Rytary interactions: Alcohol, medications, and other factors

Before you start treatment with Rytary, 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 Rytary interacts with supplements, herbs, or vitamins, see the “Rytary 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 Rytary. Keep in mind that this table doesn’t include all drugs that may interact with Rytary. Some of these interactions are described in detail just below in “Drug interactions in depth.”

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

Taking a nonselective MAOI

Doctors typically will not prescribe Rytary in combination with a type of antidepressant called a nonselective MAOI.

This is because taking Rytary with a nonselective MAOI can make your blood pressure become very high.

Below are a few examples of nonselective MAOIs that can interact with Rytary:

• phenelzine (Nardil)
• isocarboxazid (Marplan)
• tranylcypromine (Parnate)

Before you start treatment with Rytary, it’s important to tell your doctor if you take one of these MAOIs. They’ll likely have you stop taking the MAOI and wait at least 2 weeks before starting treatment with Rytary. Likewise, after you stop taking Rytary, your doctor will typically have you wait at least 2 weeks before starting treatment with a nonselective MAOI.

Rytary can also interact with another group of drugs called selective MAO-B inhibitors. To learn more about this interaction, see “Drug interactions in depth” below.

Your doctor may advise you to avoid or limit alcohol consumption during Rytary treatment. This is because Rytary can cause sleepiness. It can even make you fall asleep suddenly during activities such as eating, talking, or driving. Drinking alcohol while taking the drug may increase your risk of these side effects. (For details about Rytary’s side effects, see this article.)

Drinking alcohol while taking the drug may also worsen some of Rytary’s other side effects. For example, you may experience:

• nausea
• vomiting
• headache
• dizziness

If you have questions about drinking alcohol while taking Rytary, talk with your doctor.

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

Selective MAO-B inhibitors

Doctors may prescribe selective MAO-B inhibitors with Rytary to treat Parkinson’s disease. Some MAO-B inhibitors are prescribed for depression.

Interaction result: Taking Rytary with a selective MAO-B inhibitor can cause orthostatic hypotension. This is a drop in blood pressure upon getting up from sitting or lying down. It can make you feel lightheaded or dizzy or even cause fainting.

Interaction explained: Rytary and selective MAO-B inhibitors can both cause orthostatic hypotension. So taking these drugs together can raise your risk of this side effect. For details about Rytary’s side effects, see this article.

Examples of MAO-B inhibitor drugs: Here are some MAO-B inhibitors that may interact with Rytary:

• rasagiline (Azilect)
• selegiline (Emsam, Zelapar)

Steps you or your doctor may take: If you take Rytary with a selective MAO-B inhibitor, your doctor will monitor you for side effects of both drugs. While taking these drugs together, be sure to move slowly when getting up from sitting or lying down. This can help prevent your blood pressure from dropping suddenly.

If you feel dizzy or lightheaded upon getting up, sit or lie down until this gets better. Tell your doctor if you have orthostatic hypotension when taking this combination of drugs. Your doctor may adjust your dosage of one or both medications.

If you have questions about taking Rytary with a selective MAO-B inhibitor, talk with your doctor or pharmacist.

Blood pressure medications

Rytary can interact with medications prescribed to treat high blood pressure. Doctors commonly prescribe Rytary with blood pressure medications for people who have Parkinson’s disease and high blood pressure.

Interaction result: Taking Rytary with blood pressure medications can raise your risk of orthostatic hypotension.

Interaction explained: Rytary can sometimes cause orthostatic hypotension as a side effect. If you take Rytary with medications that lower your blood pressure, you may have a higher risk of this side effect. For details about Rytary’s side effects, see this article.

Examples of blood pressure medications: Here are some blood pressure medications that may interact with Rytary:

• doxazosin (Cardura)
• furosemide (Lasix)
• losartan (Cozaar)
• propranolol (Inderal LA, InnoPran XL)
• ramipril (Altace)

Steps you or your doctor may take: If you take Rytary with a blood pressure medication, you can help prevent orthostatic hypotension by moving slowly when you get up. Moving slowly gives your blood pressure time to adjust to your change in position.

If you feel dizzy or lightheaded, sit or lie down until this goes away. If you often feel dizzy, tell your doctor. They may adjust your dosage of blood pressure medication.

If you have questions or concerns about taking Rytary with a blood pressure medication, talk with your doctor or pharmacist.

Antipsychotics

Antipsychotics are medications prescribed to treat certain mental health conditions such as schizophrenia.

Doctors sometimes prescribe antipsychotics for people with Parkinson’s disease who have psychosis. With psychosis, you may have hallucinations and delusions (thoughts or beliefs that aren’t true).

Interaction result: Taking Rytary with an antipsychotic can make both drugs less effective. It can also raise your risk of certain side effects of both drugs, such as sleepiness and dizziness.

Interaction explained: Rytary treats Parkinson’s disease by increasing the action of a chemical called dopamine in your brain. Many antipsychotics work by reducing the action of dopamine in your brain. So these drugs can oppose each other’s effects.

These drugs can also cause some similar side effects. So you may be more likely to have these side effects if you take the drugs together.

Examples of antipsychotic drugs: Here are some antipsychotics that may interact with Rytary:

• chlorpromazine
• haloperidol (Haldol)
• risperidone (Risperdal)

Steps you or your doctor may take: If your doctor prescribes an antipsychotic with Rytary, they’ll likely avoid older antipsychotics, such as those listed above. This is because they work mainly on dopamine in your brain. Instead, your doctor may prescribe a newer type of antipsychotic, such as quetiapine (Seroquel) or pimavanserin (Nuplazid). These drugs have less or no effect on dopamine in your brain, so they’re less likely to interact with Rytary. However, they may still cause some of the same side effects.

If you take Rytary with an antipsychotic, your doctor will monitor your progress to check that both medications are working for you. They’ll also monitor you closely for side effects of both drugs. Tell your doctor if you have new or worsening symptoms or side effects. Your doctor may adjust your dosage of either medication until they reach the correct balance for you. For details about Rytary’s side effects, see this article.

If you have questions about taking Rytary with an antipsychotic, talk with your doctor.

Rytary 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 does not include all other possible interactions with Rytary.

Rytary interactions with supplements

Before you start treatment with Rytary, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

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

Rytary and herbs

There are no specific reports of herbs interacting with Rytary. 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 Rytary treatment.

Rytary interactions with vitamins and minerals

There are no specific reports of vitamins interacting with Rytary. However, Rytary can interact with iron supplements, including multivitamins that contain iron. Iron can bind to Rytary in your digestive system, which can reduce the amount of Rytary that gets absorbed into your body. This can make Rytary less effective at treating your condition.

If you take Rytary with iron supplements or multivitamins containing iron, you should avoid taking them at the same time of day. Instead, take them at least 2 hours apart to prevent this interaction.

If you have questions about taking Rytary with other supplements, talk with your doctor or pharmacist.

Rytary interactions with food

You can take Rytary with or without food. However, taking Rytary with foods that are high in protein, fat, or fiber can slow down the absorption of Rytary into your body. This means the drug can take longer to start working. Taking Rytary with such foods can also reduce the amount of Rytary that your body absorbs. This can make Rytary less effective at reducing your Parkinson’s symptoms.

Talk with your doctor about when you should take Rytary in relation to your meals. They can help you determine the best time to take your doses based on your usual diet.

If you have additional questions or want more information about eating certain foods during Rytary treatment, talk with your doctor. To learn more, you can read this article about diet and Parkinson’s disease.

Rytary interactions with vaccines

There aren’t any known interactions between Rytary and vaccines. Talk with your doctor or pharmacist to see whether you’re due for any vaccines.

Rytary interactions with lab tests

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

RYTARY INTERACTION WITH CANNABIS OR CBD

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

Using cannabis with Rytary may raise your risk of certain side effects of Rytary, such as sleepiness and suddenly falling asleep during daily activities. Your doctor will likely recommend that you avoid using cannabis or cannabis products while taking Rytary.

Before you start treatment with Rytary, 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 Rytary. Before you take this drug, be sure to talk with your doctor about your health history. Rytary 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 Rytary include:

• Psychotic illness: If you have a psychotic illness, such as schizophrenia, your doctor will likely not prescribe Rytary. It could make your condition worse. You can ask them about other treatments that may be better choices for you.
• Heart disease: If you have heart disease, Rytary may raise your risk of heart attack or other heart problems. Your doctor will likely monitor your heart when you start Rytary. This is especially true if you have an irregular heart rhythm due to a past heart attack. In this case, your doctor will likely have you start Rytary treatment in a hospital’s heart monitoring unit.
• Sleep disorders: Rytary can cause sleepiness and sleep attacks (suddenly falling asleep during daily activities, such as while eating or talking). If you have a sleep disorder that causes daytime sleepiness, such as insomnia or narcolepsy, you may have an increased risk of this side effect. Talk with your doctor about whether Rytary is right for you.
• Glaucoma: If you have glaucoma, taking Rytary could worsen your condition. Your doctor may check the pressure in your eye more often while you’re taking Rytary.
• Stomach or intestinal ulcer: If you’ve had a past ulcer in your stomach or intestine, taking Rytary could raise your risk of bleeding in your intestine. Before starting Rytary, talk with your doctor about whether it’s the right treatment option for you.
• Allergic reaction: If you’ve had an allergic reaction to Rytary or any of its ingredients, your doctor will likely not prescribe Rytary. 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 not known whether it’s safe to take Rytary while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects Rytary may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before taking Rytary. Together, you can discuss your treatment options and ways to feed your child.
• Pregnancy: There haven’t been enough clinical trials to determine whether Rytary is safe to take while pregnant. Animal studies show that the drug may cause congenital anomalies (commonly known as birth defects) or pregnancy loss. 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 Rytary. They can advise you on the right treatment plan for you.

You can take certain steps to help prevent interactions with Rytary. 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 Rytary 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 Rytary 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 Rytary by taking it exactly as your doctor prescribes.

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.