Amvasc Plus Drug Interactions

Amlodipine Besilate: Concomitant use of amlodipine with cimetidine, grapefruit juice, antacid (aluminum/magnesium hydroxide), or sildenafil had no significant effect on the pharmacokinetics of amlodipine.
Atorvastatin: Concomitant use resulted in no significant change in steady state pharmacokinetic parameters of atorvastatin.
Ciclosporin: Amlodipine does not significantly alter the pharmacokinetics of ciclosporin.
Digoxin: Concomitant use did not change the serum digoxin levels or digoxin renal clearance in normal volunteers.
Ethanol (Alcohol): Concomitant use had no significant effect on the pharmacokinetics of ethanol.
Warfarin: Concomitant use did not change the warfarin prothrombin response time.
Hydrochlorothiazide: Alcohol, Barbiturates, or Narcotics: Potentiation of orthostatic hypotension may be observed.
Amantadine: Increased risk of adverse effects.
Aminoglycoside Antibiotics: Diuretic-induced volume depletion can potentiate aminoglycoside nephrotoxicity.
Anticholinergic Agents (eg, Atropine, Biperidine): May increase availability of thiazide diuretics by decreasing gastrointestinal motility and stomach emptying rate.
Antidiabetic Drugs (Oral Agents and Insulin): Dosage adjustment of the antidiabetic drug may be necessary.
Cholestyramine and Colestipol Resins: HCTZ absorption is impaired in the presence of anionic exchange resins. Single doses of either cholestyramine or colestipol resins bind the HCTZ and reduce its absorption from the gastrointestinal tract by up to 85% and 43%, respectively.
Corticosteroids, ACTH: Intensified electrolyte depletion, particularly hypokalemia.
Cytotoxic Agents: Decreased renal excretion; increased myelosuppressive effects.
Pressor Amines (eg, Adrenaline): Possible decreased response to pressor amines but not sufficient to prevent their use.
Nondepolarizing Skeletal Muscle Relaxants (eg, Tubocurarine): Possible increased responsiveness to the muscle relaxant.
Lithium: Volume depletion increases lithium absorption and may cause lithium toxicity, unless levels are closely monitored and dosage reduced accordingly. Conversely, sudden stopping of diuretic treatment may result in a subtherapeutic level of circulating lithium.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) Including COX-2 Inhibitors: The administration of NSAIDs including selective COX-2 inhibitors can reduce the diuretic, natriuretic and antihypertensive effects of diuretics in some patients.
Other Antihypertensive Drugs: Additive effect.