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What Are The Interactions When Levothyroxine, Cyclosporine, Imbruvica And Olmesartan Are Taken Together?
Question: I am checking on the combinations of medicine my mother is taking: they include:
Pantroprazole/ 20 mg in am
Olmesartan/hctz 20-12.5mg
Levothyroxine 100mg daily
Cyclosporine 50mg am and 50mg pm
Imbruvica 1 tab daily 140mg
YYYY@YYYY
She seems to be very forgetful and regressing to a childlike stage. She also seems very depressed.
Can you tell me if there is any danger in the combination of the above medicines?
Pantroprazole/ 20 mg in am
Olmesartan/hctz 20-12.5mg
Levothyroxine 100mg daily
Cyclosporine 50mg am and 50mg pm
Imbruvica 1 tab daily 140mg
YYYY@YYYY
She seems to be very forgetful and regressing to a childlike stage. She also seems very depressed.
Can you tell me if there is any danger in the combination of the above medicines?
Brief Answer:
Mostly moderate interactions
Detailed Answer:
Hello,
Thank you for using HCM to post your question.
I read it carefully and I understand your concern.
I checked all the interactions of the drugs and seems like there are not severe interactions but moderate ones.
Cyclosporine is the drug which interacts with almost everyone of the drugs. For example: Using cyclosporine together with olmesartan may increase potassium levels in the blood. High levels of potassium can develop into a condition known as hyperkalemia, which in severe cases can lead to kidney failure, muscle paralysis, irregular heart rhythm, and cardiac arrest. So your mother should check regularly the Potassium levels in the blood.
Also using pantoprazole together with hydrochlorothiazide may cause a condition called hypomagnesemia, or low blood magnesium. In severe cases, hypomagnesemia can lead to irregular heart rhythm, palpitations, muscle spasm, tremor, or seizures.
Using cyclosporine together with hydrochlorothiazide can increase magnesium and uric acid blood levels. Using these medications together can also damage the kidneys.
There are other interactions as well. But basically, the most important thing to keep in mind while being under this medications its to check the electrolytes levels regularly and adjust the dosage. There is a risk of side effects with every medicine but we need to outweight the benefits toward the risks and be constantly under medical suppervision.
Hope this is helpful.
Let me know if you need more clarifications.
Otherwise please kindly close and rate the answer.
Regards,
Dr.Papaqako
Mostly moderate interactions
Detailed Answer:
Hello,
Thank you for using HCM to post your question.
I read it carefully and I understand your concern.
I checked all the interactions of the drugs and seems like there are not severe interactions but moderate ones.
Cyclosporine is the drug which interacts with almost everyone of the drugs. For example: Using cyclosporine together with olmesartan may increase potassium levels in the blood. High levels of potassium can develop into a condition known as hyperkalemia, which in severe cases can lead to kidney failure, muscle paralysis, irregular heart rhythm, and cardiac arrest. So your mother should check regularly the Potassium levels in the blood.
Also using pantoprazole together with hydrochlorothiazide may cause a condition called hypomagnesemia, or low blood magnesium. In severe cases, hypomagnesemia can lead to irregular heart rhythm, palpitations, muscle spasm, tremor, or seizures.
Using cyclosporine together with hydrochlorothiazide can increase magnesium and uric acid blood levels. Using these medications together can also damage the kidneys.
There are other interactions as well. But basically, the most important thing to keep in mind while being under this medications its to check the electrolytes levels regularly and adjust the dosage. There is a risk of side effects with every medicine but we need to outweight the benefits toward the risks and be constantly under medical suppervision.
Hope this is helpful.
Let me know if you need more clarifications.
Otherwise please kindly close and rate the answer.
Regards,
Dr.Papaqako
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you, your response was very helpful. Is there an alternate drug for Cyclosporine that could be used that would have a better interaction with these drugs?
What is the normal potassium level for a female age 76 ?
She has kidney failure stage IV Is this dangerous, is there a reverse for the damage?
She also has a history of a heart attack in her mid 50's
Thank you for your help
XXXX
What is the normal potassium level for a female age 76 ?
She has kidney failure stage IV Is this dangerous, is there a reverse for the damage?
She also has a history of a heart attack in her mid 50's
Thank you for your help
XXXX
Brief Answer:
Switched drugs will depend on many general health factors
Detailed Answer:
Hello,
Thank you for the follow-up question.
Cyclosporine it is a very complex drug, used for many problems. It will depend on the specific details of her problem that she is taking it and her general health, so that cyclosporine can be switched and that she can use something else. I am sure the doctors follow her up well. So only they know what she needs to take. So my best help I can give to you its to recommend talking this through with them.
The normal levels of potassium are 3.5-5.2 mmol/l.
Kidney failure it is not reversible but can be kept under control.
Regards,
Dr.Papaqako
Switched drugs will depend on many general health factors
Detailed Answer:
Hello,
Thank you for the follow-up question.
Cyclosporine it is a very complex drug, used for many problems. It will depend on the specific details of her problem that she is taking it and her general health, so that cyclosporine can be switched and that she can use something else. I am sure the doctors follow her up well. So only they know what she needs to take. So my best help I can give to you its to recommend talking this through with them.
The normal levels of potassium are 3.5-5.2 mmol/l.
Kidney failure it is not reversible but can be kept under control.
Regards,
Dr.Papaqako
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Nagamani Ng
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