Interaksi Obat (medscape pharmacy drug interaction checker)

Medscape Pharmacy Drug Interaction Checker

Tn. OB  65 th

Dx : Stroke Hemorologic

Tx : 

heparin                     P.O     1x1

nifedipine                 P.O     2x1

furosemide               P.O     2x1

spironolactone         P.O     2x1

phenytoin                 P.O     2x1

Serious - Use Alternative

 

 

• phenytoin + nifedipine

  phenytoin will decrease the level or effect of nifedipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Phenytoin decreases systemic exposure of nifedipine by about 70%

 

 

Monitor Closely

 

• heparin + phenytoin

  heparin increases levels of phenytoin by unknown mechanism. Use Caution/Monitor.
  

• phenytoin + heparin

  phenytoin, heparin. Other (see comment). Use Caution/Monitor. Comment: Hydantoin anticonvulsants increase anticoagulant effects at first, then decrease those effects with continued use (2+ wks). There are multiple mechanisms involved, including enzyme induction, plasma protein binding site competition, and additive effects on prothrombin time.
  

• spironolactone + furosemide

  spironolactone increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
  
  
  
  

Minor

 

• phenytoin + furosemide

  phenytoin decreases levels of furosemide by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.