Drug General Information (ID: DDIORS4N56)
Drug Name			Apomorphine		Drug Info		Diclofenamide		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Dopaminergic Antiparkinsonism Agents				Ophthalmic Glaucoma Agents
Structure

Mechanism of Apomorphine-Diclofenamide Interaction (Severity Level: Moderate)
Additive hypotensive effects Click to Show/Hide Mechanism Graph
Drug Name		Apomorphine				Diclofenamide
Mechanism 1		Antihypertensive agent				Antihypertensive agent
Key Mechanism Factor 1
		Factor Name		Hypotensive effects
		Factor Description		Hypotension is a blood pressure reading below the prescribed limit (90/60 mmHg). Symptoms of hypotension may include: blurred or faded vision , dizziness or light-headedness, fainting , fatigue , difficulty concentrating, nausea.
Mechanism Description		Additive hypotensive effects by the combination of Apomorphine and Diclofenamide
Mechanism 2		Hypotensive effects				Antihypertensive agent
Key Mechanism Factor 2
		Factor Name		Hypotensive effects
		Factor Description		Hypotension is a blood pressure reading below the prescribed limit (90/60 mmHg). Symptoms of hypotension may include: blurred or faded vision , dizziness or light-headedness, fainting , fatigue , difficulty concentrating, nausea.
Mechanism Description		Additive hypotensive effects by the combination of Apomorphine and Diclofenamide
Mechanism 3		Antihypertensive agent				Hypotensive effects
Key Mechanism Factor 3
		Factor Name		Hypotensive effects
		Factor Description		Hypotension is a blood pressure reading below the prescribed limit (90/60 mmHg). Symptoms of hypotension may include: blurred or faded vision , dizziness or light-headedness, fainting , fatigue , difficulty concentrating, nausea.
Mechanism Description		Additive hypotensive effects by the combination of Apomorphine and Diclofenamide
Mechanism 4		Hypotensive effects				Hypotensive effects
Key Mechanism Factor 4
		Factor Name		Hypotensive effects
		Factor Description		Hypotension is a blood pressure reading below the prescribed limit (90/60 mmHg). Symptoms of hypotension may include: blurred or faded vision , dizziness or light-headedness, fainting , fatigue , difficulty concentrating, nausea.
Mechanism Description		Additive hypotensive effects by the combination of Apomorphine and Diclofenamide

Recommended Action
Management		Caution and close monitoring for altered efficacy and safety are recommended if patients receive apomorphine with an antihypertensive agent or vasodilator. Patients should be made aware of the possible side effects (e.g., dizziness, lightheadedness, orthostasis) and be cautioned about driving, operating machinery, or performing other hazardous tasks. They should also be advised to avoid rising abruptly from a sitting or recumbent position and to contact their physician if they experience symptoms of hypotension such as dizziness, lightheadedness, or fainting.

References
1	Bailey DG, Dresser GK "Natural products and adverse drug interactions." Can Med Assoc J 170 (2004): 1531-2. [PMID: 15136542]
2	Ho PC, Ghose K, Saville D, Wanwimolruk S "Effect of grapefruit juice on pharmacokinetics and pharmacodynamics of verapamil enantiomers in healthy volunteers." Eur J Clin Pharmacol 56 (2000): 693-8. [PMID: 11214778]
3	Product Information. Apokyn (apomorphine). Mylan Pharmaceuticals Inc, Morgantown, WV.