Tikosyn interactions: Alcohol, medications, and other factors

Before you start treatment with Tikosyn, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Tikosyn interacts with supplements, herbs, or vitamins, see the “Tikosyn and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Tikosyn. Keep in mind that this table doesn’t include all drugs that may interact with Tikosyn. Some of these interactions are described in detail just below in “Drug interactions in depth.”

* For details about this interaction, see the “When to avoid Tikosyn” section below.
† To learn about Tikosyn’s side effects, see this article.
‡ For details about this interaction, see the “Drug interactions in depth” section below.

In some cases, factors or conditions could prevent your doctor from prescribing Tikosyn due to the risk of harm. These are known as contraindications. The contraindications of Tikosyn include:

Having long QT syndrome

Doctors typically won’t prescribe Tikosyn for people with long QT syndrome. This is a heart condition that can cause an arrhythmia (irregular heart rhythm).* Tikosyn may cause QT prolongation as a side effect, which could further increase the risk of arrhythmia in people with this condition.

If you have long QT syndrome, talk with your doctor before taking Tikosyn. They’ll likely prescribe a treatment other than Tikosyn for your condition.

* Tikosyn has a boxed warning about the risk of new or worsening arrhythmia. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see “Boxed warning” at the beginning of this article.

Having severe kidney disease

Doctors typically won’t prescribe Tikosyn for people with severe kidney disease, including kidney failure. It isn’t known for certain whether Tikosyn is safe for people with severe kidney disease.

If you have kidney disease, talk with your doctor before taking Tikosyn. They may suggest a different treatment option instead.

Taking certain drugs that affect the level of Tikosyn

Doctors typically won’t prescribe Tikosyn in combination with certain medications that increase the level of Tikosyn in your body. This is because taking Tikosyn with these drugs can raise your risk of side effects from Tikosyn. To learn about Tikosyn’s side effects, see this article.

Below are a few examples of drugs that can increase the level of Tikosyn:

• cimetidine (Tagamet HB)
• dolutegravir (Tivicay)
• hydrochlorothiazide (Microzide)
• ketoconazole
• megestrol (Megace ES)
• prochlorperazine (Compro, Procomp)
• sulfamethoxazole/trimethoprim (Bactrim, Septra, others)
• trimethoprim

Before you start treatment with Tikosyn, it’s important to tell your doctor about other medications you take. They can tell you whether it’s safe to take Tikosyn or whether a different treatment option should be prescribed instead.

Having had an allergic reaction to Tikosyn or any of its ingredients

If you’ve had an allergic reaction to Tikosyn or any of its ingredients, your doctor will likely not prescribe Tikosyn. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Before you start treatment with Tikosyn, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe Tikosyn.

There aren’t any known interactions between Tikosyn and alcohol. However, consuming alcohol while taking the drug may worsen some of Tikosyn’s side effects. Examples include nausea, headache, and dizziness. To learn more about Tikosyn’s side effects, you can read this article.

If you drink alcohol and have questions about drinking it during your treatment with Tikosyn, talk with your doctor or pharmacist.

Here’s a closer look at certain drug interactions of Tikosyn.

Metformin

Metformin (Fortamet, Glumetza) is prescribed for type 2 diabetes.

Interaction result. Taking Tikosyn with metformin can increase the risk of side effects from either drug.

Interaction explained. Your kidneys help clear Tikosyn and metformin from your body. When taken together, your kidneys may not clear both drugs as well as either drug alone. This could raise the level of Tikosyn or metformin in your body. A higher drug level increases your risk of side effects. To learn more about the side effects of Tikosyn, see this article.

Steps you or your doctor may take. Before starting Tikosyn treatment, tell your doctor if you take metformin. They’ll recommend whether it’s safe to take these medications together.

If your doctor tells you it’s safe, they may monitor you closely for side effects from either drug. They’ll tell you about symptoms to watch for and what to do if you have them.

To learn more about Tikosyn and metformin, talk with your doctor or pharmacist.

Certain antidepressants

Antidepressants are prescribed to treat depression and certain other mental health conditions.

Interaction result. Taking Tikosyn with certain antidepressants can increase the risk of side effects from either drug.

Interaction explained. When taken individually, Tikosyn and certain antidepressants may cause QT prolongation as a side effect. QT prolongation is a type of arrhythmia (irregular heart rhythm).* Taking these medications together further increases this risk. To learn more about the side effects of Tikosyn, see this article.

Examples of antidepressant drugs. Citalopram (Celexa) and escitalopram (Lexapro) are examples of antidepressants that may interact with Tikosyn.

Steps you or your doctor may take. Before taking Tikosyn, be sure your doctor knows if you’re taking an antidepressant. They can advise you on whether it’s safe to take these medications together. If your doctor says it’s safe, they may periodically perform tests to check your heart rhythm.

To learn more about Tikosyn and certain antidepressants, talk with your doctor or pharmacist.

Corticosteroids

Corticosteroids are prescribed to ease inflammation.

Interaction result. Taking Tikosyn with corticosteroids can increase the risk of side effects from Tikosyn.

Interaction explained. Corticosteroids may cause a low blood level of potassium as a side effect. This may increase the risk of new or worsening arrhythmia.* Taking Tikosyn with a corticosteroid could further increase the risk of this side effect. To learn more about the side effects of Tikosyn, see this article.

Examples of corticosteroid drugs. Here are some corticosteroids that may interact with Tikosyn:

• dexamethasone (Hemady)
• prednisone (Rayos)
• methylprednisolone (Medrol)

Steps you or your doctor may take. If you’re prescribed a corticosteroid with Tikosyn, be sure the healthcare professional who prescribed it knows that you’re taking Tikosyn. They can tell you whether it’s safe to take these medications together. If they tell you it’s safe, your doctor may perform tests to check your potassium level and heart rhythm.

To learn more about Tikosyn and corticosteroids, talk with your doctor or pharmacist.

* Tikosyn has a boxed warning about the risk of new or worsening arrhythmia. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see “Boxed warning” at the beginning of this article.

Tikosyn may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information doesn’t include all other possible interactions with Tikosyn.

Tikosyn and supplements

It’s possible for drugs to interact with supplements such as vitamins and herbs.

Tikosyn and herbs

There are no specific reports of herbs interacting with Tikosyn. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Tikosyn treatment.

Tikosyn and vitamins

There are no specific reports of vitamins interacting with Tikosyn. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, be sure to talk with your doctor or pharmacist before taking any vitamin product with Tikosyn.

Tikosyn and food

There were no reports of food interactions with Tikosyn. If you’d like to learn more about eating certain foods during treatment with Tikosyn, talk with your doctor.

Tikosyn and vaccines

There aren’t any known interactions between Tikosyn and vaccines. You can talk with your doctor or pharmacist to find out whether you’re due for any vaccines.

Tikosyn and lab tests

Tikosyn isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

TIKOSYN INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Tikosyn.

The effect of cannabis products on Tikosyn can vary from person to person. For example, cannabis products may lower or raise the level of Tikosyn in your body. A decreased level of Tikosyn could cause the drug to be less effective than usual. An increased level of Tikosyn could raise your risk of side effects from the drug. To learn about the side effects of Tikosyn, see this article.

Before you start treatment with Tikosyn, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many U.S. states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Tikosyn. Before you take this drug, be sure to talk with your doctor about your health history. Tikosyn may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Tikosyn include:

• Long QT syndrome. Doctors typically won’t prescribe Tikosyn for people with long QT syndrome. To learn more, see the “When to avoid Tikosyn” section above.
• Severe kidney disease. Doctors typically won’t prescribe Tikosyn for people with severe kidney disease. To learn more, see the “When to avoid Tikosyn” section above.
• Liver disease. If you have liver disease, talk with your doctor before starting Tikosyn treatment. It isn’t known for certain whether the drug is safe for people with this condition. Your doctor can recommend whether Tikosyn is the right treatment option for you.
• Allergic reaction. If you’ve had an allergic reaction to Tikosyn or any of its ingredients, your doctor will likely not prescribe Tikosyn. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
• Breastfeeding. It’s recommended that you do not take Tikosyn while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects Tikosyn may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before taking Tikosyn. They can talk with you about treatment options and ways to feed your child.
• Pregnancy. There haven’t been enough clinical trials to determine whether Tikosyn is safe to take while pregnant. Animal studies show that the drug may cause congenital anomalies (commonly known as birth defects). However, it’s important to note that animal studies don’t always indicate what may happen in humans. If you’re pregnant or planning to become pregnant, tell your doctor before starting Tikosyn. They can advise you on the right treatment plan for you.
• Risk of new or worsening arrhythmia. Tikosyn has a boxed warning about the risk of new or worsening arrhythmia (irregular heart rhythm). This is the most serious warning from the Food and Drug Administration (FDA). For details, see “Boxed warning” at the beginning of this article.

Here are some frequently asked questions about Tikosyn and possible interactions.

Is there an interaction between Tikosyn and metoprolol?

No. There are no specific reports of Tikosyn interacting with metoprolol (Lopressor, Toprol XL, others).

Tikosyn is prescribed to treat atrial fibrillation (AFib) and atrial flutter. Certain forms of metoprolol may be prescribed off-label for these conditions. Your doctor can tell you whether Tikosyn may be prescribed with metoprolol for your condition.

If you have other questions about Tikosyn and metoprolol, talk with your doctor or pharmacist.

* With off-label use, a drug is prescribed for a different purpose than what it’s approved to treat.

Is it safe to take Tikosyn and magnesium together?

Yes, it’s generally safe to take Tikosyn and magnesium together if your doctor recommends it. There are no reports of this mineral interacting with Tikosyn.

Magnesium plays an important role in keeping a regular heart rhythm. Having low blood levels of magnesium may increase the risk of an irregular heart rhythm* called AFib. Your doctor may prescribe Tikosyn to treat AFib. They can tell you whether taking magnesium with Tikosyn may offer any additional benefit for your condition.

Before taking magnesium with Tikosyn, talk with your doctor or pharmacist. They can advise you on whether the mineral is safe for you and what the right dosage is.

* Tikosyn has a boxed warning about the risk of new or worsening arrhythmia (irregular heart rhythm). This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see “Boxed warning” at the beginning of this article.

You can take certain steps to help prevent interactions with Tikosyn. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Tikosyn label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Tikosyn doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Tikosyn by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Tikosyn. These resources might help:

• Overview of Tikosyn. For a general overview of Tikosyn, you can see this article.
• Side effects. If you’re interested in the side effects of Tikosyn, you can see this article. Another option is to refer to the Tikosyn prescribing information.
• Dosage specifics. To learn about the dosage of Tikosyn, you can view this article.
• Facts about your condition. To learn more about your condition, see our cardiovascular health hub and list of arrhythmia articles.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.