Halofantrine, pentamidine, sparfloxacin, moxifloxacin. There is a growing risk of ventricular arrhythmias, in particular, «torsade des pointes». If possible, you should cancel the antimicrobial agent, causing ventricular fibrillation. If the combination is unavoidable, pre-check the QT interval and monitor ECG. Combinations requiring caution drugs that cause bradycardia (blockers «slow» calcium edges with bradycardic action: diltiazem, halotestin tablets verapamil, beta-blockers, clonidine, guanfacine, cardiac glycosides, inhibitors cholinesterase: donepezil, rivastigmine, tacrine, ambenonium chloride, galantamine, pyridostigmine, neomycin methylsulfate: There is a growing risk of ventricular arrhythmias, in particular, «torsade des pointes»
It is recommended that clinical and cardiographic control.. Drugs that decrease in blood potassium concentration (kaliyvyvodyaschie diuretics , laxatives, stimulating character, amphotericin B (IV), glucocorticosteroids, tetrakozaktid. amplifies the risk of ventricular arrhythmias, in particular, «torsade des pointes». Before the appointment of the drug should be removed hypokalemia, establish clinical and cardiographic control, and monitoring the concentration of electrolytes. Combinations that should be taken into account antihypertensive drugs. Increased hypotensive action and increased the possibility of postural hypotension (additive effect). other medicines that suppress the central nervous system: derivatives of morphine (opioid analgesics, antitussives and substitution therapy), barbiturates, benzodiazepines and other anxiolytics, hypnotics, sedatives, antidepressants, sedatives blokatorg H 1 histamine receptors, antihypertensives central halotestin tablets action, baclofen, thalidomide, central nervous system depression. Violation of attention creates a danger for driving and using machinery that require attention. Sucralfate, antacids containing of Mg 2+ and / or Al 3+ , reduce bioavailability of dosage forms for oral administration is 20-40%. Sulpiride should be administered two hours prior to their admission.
Cautions Neuroleptic malignant syndrome: the development of hyperthermia of unknown etiology sulpiride should be abolished, as this may be one of the symptoms of neuroleptic malignant syndrome, as described in the application of neuroleptics (pallor, hyperthermia, autonomic dysfunction, impaired consciousness, muscle rigidity). Signs of autonomic dysfunction, such as sweating and labile blood pressure may precede the onset of hyperthermia and, therefore, represent the early warning signs. Although such action may have idiosyncratic neuroleptics origin, apparently certain risk factors can predispose to it, such as dehydration or organic brain damage. Increased QT interval: sulpiride prolongs QT interval in a dose dependent manner. This action, which is known to increase the risk of developing a serious ventricular arrhythmia as «torsade des pointes», is more pronounced in the presence of bradycardia, hypokalemia, or congenital or acquired prolongation of the interval halotestin tablets (combination with a drug that causes QT interval prolongation). If the clinical situation allows, it is recommended before prescribing the drug to ensure that there are no factors that could contribute to the development of this type of arrhythmia:
- bradycardia with a heart rate less than 55 beats / min.;
- congenital prolongation of the interval QT;
- simultaneous treatment of drug that can cause severe bradycardia (less than 55 u. / min), hypokalaemia, slowing of intracardiac conduction, or prolongation of the interval the QT.
Except for urgent intervention, patients who require treatment with neuroleptics, it is recommended to conduct the process of evaluating the status of the ECG. Apart from exceptional cases, this drug should not be used in patients with Parkinson’s disease.
In patients with impaired renal function should use lower doses of sulpiride and increase control; conducting intermittent courses of treatment is recommended in severe forms of renal failure. The control in the treatment of sulpiride should be strengthened:
- in patients with epilepsy, as the seizure threshold may be lowered;
- in the treatment of elderly patients who are more sensitive to postural hypotension, sedation and extrapyramidal effects.
During halotestin tablets treatment with Prosulpin ® prohibited from driving and operating machinery that require attention, as well as the use of alcohol or use medicines that contain alcohol.