Multaq Interactions: Alcohol, Medications, and Others

Does Multaq interact with other drugs?

Before you start taking Multaq, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Multaq interacts with herbs or vitamins and supplements, see the “Are there other interactions with Multaq?” section below.)

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist. They can tell you more about the drugs you should not take with Multaq.

The table below lists drugs that may interact with Multaq. Keep in mind that this table doesn’t include all drugs that may interact with Multaq. For more information about some of these interactions, see the “Drug interactions explained” section below.

You can learn more about the side effects of Multaq in this article. And you can learn more about the following interactions in the “When should I avoid Multaq?” section below:

• certain antipsychotics
• certain irregular heart rhythm drugs
• certain antibiotics
• certain antifungals
• certain antidepressants
• cyclosporine (Gengraf, Neoral, others)
• ritonavir (Norvir)

When should I avoid Multaq?

Certain health conditions or other factors could raise your risk of harm if you take Multaq. In such cases, your doctor may not prescribe Multaq for you. These are known as contraindications. The list below includes contraindications of Multaq.

If you have severe heart failure or permanent AFib: Doctors are unlikely to prescribe Multaq for people who have a certain type of severe heart failure or permanent AFib. This is because Multaq has a boxed warning about the increased risk of death, stroke, and heart failure in people with these conditions.

A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For more information, see the “Boxed warning” section at the beginning of this article.

If you have severe liver disease: If you have severe liver disease or liver failure, your doctor likely won’t prescribe Multaq for you. This is because Multaq can cause liver damage as a side effect, which could worsen liver disease.

If you have severe liver disease, your doctor can recommend a different treatment option for you. To learn more about Multaq’s side effects, see this article.

If you have certain heart rate or heart rhythm problems: Doctors are unlikely to prescribe Multaq for people who have certain heart rate or heart rhythm problems. This is because Multaq can cause heart rate or heart rhythm problems as side effects. So taking Multaq could worsen these problems if they already exist.

Examples of these problems include:

• a slow heart rate of fewer than 50 beats per minute
• sick sinus syndrome, second-degree heart block, or complete heart block that isn’t managed with a pacemaker
• prolonged intervals between specific electrical signals on an electrocardiogram (EKG)

If you have a heart rate or heart rhythm problem, talk with your doctor before taking Multaq. They can advise whether it’s safe to take. If needed, your doctor can recommend a different treatment option for you.

If you take certain medications that increase the risk of a specific heart rhythm problem: Doctors are unlikely to prescribe Multaq with medications that increase the risk of a specific heart rhythm problem known as long QT syndrome. Multaq can also cause this syndrome as a side effect, so taking it with certain medications could further increase this risk.

Examples of these medications include:

• tricyclic antidepressants, such as nortriptyline (Pamelor) and amitriptyline
• certain antipsychotics, such as aripiprazole (Abilify, Aristada, others) and risperidone (Risperdal, Uzedy, others)
• certain irregular heart rhythm drugs, such as flecainide and sotalol (Betapace, Sorine, others)
• certain antibiotics, such as erythromycin (Eryc, Ery-Tab, others) and clarithromycin
• certain antifungals, such as ketoconazole and itraconazole (Sporanox, Tolsura)

Before taking Multaq, tell your doctor about other medications you take. They can advise you on any possible interactions with Multaq.

If you take certain medications that affect the level of Multaq: Doctors are unlikely to prescribe Multaq with medications that raise the level of Multaq in your body. Taking Multaq with these medications could increase your risk of side effects from Multaq.

Examples of these medications include:

• certain antibiotics, such as erythromycin (Eryc, Ery-Tab, others) and clarithromycin
• certain antifungals, such as ketoconazole and itraconazole (Sporanox, Tolsura)
• the antidepressant drug nefazodone
• the immunosuppressant drug cyclosporine (Gengraf, Neoral, others)
• the HIV drug ritonavir (Norvir)

Before taking Multaq, tell your doctor about other medications you take. They can advise you on any possible interactions with Multaq.

If you’ve had a liver or lung problem with amiodarone: If you’ve had a liver or lung problem with amiodarone (Nexterone, Pacerone), your doctor likely won’t prescribe Multaq. This is because Multaq and amiodarone are similar. So taking Multaq could lead to the same liver or lung problems.

Before taking Multaq, tell your doctor if you’ve had a liver or lung problem with amiodarone. They can recommend an alternative to Multaq instead.

If you’ve had an allergic reaction: If you’ve had an allergic reaction to Multaq or any of its ingredients, your doctor likely won’t prescribe Multaq for you. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.

