Drug General Information (ID: DDIJN6WQ3O)
Drug Name			Carteolol (ophthalmic)		Drug Info		Metolazone		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antihypertensive Agents				Antihypertensive Agents
Structure

Mechanism of Carteolol (ophthalmic)-Metolazone Interaction (Severity Level: Moderate)
Increased risk of hyperglycemia Click to Show/Hide Mechanism Graph
Drug Name		Carteolol (ophthalmic)				Metolazone
Mechanism 1		Hyperglycemia				Hyperglycemia
Key Mechanism Factor 1
		Factor Name		Hyperglycemia
		Factor Description		Drugs can induce hyperglycemia through a variety of mechanisms, including altered insulin secretion and sensitivity, direct cytotoxic effects on pancreatic cells, and increased glucose production. Hyperglycemia may increase the risk of microvascular and macrovascular complications, infection, metabolic coma and even death.
Mechanism Description		Increased risk of hyperglycemia by the combination of Carteolol (ophthalmic) and Metolazone
Mechanism 2		Hyperglycemic effects				Hyperglycemia
Key Mechanism Factor 2
		Factor Name		Hyperglycemia
		Factor Description		Drugs can induce hyperglycemia through a variety of mechanisms, including altered insulin secretion and sensitivity, direct cytotoxic effects on pancreatic cells, and increased glucose production. Hyperglycemia may increase the risk of microvascular and macrovascular complications, infection, metabolic coma and even death.
Mechanism Description		Increased risk of hyperglycemia by the combination of Carteolol (ophthalmic) and Metolazone
Mechanism 3		Hyperglycemia				Hyperglycemic effects
Key Mechanism Factor 3
		Factor Name		Hyperglycemia
		Factor Description		Drugs can induce hyperglycemia through a variety of mechanisms, including altered insulin secretion and sensitivity, direct cytotoxic effects on pancreatic cells, and increased glucose production. Hyperglycemia may increase the risk of microvascular and macrovascular complications, infection, metabolic coma and even death.
Mechanism Description		Increased risk of hyperglycemia by the combination of Carteolol (ophthalmic) and Metolazone
Mechanism 4		Hyperglycemic effects				Hyperglycemic effects
Key Mechanism Factor 4
		Factor Name		Hyperglycemia
		Factor Description		Drugs can induce hyperglycemia through a variety of mechanisms, including altered insulin secretion and sensitivity, direct cytotoxic effects on pancreatic cells, and increased glucose production. Hyperglycemia may increase the risk of microvascular and macrovascular complications, infection, metabolic coma and even death.
Mechanism Description		Increased risk of hyperglycemia by the combination of Carteolol (ophthalmic) and Metolazone
Increased risk of hypertriglyceridemia Click to Show/Hide Mechanism Graph
Drug Name		Carteolol (ophthalmic)				Metolazone
Mechanism 5		Hypertriglyceridemia				Hypertriglyceridemia
Key Mechanism Factor 5
		Factor Name		Hypertriglyceridemia
		Factor Description		Hypertriglyceridemia is a common dyslipidemia often associated with other lipid and metabolic disorders. Hypertriglyceridemia is associated with an increased risk of cardiovascular events and acute pancreatitis.
Mechanism Description		Increased risk of hypertriglyceridemia by the combination of Carteolol (ophthalmic) and Metolazone
Increased risk of ventricular arrhythmias Click to Show/Hide Mechanism Graph
Drug Name		Carteolol (ophthalmic)				Metolazone
Mechanism 6		Prolong QT interval				Hypokalemia
Key Mechanism Factor 6
		Factor Name		Ventricular arrhythmias
		Factor Description		Ventricular arrhythmias are abnormal heart rhythms that cause your heart's lower chambers to pump blood instead of pumping it. This can limit or stop your heart from supplying blood to your body. While some of these arrhythmias are harmless and do not cause symptoms, others can have serious, even fatal, effects on your body.
Mechanism Description		Increased risk of ventricular arrhythmias by the combination of Carteolol (ophthalmic) and Metolazone

Recommended Action
Management		Monitoring of serum potassium levels, blood pressure, and blood glucose is recommended during coadministration. Patients should be advised to seek medical assistance if they experience dizziness, weakness, fainting, fast or irregular heartbeats, or loss of blood glucose control.

References
1	Dean S, Kendall MJ, Potter S, Thompson MH, Jackson DA "Nadolol in combination with indapamide and xipamide in resistant hypertensives." Eur J Clin Pharmacol 28 (1985): 29-33. [PMID: 3987783]
2	Dornhorst A, Powell SH, Pensky J "Aggravation by propranolol of hyperglycaemic effect of hydrochlorothiazide in type II diabetics without alteration of insulin secretion." Lancet 1 (1985): 123-6. [PMID: 2857210]
3	Product Information. Lozol (indapamide). Rhone-Poulenc Rorer, Collegeville, PA.