DRUG INTERACTIONS
Methyclothiazide
Hypokalemia can sensitize or exaggerate the response of the heart to the toxic effects of digitalis (e.g., increased ventricular irritability).
Hypokalemia may develop during concomitant use of steroids or ACTH.
Insulin requirements in diabetic patients may be increased, decreased, or unchanged.
Thiazides may decrease arterial responsiveness to norepinephrine. This diminution is not sufficient to preclude effectiveness of the pressor agent for therapeutic use.
Non-steroidal Anti-inflammatory Drugs – In some patients the administration of a non-steroidal anti-inflammatory agent can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium-sparing, and thiazide diuretics. Therefore, when Enduronyl tablets and non-steroidal anti-inflammatory agents are used concomitantly, the patient should be observed closely to determine if the desired effect of the diuretic is obtained.
Thiazide drugs may increase the responsiveness to tubocurarine.
Lithium renal clearance is reduced by thiazides, increasing the risk of lithium toxicity.
Thiazides may add to or potentiate the action of other antihypertensive drugs. Potentiation occurs with ganglionic or peripheral adrenergic blocking drugs.
Deserpidine
Use deserpidine cautiously with digitalis and quinidine since cardiac arrhythmias have occurred with rauwolfia preparations.
Hypotensive effects of rauwolfia alkaloids may be enhanced when used concurrently with other antihypertensive agents, diuretics, or phenothiazine derivatives, therefore, careful titration of dosage is necessary.
Additive CNS-depressant effects can occur when rauwolfia alkaloids are taken concomitantly with other CNS-depressant agents or alcohol.
Monoamine oxidase inhibitors should be avoided or used with extreme caution.
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