Before you start taking Multaq, talk with your doctor if any of the factors above apply to you. Your doctor can determine whether Multaq is safe for you to take.

Does Multaq interact with alcohol?

Multaq is not known to interact with alcohol. But both Multaq and large amounts of alcohol can cause liver damage as a side effect. If you drink alcohol, your doctor may advise you to limit or avoid it during your Multaq treatment.

If you have questions about consuming alcohol while taking Multaq, talk with your doctor or pharmacist. To learn more about Multaq’s side effects, see this article.

Drug interactions explained

Learn more about certain drug interactions that can occur with Multaq.

Interaction with certain blood thinners

Multaq can interact with certain blood thinners. These medications treat or help prevent blood clots in certain situations.

Examples of blood thinners include:

• rivaroxaban (Xarelto)
• warfarin (Jantoven)
• dabigatran (Pradaxa)

What could happen

Taking Multaq with certain blood thinners may cause your body to break down the blood thinner too slowly. This can lead to a high level of blood thinner in your body. As a result, you may have a greater risk of serious bleeding as a side effect of the blood thinner.

What you can do

Before starting Multaq treatment, tell your doctor if you take a blood thinner. They can advise whether it’s safe to take these medications together.

If you take Multaq and a blood thinner, your doctor may prescribe a lower dosage of the blood thinner in certain situations. Doing so may help reduce your risk of bleeding.

If you have questions about taking Multaq with a blood thinner, talk with your doctor or pharmacist.

Interaction with certain statins

Multaq can interact with certain statins, which are prescribed to treat high cholesterol.

Examples of statins include:

• atorvastatin (Atorvaliq, Lipitor)
• lovastatin (Altoprev)
• simvastatin (FloLipid, Zocor)

What could happen

Taking Multaq with certain statins may cause your body to break down the statin too slowly. This can raise the level of the statin drug in your body. In turn, that could increase your risk of muscle problems as a side effect of the statin.

What you can do

If you take Multaq with certain statins, your doctor may prescribe a dosage of the statin that’s lower than usual. Doing so may help reduce your risk of muscle problems as a side effect. You should not take a higher dose of either medication than your doctor prescribes.

If you have questions about taking Multaq with certain statins, talk with your doctor or pharmacist.

Interaction with saxagliptin

Multaq can interact with saxagliptin, which is used to treat type 2 diabetes.

What could happen

Taking Multaq with saxagliptin can cause your body to break down saxagliptin slower than it should. This may lead to a high level of saxagliptin in your body. In turn, that can increase your risk of low blood sugar as a side effect of saxagliptin.

What you can do

Before starting Multaq treatment, tell your doctor if you take saxagliptin. They can determine whether it’s safe to take these medications together.

If your doctor prescribes both medications, they may recommend blood tests more frequently to monitor your blood sugar closely. They can also tell you what to do if you have low blood sugar.

If you have questions about taking Multaq with saxagliptin, talk with your doctor or pharmacist.

Are there other interactions with Multaq?

Multaq may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below doesn’t include all other interactions possible with Multaq.

Does Multaq interact with supplements?

Before you start taking Multaq, talk with your doctor and pharmacist about any herbs or vitamins and supplements you take. Sharing this information with them may help you avoid possible interactions.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Multaq interactions with herbs

Multaq can interact with St. John’s wort. This herb helps ease symptoms of depression and other conditions.

Taking Multaq with St. John’s wort may cause Multaq to break down too quickly. This could result in a lower level of Multaq in your body. And that may cause the drug to be less effective.

For this reason, it’s important to check with your doctor or pharmacist before taking St. John’s wort with Multaq.

Multaq interactions with vitamins

Multaq currently has no reports of interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products during your treatment with Multaq.

Does Multaq interact with food?

Multaq may interact with grapefruit or grapefruit juice. Consuming grapefruit products while taking Multaq may cause the drug to build up in your body. And this could increase your risk of side effects from the drug.

If you consume grapefruit products, talk with your doctor before taking Multaq. They can recommend whether there’s a safe amount to consume during Multaq treatment.

Does Multaq interact with vaccines?

Multaq currently has no reports of interacting with vaccines. If you have questions about getting certain vaccines during your Multaq treatment, talk with your doctor.

Does Multaq interact with lab tests?

Multaq currently has no reports of interacting with lab tests. If you have questions about having certain lab tests during your treatment with Multaq, talk with the healthcare professional ordering the test.

Does Multaq interact with cannabis or CBD?

