Concomitant use w/ other cholinomimetics (eg, ambenonium, donepezil, neostigmine, pyridostigmine, rivastigmine or systemically administered pilocarpine). May antagonise effect of anticholinergics. Exacerbated effect upon abrupt discontinuation of anticholinergics eg, atropine. Drugs that significantly reduce heart rate eg, digoxin, β-blockers, certain Ca-channel blockers & amiodarone; & drugs that have potential to cause Torsades de Pointes. May exaggerate succinylcholine-type muscle relaxation during anesth. Increased incidence of cholinergic adverse reactions w/ potent CYP2D6 inhibitors (eg, quinidine, paroxetine, fluoxetine) or CYP3A4 inhibitors (eg, ketoconazole, ritonavir).
Sign Out
