Use Alternative (1)lofexidine, nisoldipine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.nitroglycerin IVSerious - Use Alternative (1)lofexidine, nitroglycerin IV. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.nitroglycerin POSerious - Use Alternative (1)lofexidine, nitroglycerin PO. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.nitroglycerin sublingualSerious - Use Alternative (1)lofexidine, nitroglycerin sublingual. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.nitroglycerin topicalSerious - Use Alternative (1)lofexidine, nitroglycerin topical. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.nitroglycerin transdermalSerious - Use Alternative (1)lofexidine, nitroglycerin transdermal. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.nitroglycerin translingualSerious - Use Alternative (1)lofexidine, nitroglycerin translingual. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.nitroprusside sodiumSerious - Use Alternative (1)lofexidine, nitroprusside sodium. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.norepinephrineMonitor Closely (1)lofexidine increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.nortriptylineMonitor Closely (2)nortriptyline decreases effects of lofexidine by unspecified interaction mechanism. Use Caution/Monitor. nortriptyline and lofexidine both increase sedation. Use Caution/Monitor.nylidrinSerious - Use Alternative (1)lofexidine, nylidrin. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.olanzapineMonitor Closely (2)olanzapine and lofexidine both increase QTc interval. Use Caution/Monitor. olanzapine and lofexidine both increase sedation. Use Caution/Monitor.olmesartanSerious - Use Alternative (1)lofexidine, olmesartan. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.opium tinctureMonitor Closely (1)opium tincture and lofexidine both increase sedation. Use Caution/Monitor.orphenadrineMonitor Closely (1)orphenadrine and lofexidine both increase sedation. Use Caution/Monitor.osilodrostatMonitor Closely (1)osilodrostat and lofexidine both increase QTc interval. Use Caution/Monitor.oxaliplatinMonitor Closely (1)oxaliplatin will increase the level or effect of lofexidine by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.Serious - Use Alternative (1)oxaliplatin and lofexidine both increase QTc interval. Avoid or Use Alternate Drug.oxazepamMonitor Closely (1)oxazepam and lofexidine both increase sedation. Use Caution/Monitor.oxycodoneMonitor Closely (1)oxycodone and lofexidine both increase sedation. Use Caution/Monitor.oxymorphoneMonitor Closely (1)oxymorphone and lofexidine both increase sedation. Use Caution/Monitor.ozanimodMonitor Closely (1)ozanimod and lofexidine both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.paliperidoneMonitor Closely (2)paliperidone and lofexidine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended. paliperidone and lofexidine both increase sedation. Use Caution/Monitor.papaveretumMonitor Closely (1)papaveretum and lofexidine both increase sedation. Use Caution/Monitor.papaverineMonitor Closely (1)lofexidine and papaverine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)lofexidine, papaverine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.paroxetineMonitor Closely (1)paroxetine will increase the level or effect of lofexidine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Concomitant use of lofexidine with strong CYP2D6 inhibitors may increase lofexidine plasma levels. Monitor for symptoms of orthostasis and bradycardia if coadministered with a CYP2D6 inhibitor. Consider lofexidine dose reduction.penbutololSerious - Use Alternative (1)lofexidine, penbutolol. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.pentazocineMonitor Closely (1)pentazocine and lofexidine both increase sedation. Use Caution/Monitor.pentobarbitalMonitor Closely (1)pentobarbital and lofexidine both increase sedation. Use Caution/Monitor.perindoprilSerious - Use Alternative (1)lofexidine, perindopril. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.perphenazineMonitor Closely (1)perphenazine and lofexidine both increase sedation. Use Caution/Monitor.phendimetrazineMonitor Closely (1)lofexidine increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenobarbitalMonitor Closely (1)phenobarbital and lofexidine both increase sedation. Use Caution/Monitor.phenoxybenzamineSerious - Use Alternative (1)lofexidine, phenoxybenzamine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.phentermineMonitor Closely (1)lofexidine increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phentolamineSerious - Use Alternative (1)lofexidine, phentolamine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.phenylephrineMonitor Closely (1)lofexidine increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenylephrine POMonitor Closely (1)lofexidine increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .pholcodineMonitor Closely (1)lofexidine and pholcodine both increase sedation. Use Caution/Monitor.pimavanserinMonitor Closely (1)pimavanserin and lofexidine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended.pimozideMonitor Closely (2)pimozide and lofexidine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended. pimozide and lofexidine both increase sedation. Use Caution/Monitor.pindololSerious - Use Alternative (1)lofexidine, pindolol. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.pirbuterolMonitor Closely (1)lofexidine increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.pitolisantSerious - Use Alternative (1)lofexidine and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.ponesimodSerious - Use Alternative (1)ponesimod, lofexidine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Consult cardiologist if considering treatment. Coadministration of ponesimod with drugs that decrease HR may have additive effects on decreasing HR and should generally not be initiated in these patients.prazosinSerious - Use Alternative (1)lofexidine, prazosin. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.primaquineSerious - Use Alternative (1)primaquine and lofexidine both increase QTc interval. Avoid or Use Alternate Drug.primidoneMonitor Closely (1)primidone and lofexidine both increase sedation. Use Caution/Monitor.procainamideMonitor Closely (1)procainamide and lofexidine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended.prochlorperazineMonitor Closely (1)prochlorperazine and lofexidine both increase sedation. Use Caution/Monitor.promethazineMonitor Closely (1)promethazine and lofexidine both increase sedation. Use Caution/Monitor.propofolMonitor Closely (1)propofol and lofexidine both increase sedation. Use Caution/Monitor.propranololSerious - Use Alternative (1)lofexidine, propranolol. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.propylhexedrineMonitor Closely (1)lofexidine increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.protriptylineMonitor Closely (2)protriptyline decreases effects of lofexidine by unspecified interaction mechanism. Use Caution/Monitor. protriptyline and lofexidine both increase sedation. Use Caution/Monitor.quazepamMonitor Closely (1)quazepam and lofexidine both increase sedation. Use Caution/Monitor.quetiapineMonitor Closely (2)quetiapine and lofexidine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended. quetiapine and lofexidine both increase sedation. Use Caution/Monitor.quinaprilSerious - Use Alternative (1)lofexidine, quinapril. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.quinidineMonitor Closely (2)quinidine and lofexidine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended. quinidine will increase the level or effect of lofexidine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Concomitant use of lofexidine with strong CYP2D6 inhibitors may increase lofexidine plasma levels. Monitor for symptoms of orthostasis and bradycardia if coadministered with a CYP2D6 inhibitor. Consider lofexidine dose reduction.ramelteonMonitor Closely (1)lofexidine and ramelteon both increase sedation. Use Caution/Monitor.ramiprilSerious - Use Alternative (1)lofexidine, ramipril. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.ribociclibMonitor Closely (1)ribociclib and lofexidine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended.risperidoneMonitor Closely (1)risperidone and lofexidine both increase sedation. Use Caution/Monitor.ritonavirMonitor Closely (1)ritonavir will increase the level or effect of lofexidine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Concomitant use of lofexidine with strong CYP2D6 inhibitors may increase lofexidine plasma levels. Monitor for symptoms of orthostasis and bradycardia if coadministered with a CYP2D6 inhibitor. Consider lofexidine dose reduction.rolapitantMonitor Closely (1)rolapitant will increase the level or effect of lofexidine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Concomitant use of lofexidine with strong CYP2D6 inhibitors may increase lofexidine plasma levels. Monitor for symptoms of orthostasis and bradycardia if coadministered with a CYP2D6 inhibitor. Consider lofexidine dose reduction.sacubitril/valsartanSerious - Use Alternative (1)lofexidine, sacubitril/valsartan. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.sageMinor (1)lofexidine and sage both increase sedation. Minor/Significance Unknown.salmeterolMonitor Closely (1)lofexidine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.scullcapMonitor Closely (1)lofexidine and scullcap both increase sedation. Use Caution/Monitor.secobarbitalMonitor Closely (1)secobarbital and lofexidine both increase sedation. Use Caution/Monitor.selpercatinibMonitor Closely (1)selpercatinib increases toxicity of lofexidine by QTc interval. Use Caution/Monitor.sertralineSerious - Use Alternative (1)sertraline and lofexidine both increase QTc interval. Avoid or Use Alternate Drug.sevofluraneMonitor Closely (1)sevoflurane and lofexidine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)sevoflurane and lofexidine both increase QTc interval. Avoid or Use Alternate Drug.shepherd's purseMonitor Closely (1)lofexidine and shepherd's purse both increase sedation. Use Caution/Monitor.siponimodSerious - Use Alternative (1)siponimod and lofexidine both increase QTc interval. Avoid or Use Alternate Drug.sodium oxybateSerious - Use Alternative (1)lofexidine, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.solifenacinMonitor Closely (1)solifenacin and lofexidine both increase QTc interval. Use Caution/Monitor.sotalolMonitor Closely (1)sotalol and lofexidine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended.Serious - Use Alternative (1)lofexidine, sotalol. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.spironolactoneSerious - Use Alternative (1)lofexidine, spironolactone. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.stiripentolMonitor Closely (1)stiripentol, lofexidine. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.sufentanilMonitor Closely (1)sufentanil and lofexidine both increase sedation. Use Caution/Monitor.sunitinibSerious - Use Alternative (1)sunitinib and lofexidine both increase QTc interval. Avoid or Use Alternate Drug.tacrolimusSerious - Use Alternative (1)tacrolimus and lofexidine both increase QTc interval. Avoid or Use Alternate Drug.tapentadolMonitor Closely (1)tapentadol and lofexidine both increase sedation. Use Caution/Monitor.telmisartanSerious - Use Alternative (1)lofexidine, telmisartan. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure