Low white blood cell levels may increase your risk for infection. If you notice any signs of infection e. ACE inhibitors such as cilazapril may cause severe harm or death to the developing baby if taken by the mother during pregnancy.

This medication should not be used during pregnancy. If you become pregnant while taking this medication, stop taking it immediately and contact your doctor. Hydrochlorothiazide passes into breast milk. It is not known if cilazapril passes into breast milk.

If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

The safety and effectiveness of using this medication have not been established for children. Its use by this age group is not recommended. Do not take it. I've been using Ativan every so often for six years. I hadn't taken it in ages but had a panic attack tonight and I feel really good now after taking it. I know when my anxiety was a lot worse, it didn't bring me down to 0 anxiety but took the edge off.

At one point in the past I was taking it pretty much daily but never became dependent on it I only take the 0. Dosage adjustment of the antidiabetic drug may be required.

Metformin should be used with caution because of the risk of lactic acidosis induced by possible functional renal failure linked to hydrochlorothiazide. Other antihypertensive drugs Additive effect. Cholestyramine and colestipol resins Absorption of hydrochlorothiazide is impaired in the presence of anionic exchange resins. Single doses of either cholestyramine or colestipol resins bind the hydrochlorothiazide and reduce its absorption from the gastrointestinal tract by up to 85 and 43 percent, respectively.

Skeletal muscle relaxants, nondepolarizing e. Lithium Diuretic agents reduce the renal clearance of lithium and add a high risk of lithium toxicity; concomitant use is not recommended. Medicinal products used in the treatment of gout probenecid, sulfinpyrazone and allopurinol Dosage adjustment of uricosuric medicinal products may be necessary since hydrochlorothiazide may raise the level of serum uric acid. Increase in dosage of probenecid or sulfinpyrazone may be necessary.

Coadministration of a thiazide may increase the incidence of hypersensitivity reactions to allopurinol. Salicylates In case of high dosages of salicylates hydrochlorothiazide may enhance the toxic effect of the salicylates on the central nervous system.

Methyldopa There have been isolated reports of haemolytic anaemia occurring with concomitant use of hydrochlorothiazide and methyldopa.

Cyclosporin Concomitant treatment with cyclosporin may increase the risk of hyperuricaemia and gout-type complications. Digitalis glycosides Thiazide-induced hypokalaemia or hypomagnesaemia may favour the onset of digitalis-induced cardiac arrhythmias. Calcium salts Thiazide diuretics may increase serum calcium levels due to decreased excretion.

If calcium supplements must be prescribed, serum calcium levels should be monitored and calcium dosage should be adjusted accordingly.

Laboratory Test Interactions Because of their effects on calcium metabolism, thiazides may interfere with tests for parathyroid function see section 4. And secondly, because I don't need to read about how bad high BP is to your health, and what can happen to you if you don't take care of it.

I don't mind the lecture about nutrition, but I'm sure I can find the same information on a google search. Anyway, thanks again for this thread. It really made me feel good, supported and understood. Love you guys and gals. This is nice because you only need to take 1 tablet a day. The downside is it's a high tier drug for insurance companies its price is really up there. I found the drug easy to tolerate, and experience limited side effects.

Read More He has also prescribed Metoprolol Tartrate 25 mg twice a day. If this medicine lowers my BP will it not be dangerously low? Prior to cartroid artery surgery, I took a beta blocker like this and my BP dropped to dangerous levels. Will this not happen again? I have no chest pains. The only time I had chest pains or pressure was during the stress test. I take regularly the xanax for over two weeks while the beta blocker occasionally - when I feel danger i.

In fact I had two crisis in the first week with xanax but I was then in a stressful situation at work. Luckily the heart beating and the shiver disappeared, probably due to the xanax and vit Bs.

Can you please advise me what doctor to visit: Coadministration may increase etoposide concentrations. Carvedilol is a P-glycoprotein substrate. Increased concentrations of carvedilol may occur if it is coadministered with etravirine; exercise caution. Carvedilol and simvastatin are both substrates and inhibitors of P-glycoprotein P-gp. In addition, increased concentrations of fentanyl may occur if it is coadministered with carvedilol; exercise caution. Carvedilol is a P-glycoprotein P-gp inhibitor and fentanyl is a P-gp substrate.

If these drugs are coadministered, the fentanyl dose may need to be very conservative, and the patient should be carefully monitored for an extended time period for signs of too much fentanyl such as oversedation, respiratory depression, and hypotension. Minor Increased concentrations of fexofenadine may occur if it is coadministered with carvedilol; exercise caution. Carvedilol is a P-glycoprotein P-gp inhibitor and fexofenadine is a P-gp substrate. Major If possible, do not start fingolimod in a patient who is taking a drug that slows the heart rate or atrioventricular conduction such as beta-blockers.

Use of these drugs during fingolimod initiation may be associated with severe bradycardia or heart block. Seek advice from the prescribing physician regarding the possibility to switch to drugs that do not slow the heart rate or atrioventricular conduction before initiating fingolimod. After the first fingolimod dose, overnight monitoring with continuous ECG in a medical facility is advised for patients who cannot stop taking drugs that slow the heart rate or atrioventricular conduction.

Experience with fingolimod in patients receiving concurrent therapy with drugs that slow the heart rate or atrioventricular conduction is limited. Major Pharmacologically, beta-blockers, like carvedilol, cause AV nodal conduction depression and additive effects are possible when used in combination with flecainide.

During flecainide clinical trials, increased adverse events have not been reported in patients receiving combination therapy with beta-blockers and flecainide. However, patients should be monitored closely and the dose should be adjusted according to clinical response. Patients receiving fluconazole concurrently with carvedilol should be monitored for bradycardia or heart block, especially when one agent is added to pre-existing treatment with the other.

Moderate Patients on beta-blockers are at an increased risk of adverse reaction when administered fluorescein injection. It is thought that beta-blockers may worsen anaphylaxis severity by exacerbating bronchospasm or by increasing the release of anaphylaxis mediators; alternately, beta-blocker therapy may make the patient more pharmacodynamically resistance to epinephrine rescue treatment.

Moderate Olanzapine may induce orthostatic hypotension and thus enhance the effects of antihypertensive agents. Major Avoid administering marijuana and beta-blockers together as concurrent use may result in decreased beta-blocker efficacy.

Marijuana is known to produce significant increases in heart rate and cardiac output lasting for hours. Further, rare case reports of myocardial infarction and cardiac arrhythmias have been associated with marijuana use.

These marijuana-induced cardiovascular effects may be detrimental to patients requiring treatment with beta-blockers; thus, coadministration of beta-blockers and marijuana should be avoided. Moderate Caution is advised when administering carvedilol with fosamprenavir, as concurrent use may result in elevated fosamprenavir and reduced carvedilol plasma concentrations.

Carvedilol is an inhibitor and substrate for the drug transporter P-glycoprotein P-gp. Amprenavir, the active metabolite of fosamprenavir, is a P-gp inducer and substrate. Moderate The increase in vagal tone induced by cholinesterase inhibitors, such as galantamine, may produce bradycardia or syncope. The vagotonic effect of galantamine may theoretically be increased when given with beta-blockers. Moderate Monitor for an increased incidence of carvedilol-related adverse effects if gefitinib and carvedilol are used concomitantly.

At high concentrations, gefitinib is an inhibitor of CYP2D6, which is partially responsible for the metabolism of carvedilol. The effect of gefitinib on CYP2D6-dependent drugs is only likely to be clinically relevant when given with CYP2D6 substrates with a narrow therapeutic index or that are individually dose titrated such as carvedilol.

Minor In vitro studies have demonstrated the positive inotropic effects of certain gingerol constituents of ginger; but it is unclear if whole ginger root exhibits these effects clinically in humans. It is theoretically possible that excessive doses of ginger could affect the action of inotropes; however, no clinical data are available. Moderate Caution is advised with the coadministration of glecaprevir and carvedilol as coadministration may increase serum concentrations of both drugs and increase the risk of adverse effects.

Glecaprevir and carvedilol are both substrates and inhibitors of P-glycoprotein P-gp. Moderate Caution is advised with the coadministration of pibrentasvir and carvedilol as coadministration may increase serum concentrations of both drugs and increase the risk of adverse effects. Both pibrentasvir and carvedilol are substrates and inhibitors of P-glycoprotein P-gp.

Minor Because beta-blockers blunt sympathomimetic-mediated hepatic gluconeogenesis, beta-blockers can inhibit the hyperglycemic actions of glucagon. In addition, intravenous administration of glucagon has been shown to have positive inotropic and chronotropic effects.

A transient increase in both blood pressure and pulse rate may occur following the administration of glucagon, especially in patients taking beta-blockers. Clinicians should be aware of these opposing pharmacologic actions of glucagon and beta-blockers.

Moderate Guanabenz can have additive effects when administered with other antihypertensive agents, including beta-blockers. Moderate Guanfacine can have additive effects when administered with other antihypertensive agents, including beta-blockers. Moderate Haloperidol should be used cautiously with carvedilol due to the possibility of additive hypotension. In addition, haloperidol inhibits CYP 2D6 and may increase plasma concentrations of carvedilol.

Moderate Hawthorn, Crataegus laevigata also known as C. Following hawthorn administration, the cardiac action potential duration is increased and the refractory period is prolonged. Hawthorn may also lower peripheral vascular resistance.

Patients with hypertension or heart failure should be advised to only use hawthorn with their prescribed medications after discussion with their prescriber.

Patients who choose to take hawthorn should receive periodic blood pressure and heart rate monitoring. Clinicians should use these drugs cautiously in patients stabilized on carvedilol. Moderate Beta-blockers may exacerbate hypertriglyceridemia and should be discontinued or changed to alternate therapy, if possible, prior to initiation of icosapent ethyl. Moderate Secondary to alpha-blockade, iloperidone can produce vasodilation that may result in additive effects during concurrent use with antihypertensive agents.

If concurrent use of iloperidone and antihypertensive agents is necessary, patients should be counseled on measures to prevent orthostatic hypotension, such as sitting on the edge of the bed for several minutes prior to standing in the morning and rising slowly from a seated position. Close monitoring of blood pressure is recommended until the full effects of the combination therapy are known. Moderate Additive reductions in blood pressure may occur when inhaled iloprost is administered to patients receiving other antihypertensive agents.

Minor Imatinib is a potent inhibitor of cytochrome P 2D6 and may increase concentrations of other drugs metabolized by this enzyme including carvedilol.

Caution is recommended when administering imatinib with carvedilol. Moderate Increased concentrations of indinavir may occur if it is coadministered with carvedilol; exercise caution. Carvedilol is a P-glycoprotein P-gp inhibitor and indinavir is a P-gp substrate. Moderate Although no pharmacokinetic interaction has been observed between beta-blockers and antidiabetic agents, patients receiving beta-blockers and insulin concomitantly should be closely monitored for an inappropriate response.

Moderate Increased concentrations of irinotecan may occur if it is coadministered with carvedilol; exercise caution. Carvedilol is a P-glycoprotein P-gp inhibitor and irinotecan is a P-gp substrate. Use caution if concomitant use is necessary and monitor for increased irinotecan side effects, including diarrhea, nausea, vomiting, and myelosuppression.

Moderate Additive hypotensive effects may be seen when monoamine oxidase inhibitors MAOIs are combined with antihypertensives. Careful monitoring of blood pressure is suggested during concurrent therapy of MAOIs with beta-blockers. Limited data suggest that bradycardia is worsened when MAOIs are administered to patients receiving beta-blockers.

Although the sinus bradycardia observed was not severe, until more data are available, clinicians should use MAOIs cautiously in patients receiving beta-blockers. Patients should be instructed to rise slowly from a sitting position, and to report syncope or changes in blood pressure or heart rate to their health care provider. Moderate Concurrent use of carvedilol and rifampin may result in decreased carvedilol concentrations and reduced beta-blocker efficacy.

Dosage must be individualized to the patient's response and tolerance. Monitor for signs of altered carvedilol response. Moderate Although concomitant therapy with beta-blockers and isradipine is generally well tolerated and can even be beneficial in some cases, coadministration of these agents can induce excessive bradycardia or hypotension. Isradipine when used in combination with beta-blockers, especially in heart failure patients, can result in additive negative inotropic effects.

Finally, angina has been reported when beta-adrenergic blocking agents are withdrawn abruptly when isradipine therapy is initiated. A gradual downward titration of the beta-adrenergic blocking agent dosage during initiation of isradipine therapy can minimize or eliminate this potential interaction.

Patients should be monitored carefully, however, for excessive bradycardia, cardiac conduction abnormalities, or hypotension when these drugs are given together.

In general, these reactions are more likely to occur with other non-dihydropyridine calcium channel blockers than with isradipine. Carvedilol and itraconazole are both substrates and inhibitors of P-glycoprotein P-gp.

Moderate Monitor heart rate if ivabradine is coadministered with other negative chronotropes like beta-blockers. Most patients receiving ivabradine will receive concomitant beta-blocker therapy.

Coadministration of drugs that slow heart rate increases the risk for bradycardia. Moderate Increased monitoring is recommended if ivacaftor is administered concurrently with CYP2C9 substrates, such as carvedilol. Co-administration of ivacaftor with CYP3A, CYP2C9, and Pgp substrates,such as carvedilol, can theoretically increase carvedilol exposure leading to increased or prolonged therapeutic effects and adverse events; however, the clinical impact of this has not yet been determined.

Minor Ixabepilone is a weak inhibitor of P-glycoprotein Pgp. Carvedilol is a Pgp substrate, and concomitant use of ixabepilone with a Pgp substrate may cause an increase in carvedilol concentrations. Use caution if ixabepilone is coadministered with a Pgp substrate. Moderate Lacosamide causes PR interval prolongation in some patients. Caution is advised during coadministration of lacosamide with other drugs that cause PR prolongation, such as beta-blockers, since further PR prolongation is possible.

If concurrent use is necessary, an ECG is recommended prior to initiation of lacosamide and after the drug is titrated to the maintenence dose.

Patients receiving intravenous lacosamide should be closely monitored due to the potential for profound bradycardia and AV block during coadministration. Moderate Concomitant administration of bradycardia-inducing drugs e. Adjust the beta-blocker dose if necessary. Moderate Concurrent administration of ledipasvir; sofosbuvir and carvedilol may result in elevated plasma concentrations of ledipasvir, sofosbuvir, and carvedilol.

All three are substrates for the drug transporter, P-glycoprotein P-gp , while both ledipasvir and carvedilol are also P-gp inhibitors.

According to the manufacturer, no dosage adjustments are required when ledipasvir; sofosbuvir is administered concurrently with P-gp inhibitors; however, if these drugs are given together, consider increased monitoring for potential adverse effect. For carvediolol, monitor heart rate and blood pressure as per standards of care Minor Coadministration of sofosbuvir and carvedilol may result in elevated sofosbuvir plasma concentrations.

Sofosbuvir is a substrate for the drug transporter P-glycoprotein P-gp ; carvedilol is a P-gp inhibitor. According to the manufacturer, no dosage adjustments are required when sofosbuvir is administered concurrently with P-gp inhibitors; however, if these drugs are given together, consider increased monitoring for potential adverse effect. Moderate Levomilnacipran has been associated with an increase in blood pressure.

The effectiveness of beta-blockers may be diminished during concurrent use of levomilnacipran. Moderate Linezolid is an antibiotic that is also a reversible, non-selective MAO inhibitor. Bradycardia may be worsened when MAO-inhibitors are co-administered to patients receiving beta-blockers. Use linezolid cautiously in patients receiving beta-blockers. Moderate Beta-blockers have been used to treat lithium-induced tremor. Because tremor may be a sign of lithium toxicity and may be masked by the coadministration of beta-blockers, patients should be monitored for other clinical signs of lithium toxicity if these medications are taken concurrently.

Other clinical signs of toxicity include: Limited data suggest that using propranolol, even in low doses, with lithium can lead to bradycardia and syncope.

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