Isoptin SR and Omeclamox-Pak

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Using verapamil and clarithromycin together can lower your blood pressure and slow your heart rate. This can cause a slow heartbeat, headaches, dizziness, or feeling like you might pass out. If you take both medications together, tell your doctor if you have any of these symptoms. You may need a dose adjustment or need your blood pressure checked more often if you take both medications. 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.

MONITOR: Coadministration with certain macrolide antibiotics may increase the plasma concentrations and pharmacologic effects of verapamil. The proposed mechanism is macrolide inhibition of CYP450 3A4, the isoenzyme responsible for hepatic first-pass and systemic metabolic clearance of verapamil. Macrolides that may significantly inhibit CYP450 3A4 include clarithromycin, erythromycin, and troleandomycin. Azithromycin and dirithromycin are generally believed to have little, if any, effect on CYP450 3A4. Clinically, the interaction is supported by isolated case reports of elderly patients stabilized on verapamil and other medications who developed symptoms of verapamil toxicity (e.g., hypotension, bradycardia, atrioventricular block) within 2 to 7 days after initiation of erythromycin or clarithromycin therapy. One of the patients also had QT interval prolongation, which may be induced by elevated levels of erythromycin secondary to inhibition of intestinal P-glycoprotein and CYP450 3A4 by verapamil. The interaction was also suspected in a 53-year-old woman who was started on verapamil and clarithromycin concurrently and developed bradycardia, dizziness, hypotension and fainting after 24 hours. In all cases, discontinuation or dosage reduction of verapamil in addition to supportive care led to resolution of symptoms.

MANAGEMENT: Caution is advised if verapamil must be used with clarithromycin, erythromycin or troleandomycin, particularly in susceptible patients such as the elderly or debilitated. Cardiac function and pharmacologic response to verapamil should be monitored more closely whenever the macrolide antibiotic is added to or withdrawn from therapy in patients stabilized on their verapamil regimen, and the dosage adjusted as necessary. Azithromycin and dirithromycin may be safer alternatives during therapy with verapamil.

Isoptin SR

Generic Name: verapamil

Brand name: Calan SR, Isoptin SR, Calan, Verelan, Isoptin, Isoptin IV, Covera-HS, Verelan PM

Synonyms: n.a.

What is Isoptin SR?

Omeclamox-Pak

Generic Name: amoxicillin / clarithromycin / omeprazole

Brand name: Omeclamox-Pak

Synonyms: n.a.

What is Omeclamox-Pak?