected to have caused or may be expected to cause, an increased incidence of human fetal malformations or irreversible damage. These drugs may also have adverse pharmacological effects. 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
- "Product Information. Prinivil (lisinopril)." Merck & Co., Inc PROD (2002):
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Pharmaceutical Society of Australia "APPGuide online. Australian prescription products guide online. http://www.appco.com.au/appguide/default.asp" (2006):
- Cerner Multum, Inc. "Australian Product Information." O 0
Major
Januvia
+ Pregnancy
The following applies to the ingredients: Sitagliptin (found in Januvia)
Professional Content
Use is not recommended unless the benefit outweighs the risk to the fetus
AU TGA pregnancy category: B3
US FDA pregnancy category: Not assigned
Risk Summary: Limited data available with this drug in pregnant women are not sufficient to inform a drug-associated risk for major birth defects and miscarriage; there are risks to the mother and fetus associated with poorly controlled diabetes during pregnancy.
Comments: In the US, Merck Sharp & Dohme Corporation maintains a pregnancy registry to monitor pregnancy outcomes of women exposed to this drug while pregnant; health care providers are encouraged to report any prenatal exposure (1-800-989-8999).
Studies in rats and rabbits with doses approximately 30 and 20-times the maximum recommended human dose (MRHD), respectively did not adversely affect developmental outcomes. At doses up to 100 times MRHD, an increase in the incidence of rib malformations was observed. Placental transfer was observed in pregnant rats and rabbits. There are no adequate and well-controlled studies in pregnancy women.
AU TGA pregnancy category B3: Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed. Studies in animals have shown evidence of an increased occurrence of fetal damage, the significance of which is considered uncertain in humans.
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
- "Product Information. Januvia (sitagliptin)." Merck & Co., Inc (2006):
- Cerner Multum, Inc. "Australian Product Information." O 0
Drug and Breastfeeding Interactions
Major
Lisinopril
+ Breastfeeding
The following applies to the ingredients: Lisinopril
Professional Content
A decision should be made to discontinue nursing 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
Comments:
-ACE inhibitors have the potential to adversely affect a nursing infant.
References
- "Product Information. Prinivil (lisinopril)." Merck & Co., Inc PROD (2002):
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Pharmaceutical Society of Australia "APPGuide online. Australian prescription products guide online. http://www.appco.com.au/appguide/default.asp" (2006):
- Cerner Multum, Inc. "Australian Product Information." O 0
Major
Januvia
+ Breastfeeding
The following applies to the ingredients: Sitagliptin (found in Januvia)
Professional Content
US: Use caution
AU and UK: Use is not recommended.
Excreted into human milk: Unknown
Excreted into animal milk: Yes
The effects in the nursing infant are unknown
This drug is secreted in the milk of lactating rats at milk to plasma ratio of 4:1. Pups of rats administered this drug at 1000 mg/kg/day from gestation day 6 through lactation day 20 showed reduced birth weight and postnatal weight gain (observed prior to and after weaning). No functional or behavioral toxicity was observed. Due to lack of human data, an alternate drug may be preferred.
References
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- "Product Information. Januvia (sitagliptin)." Merck & Co., Inc (2006):
- Cerner Multum, Inc. "Australian Product Information." O 0
- United States National Library of Medicine "Toxnet. Toxicology Data Network. http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT" (2013):
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: Professional 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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