Interactions : אינטראקציות

4.5   Interaction with other medicinal products and other forms of interaction

Administration of Compound Sodium Lactate in accordance with the recommended indications and contraindications does not increase the plasma concentrations of the electrolytes contained in it. In case there is a rise of any electrolyte’s concentration due to other reasons the following interactions should be considered.

•       Related to sodium
Corticoids/steroids and carbenoxolone may be associated with the retention of sodium and water (with oedema and hypertension).

•       Related to potassium
Suxamethonium, potassium-sparing diuretics (amilorid, spironolactone, triamteren, alone or in association), ACE inhibitors (e.g. captopril, enalapril), Angiotensin II receptor antagonists (e.g. valsartan, losartan), tacrolimus, cyclosporine may increase the concentration of potassium in the plasma and lead to potentially fatal hyperkalaemia notably in case of renal failure increasing the hyperkalaemic effect.
•        Related to calcium
-        Digitalis glycosides (cardiac glycosides) may undergo enhancement of their effects during hypercalcaemia and lead to serious or fatal cardiac arrhythmia.
-        Thiazid-diuretics and Vitamin D administered simultaneously with calcium may induce hypercalcaemia.
•        If bisphosphonates, fluorides, several fluorchinolones and tetracyclines are administered simultaneously with calcium containing solutions the bioavailablility (reduced absorption) of above named medicinal products may be reduced.

•        Related to lactate
The administration of bicarbonate or bicarbonate precursor like lactate leads to alkalini-sation of the urine with increased renal clearance of acidic drugs (e.g.
salicylic acid). The half life of basic medicinal products – especially sympathomimetics (e.g. ephedrine, pseudoephedrine) and stimulants (e.g.
dexamphetaminesulphate, fenfluramine hydrochloride) will be prolonged if lactate containing solutions are administered simultaneously.

•     Drugs leading to an increased vasopressin effect
The below listed drugs increase the vasopressin effect, leading to reduced renal electrolyte free water excretion and may increase the risk of hospital acquired hyponatraemia following inappropriately balanced treatment with i.v. fluids (see sections 4.2, 4.4 and 4.8).
–        Drugs stimulating vasopressin release include: Chlorpropamide, clofibrate, carbamazepine, vincristine, selective serotonin reuptake inhibitors, 3.4- methylenedioxy-N-methamphetamine, ifosfamide, antipsychotics, narcotics –        Drugs potentiating vasopressin action include: Chlorpropamide, NSAIDs, cyclophosphamide
–        Vasopressin analogues include: Desmopressin, oxytocin, vasopressin, terlipressin
–        Other medicinal products increasing the risk of hyponatraemia also include diuretics in general and antiepileptics such as oxcarbazepine.