Patient/caregiver was educated on contraindications for using Dothiepin as follows:
- Dothiepin reportedly reduces the release of acetylcholine, thus reducing the action of acetylcholine on various body tissues. Dothiepin must be avoided or used with extreme caution along with any other medications that can have similar spectrum of activity of reducing the action of acetylcholine. Many inhaler medications used in treating breathing disorders and medications used to manage Parkinson’s disease can reduce action of acetylcholine and thus, can potentiate the side-effects of dothiepin intake. So, dothiepin must be avoided/used with extreme caution in individuals with history of asthma, COPD, and Parkinson’s disease. Discuss with your physician regarding safety with dothiepin intake, if you have history of breathing disorders and Parkinson’s disease.
- Dothiepin can interact with many antibacterial and antifungal antibiotics, antiarrhythmic medications, antidepressants, and antipsychotic medications, resulting in development or aggravation of underlying cardiac arrhythmias, leading to debility and sudden cardiac death. Avoid taking dothiepin along with medications belonging to the above-mentioned groups, to prevent any dangerous arrhythmias from developing.
- Dothiepin can reduce the effects of anti-seizure medications and increase the likelihood for seizures in individuals with seizure history. Dothiepin is best avoided for other alternative medications or cautiously used with periodical monitoring in individuals with seizure history.
- Dothiepin use in expectant mothers could increase risk for postnatal depression in the mother. Dothiepin use in mothers can also increase risk for complications in breastfed newborns. So, dothiepin is cautiously administered or best avoided for an alternative drug during pregnancy, in women planning for pregnancy, and in women breastfeeding the newborn.
- Dothiepin is partly metabolized in the liver and the metabolites are mainly excreted in the urine. If liver function is deficient, the metabolism of Dothiepin can be compromised. In individuals with history of compromised renal function, the excretion of dothiepin metabolites can be compromised. In either case, dothiepin and metabolites stay in the body for prolonged duration of time in comparison to normal leading to increased blood levels of the medication and metabolites for longer periods of time. This can lead to increased risk for side-effects and consequent toxicity. So, Dothiepin could be cautiously administered in individuals with hepatic and/or renal dysfunction. Periodical labs for liver and/or renal function could be ordered and individuals monitored for development of any toxic symptoms. Discuss with your physician regarding history of compromised liver or kidney function, if any.
