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Common dental interactions

Dental Drug
Interacting Drug
common examples
Interaction
Recommendation
alcohol, antidipressants, opioids
Possible additive CNS, respiratory
limit maximum dose of LAs,
CNS Depressants
benbenzodiazipines, muscle relaxants,
depression
especially with opioids
antipsychotics, antihistimines
increased affect of vasoconstrictor
Avoid vasoconstrictor with patients
can result in cardiac arrest
under the influence of cocaine
amitriptyline
may enhance systemic actions
Avoid levonordefrin, norepinephrine;
Tricyclic antidepressants
of vasoconstrictors
Use epinephrine cautiously -
imipramine
as low a dose as possible
alcohol, cannibis, benzodiazepines
increased depressant effect
Observe for increased response to
CNS depressants
barbiturates, opioids, etc
of either drug
CNS depression, decrease dose of
Benzodiazipine if necessary
medazolam (Versed),
Increased respiratory depression
titrate dosages and monitor
Benzodiazepines
triazolam (Halcion),
increased recovery time
for excessive sedation
alprazolam (Xanax)
increased risk of hypotension
slows the metabolism of opioids
alcohol, cannibis, benzodiazepines
CNS Depressants
increased CNS depression
monitor for excess sedation
barbiturates, opioids, etc
Dental Drug
Interacting Drug
common examples
Interaction
Recommendation
Dental Drug
Interacting Drug
common examples
Interaction
Recommendation
Dental Drug
Interacting Drug
common examples
Interaction
Recommendation
avoid using erithromycin both
alfentanil
prolonged and enhanced respiratory
preoperatively and postoperatively
(opioid for sedation)
depression with erithromycin
when using alfentanil
carbamazepine
increased risk of ataxia,
avoid this combination if possible,
(anticonvulsant and mood
vertigo, drowsiness, and confusion
if not possible, consult M.D.
stabilizer)
with erithromycin and clarithromycin
increased immunosuppression
cyclosporine
ciclosporin A (immunosuppressant)
and nephrotoxicity
erithromycin can increase digoxin
Digitalis glycosides
Digoxin (lanoxin)
blood levels, leading to toxicity
(for atrial fibrillation and CHF)
Digitoxin (crystodigin)
and cardiac arrythmias
felodipine (plendil)
combining erithromycin and felodipine
(a calcium channel blocker)
can increase risk of hypotension,
tachycardia and edema
combining erithromycin and lovastatin
lovastatin (mevacor)
can cause muscle pain and skeletal
(for hypercholesterolemia)
muscle lysis
increased risk of tachycardia, cardiac
theophyllines
disrythmias, tremors and seizures with
(COPD and asthma treatment)
erithromycin and clarithromycin
erithromycin can cause increased
triazolam (halcion)
blood levels of triazoam and
medazolam (versed)
medazolam, increasing sedation
tetracycline can increase digoxin
Digitalis glycosides
Digoxin (lanoxin)
blood levels, leading to toxicity
avoid this combination
tetracycli
(for atrial fibrillation and CHF)
Digitoxin (crystodigin)
and cardiac arrythmias
Dental Drug
Interacting Drug
common examples
Interaction
Recommendation
clindamycin
cimetidine (tagement)
phenobarbitol
(a barbituate and commonly
used anticonvulsant)
phenytoin (a anti-epileptic)
psychotic reactions have been
Disulfiram
reported within 2 weeks of
(alcoholism treatment)
concurrent use
Theophyllines
(COPD and asthma treatment)
-th eateni
Aminophylline or Oxtriphylline
(bronchodilators)
phenytoin, ethotoin
hydantoin anticonvulsants
can increase phenytoin serum levels
avoid this combination
mephentoin, fosphenytoin
Dental Drug
Interacting Drug
common examples
Interaction
Recommendation
clindamycin
cimetidine (tagement)
phenobarbitol
(a barbituate and commonly
used anticonvulsant)
phenytoin (a anti-epileptic)
psychotic reactions have been
Disulfiram
reported within 2 weeks of
(alcoholism treatment)
concurrent use
Theophyllines
(COPD and asthma treatment)
-th eateni
Aminophylline or Oxtriphylline
(bronchodilators)
phenytoin, ethotoin
hydantoin anticonvulsants
can increase phenytoin serum levels
avoid this combination
mephentoin, fosphenytoin

Source: http://dentchat.files.wordpress.com/2013/01/common-dental-interactions1.pdf

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