A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Atromid-S Side Effects, and Drug Interactions - Clofibrate
Atromid-S Side Effects, and Drug Interactions - Clofibrate
SIDE EFFECTS
The most common is nausea. Less frequently encountered gastrointestinal reactions
are vomiting, loose stools, dyspepsia, flatulence, and abdominal distress. Reactions
reported less often than gastrointestinal ones are headache, dizziness, and
fatigue; muscle cramping, aching, and weakness; skin rash, urticaria, and pruritus;
dry brittle hair, and alopecia.
The following reported adverse reactions are listed alphabetically by systems:
Cardiovascular
Increased or decreased angina.
Cardiac arrhythmias.
Both swelling and phlebitis at site of xanthomas.
Dermatologic
Allergic reactions including urticaria.
Skin rash.
Pruritus.
Dry skin and dry, brittle hair.
Alopecia.
Toxic epidermal necrolysis.
Erythema multiforme.
Stevens-Johnson syndrome.
Gastrointestinal
Gallstones.
Nausea.
Vomiting.
Diarrhea.
Gastrointestinal upset (bloating, flatulence, abdominal distress).
Hepatomegaly (not associated with hepatotoxicity).
Stomatitis and gastritis.
Genitourinary
Findings consistent with renal dysfunction as evidenced by dysuria, hematuria,
proteinuria, decreased urine output. One patient's renal biopsy suggested
"allergic reaction."
Impotence and decreased libido.
Hematologic
Leukopenia.
Potentiation of anticoagulant effect.
Anemia.
Eosinophilia.
Agranulocytosis.
Musculoskeletal
Myalgia (muscle cramping, aching, weakness).
"Flu-like" symptoms.
Myositis.
Myopathy.
Rhabdomyolysis in the setting of preexisting renal insufficiency.
Arthralgia.
Neurologic
Fatigue, weakness, drowsiness.
Dizziness.
Headache.
Miscellaneous
Weight gain.
Polyphagia.
Laboratory Findings
Abnormal liver-function tests as evidenced by increased transaminase (SGOT
and SGPT), BSP retention, and increased thymol turbidity.
Proteinuria.
Increased creatine phosphokinase.
Hyperkalemia in association with renal insufficiency and continuous ambulatory
peritoneal dialysis treatment.
Reported adverse reactions whose direct relationship with the drug has not
been established: peptic ulcer, gastrointestinal hemorrhage, rheumatoid arthritis,
tremors, increased perspiration, systemic lupus erythematosus, blurred vision,
gynecomastia, thrombocytopenic purpura.
DRUG INTERACTIONS
Caution should be exercised when anticoagulants are given in conjunction with
Atromid-S. Usually, the dosage of the anticoagulant should be reduced by one-half
(depending on the individual case) to maintain the prothrombin time at the desired
level to prevent bleeding complications. Frequent prothrombin determinations
are advisable until it has been determined definitely that the prothrombin level
has been stabilized.
Atromid-S may displace acidic drugs such as phenytoin or tolbutamide from their
binding sites. Caution should be exercised when treating patients with either
of these drugs or other highly protein-bound drugs and Atromid-S. The hypoglycemic
effect of tolbutamide has been reported to increase when Atromid-S is given
concurrently.
Fulminant rhabdomyolysis has been seen as early as three weeks after initiation
of combined therapy with another fibrate and lovastatin but may be seen after
several months. For these reasons, it is felt that, in most subjects who have
had an unsatisfactory lipid response to either drug alone, the possible benefits
of combined therapy with lovastatin and a fibrate do not outweigh the risks
of severe myopathy, rhabdomyolysis, and acute renal failure. While it is not
known whether this interaction occurs with fibrates other than gemfibrozil,
myopathy and rhabdomyolysis have occasionally been associated with the use of
fibrates alone, including clofibrate. Therefore, the combined use of lovastatin
with fibrates should generally be avoided.
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