Cannabis (commonly called marijuana) and cannabis products, such as cannabidiol (CBD), have been reported to interact with Multaq. Cannabis products could increase your risk of side effects from Multaq. Or they could make Multaq less effective.

Before you start treatment with Multaq, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Does my health history affect whether I should take Multaq?

Certain medical conditions or other health factors may raise the risk of interactions with Multaq. Before taking Multaq, talk with your doctor about your health history. They’ll determine whether Multaq is right for you.

Health conditions or other factors that might interact with Multaq include:

Severe heart failure or permanent AFib: Doctors are unlikely to prescribe Multaq for people who have a certain type of severe heart failure or permanent AFib. This is because Multaq has a boxed warning about the increased risk of death, stroke, and heart failure in people with these conditions.

A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For more information, see the “Boxed warning” section at the beginning of this article.

Severe liver disease: Doctors are unlikely to prescribe Multaq for people who have severe liver disease. To learn more, see the “When should I avoid Multaq?” section above.

Certain heart rate or heart rhythm problems: Doctors are unlikely to prescribe Multaq for people who have certain heart rate or heart rhythm problems. To learn more, see the “When should I avoid Multaq?” section above.

Past liver or lung problems with amiodarone: Doctors are unlikely to prescribe Multaq for people who have had a liver or lung problem with amiodarone (Nexterone, Pacerone). To learn more, see the “When should I avoid Multaq?” section above.

Pregnancy: Multaq may not be safe to take during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before taking Multaq.

Breastfeeding: It’s not known whether it’s safe to take Multaq while breastfeeding. It’s possible that the drug may pass into breast milk and cause side effects in a child who is breastfed. To be safe, your doctor may advise you not to breastfeed during Multaq treatment.

If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options.

Allergic reaction: If you’ve had an allergic reaction to Multaq or any of its ingredients, your doctor likely won’t prescribe Multaq. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.

Common questions about Multaq and interactions

Find answers below to some frequently asked questions about Multaq and possible interactions.

Is there an interaction between Multaq and Eliquis?

No, Multaq and Eliquis don’t have any known interactions. Eliquis is a blood thinner that’s used to treat or help prevent blood clots in certain situations. Your doctor can recommend whether Multaq and Eliquis may be taken together.

Keep in mind that Multaq is known to interact with other blood thinners, including rivaroxaban (Xarelto). To learn more about this interaction, see the “Drug interactions explained” section above.

If you have questions about taking Multaq with Eliquis, talk with your doctor or pharmacist.

Is there an interaction between Multaq and caffeine?

No, Multaq and caffeine aren’t known to interact.

That said, the American Heart Association advises people who have AFib to limit their intake of caffeine. (Multaq helps lower the risk of a hospital stay in certain people who have AFib.) For this reason, your doctor may advise you to limit the amount of caffeine you consume while taking Multaq.

Examples of foods and drinks that contain caffeine include coffee, tea, and chocolate.

If you have questions about limiting caffeine while taking Multaq, talk with your doctor or pharmacist.

Is sun exposure safe while taking Multaq?

Spending time in the sun while taking Multaq may not be safe for some people. In studies of Multaq, extreme skin sensitivity to UV light was a rare side effect. This reaction may cause symptoms ranging from mild sunburn to severe skin blistering.

For this reason, your doctor may advise you to protect against sun exposure during Multaq treatment. This may include limiting your time spent in the sun. It may also include wearing protective clothing, such as long-sleeve shirts and hats.

If you have more questions about Multaq and sun exposure, talk with your doctor or pharmacist.

How can I prevent interactions?

Taking certain steps can help you avoid interactions with Multaq. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

• Whether you drink alcohol or use cannabis.
• Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a medication list.
• What to do if you start taking a new medication during your Multaq treatment.

It’s also important to understand Multaq’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you didn’t get paperwork with Multaq, ask your pharmacist to print a copy for you.)

If you have difficulty reading or understanding this information, your doctor or pharmacist can help.

Taking Multaq exactly as prescribed can also help prevent interactions.

What should I ask my doctor?

If you still have questions about Multaq and its possible interactions, talk with your doctor.

Questions you may want to ask your doctor include:

• What should I do if I suspect a possible drug interaction with Multaq?
• Do I have any health conditions that increase my risk of interactions with Multaq?
• Should I tell you if I stop or start any medications while I’m taking Multaq?

To learn more about Multaq, see these articles:

• All about Multaq
• Side Effects of Multaq: What You Need to Know
• Dosage Details for Multaq

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.