Caution in patients at known cardiac risk (eg, those w/ long QT syndrome, hypokalemia, treatment w/ any drug known to increase QT interval or inhibit CYP3A4 enzyme systems eg, azole antifungals & macrolide antibiotics). Only use systematically w/ great caution in patients w/ heart failure, recent MI or HTN, DM, epilepsy, glaucoma, hypothyroidism, hepatic failure, osteoporosis, peptic ulceration, psychoses or severe affective disorders & renal impairment. Use only during pregnancy if clearly needed. Not to be used during lactation.
Ebastine: Increased plasma levels w/ ketoconazole or erythromycin. Betamethasone: Metabolism may be enhanced & effects may be reduced w/ barbiturates, carbamazepine, phenytoin, primidone or rifampicin. Plasma conc may be increased w/ OCs or ritonavir. May cause excessive K loss w/ K-depleting diuretics eg, thiazides & furosemide. Increased risk of hypokalemia w/ amphotericin B or bronchodilator therapy w/ xanthines or β2-agonists. Potentially increased incidence of GI bleeding & ulceration w/ NSAIDs. May alter response to anticoagulants. May increase requirements of antidiabetic drugs & antihypertensives. May decrease serum conc of salicylates. May decrease effect in myasthenia gravis of antimuscarinics.
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