1 Drug-Drug Interaction Detected
Major: potassium chloride and tolterodine
* The interaction is due to tolterodine which is a component of Detrol LA
GENERALLY AVOID: Concomitant use of agents with anticholinergic properties (e.g., antihistamines, antispasmodics, neuroleptics, phenothiazines, skeletal muscle relaxants, tricyclic antidepressants, class IA antiarrhythmics especially disopyramide) may potentiate the risk of upper gastrointestinal mucosal damage associated with oral solid formulations of potassium chloride. The proposed mechanism involves increased gastrointestinal transit time due to reduction of stomach and intestinal motility by anticholinergic agents, thereby increasing the contact time of potassium chloride with GI mucosa. In clinical studies, coadministration of wax-matrix or microencapsulated formulations of potassium chloride with an anticholinergic agent such as glycopyrrolate resulted in more frequent and more serious endoscopic lesions than potassium therapy alone. However, the lesions were not accompanied by bleeding or epigastric symptoms. Some studies have reported a higher incidence of upper GI lesions with wax-matrix than microencapsulated formulations, although data are conflicting.
MANAGEMENT: Use of agents with anticholinergic properties at sufficient doses to exert anticholinergic effects should be avoided in patients treated with oral solid formulations of potassium chloride (U.S. manufacturers of potassium chloride consider this combination to be contraindicated). Alternatively, a liquid formulation of potassium chloride may be considered. Patients prescribed a solid oral formulation should be advised to discontinue potassium therapy and contact their physician if they experience potential symptoms of upper GI injury such as severe vomiting, abdominal pain, distention, and gastrointestinal bleeding.
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