Interactions : אינטראקציות

4.5 Interaction with other medicinal products and other forms of interaction

Contraindications of concomitant use
- Levodopa, antiparkinson medicines (including ropinirole): reciprocal antagonism of effects between levopoda or antiparkinsonian medicines (including ropinirole) and neuroleptics (see section 4.3).
Concomitant use not recommended:
- Alcohol: alcohol may potentiate the sedative effects of neuroleptics.
Consumption of alcoholic drinks and medicines containing alcohol must be avoided.
-   Combination with drugs that may prolong the QT interval or induce torsade de pointes (see section 4.4):
− Bradycardia-inducing medicines such as beta-blockers, calcium channel blockers and bradycardia-inducing medicines such as diltiazem and verapamil, clonidine, guanfacine; digitalis.
− Drugs that induce electrolyte imbalance, in particular those causing hypokalaemia: hypokalaemic diuretics, stimulant laxatives,
amphotericin B IV, glucocorticoids, tetracosactides. Hypokalaemia must be corrected.
− Class Ia antiarrhythmics such as quinidine and disopyramide.
− Class III antiarrhythmics such as amiodarone and sotalol.
− Other drugs such as pimozide, sultopride, haloperidol, thioridazine; methadone, imipramine antidepressants; lithium, bepridil, cisapride, erythromycin IV, vincamine IV, halofantrine, pentamidine and sparfloxacin.

Interactions to be considered:
− Antihypertensive agents: antihypertensive effect and the possibility of increasing the occurrence of postural hypotension (additive effect).

−   CNS depressants including narcotics, analgesics, sedative H1 antihistamines, barbiturates, benzodiazepines and other anxiolytics, clonidine and derivatives.

−   Antacids or sucralfate: the absorption of sulpiride is decreased after coadministration. Therefore, Modal Capsules or Modal Forte Tablets must be administered at least two hours before antacids.

−   Lithium: lithium increases the risk of extrapyramidal adverse effects.
Discontinuation of both medicines at the first sign of neurotoxicity is recommended.

−   Modal Capsules and Modal Forte Tablets may modify response to metoclopramide therapy.