diltiazem + tramadol

use alternative or monitor resp. rate, ECG, BP; consider decr. tramadol dose: combo may incr. tramadol, alter active metabolite levels, incr. risk of CNS and resp. depression, psychomotor impairment, seizures, serotonin syndrome, QT prolongation, cardiac arrhythmias, severe hypotension (incl. orthostasis, syncope), other adverse effects or decr. efficacy (hepatic metab. inhibited, may alter production of active metabolite; additive effects)

ethinyl estradiol (contraceptive) + tramadol

use alternative or monitor resp. rate, ECG, withdrawal sx: combo may incr. tramadol levels, risk of CNS and resp. depression, psychomotor impairment, seizures, serotonin syndrome, QT prolongation, cardiac arrhythmias, other adverse effects; may decr. active metabolite levels, efficacy (hepatic metab. inhibited, decr. conversion to active metabolite)

potassium acid phosphate + magnesium hydroxide

avoid combo or give phosphate 2h before: combo may decr. phosphate efficacy (absorption decreased)

diltiazem + epinephrine

monitor BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

diltiazem + ethinyl estradiol (contraceptive)

monitor BP, thrombosis s/sx, especially if oral ethinyl estradiol dose >35 mcg/day: combo may incr. ethinyl estradiol levels, risk of thromboembolism, other adverse effects; may decr. antihypertensive agent efficacy (hepatic metab. inhibited; antagonistic effects)

diltiazem + naphazoline ophthalmic

consider monitoring BP: combo may decr. antihypertensive agent efficacy (antagonistic effects)

epinephrine + glipizide

monitor glucose: combo may decr. antidiabetic agent efficacy (antagonistic effects)

epinephrine + metformin

monitor glucose: combo may decr. antidiabetic agent efficacy (antagonistic effects)

epinephrine + ethinyl estradiol (contraceptive)

monitor BP: combo may incr. risk of HTN (additive effects)

glipizide + ethinyl estradiol (contraceptive)

monitor glucose: combo may decr. antidiabetic agent efficacy (antagonistic effects)

glipizide + norethindrone (contraceptive)

monitor glucose: combo may decr. antidiabetic agent efficacy (antagonistic effects)

metformin + ethinyl estradiol (contraceptive)

monitor glucose: combo may decr. antidiabetic agent efficacy (antagonistic effects)

metformin + norethindrone (contraceptive)

monitor glucose: combo may decr. antidiabetic agent efficacy (antagonistic effects)

glipizide + magnesium hydroxide

monitor glucose: combo may incr. glipizide levels, risk of hypoglycemia, other adverse effects (absorption possibly increased at higher gastric pH)

glipizide + tramadol

monitor glucose: combo may incr. risk of severe hypoglycemia (additive effects)

potassium acid phosphate + tramadol

caution advised w/ solid potassium formulations; liquid potassium formulations OK: combo may incr. risk of GI ulcerative, stenotic lesions (GI transit delayed, increased local exposure to high potassium concentration)