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Drug Interactions between Ana-Kit and timothy grass pollen allergen extract

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

chlorpheniramine timothy grass pollen allergen extract

Applies to: Ana-Kit (chlorpheniramine / epinephrine) and timothy grass pollen allergen extract

MONITOR: Monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs), catechol-O-methyltransferase (COMT) inhibitors, thyroid hormone, antihistamines, cardiac glycosides (e.g. digoxin) and diuretics may potentiate the response to epinephrine, including fatal consequences, in the treatment of serious systemic reactions that may occur during immunotherapy with allergenic extracts. Vasoconstricting and hypertensive effects may be potentiated by MAOIs, tricyclic antidepressants, and COMT inhibitors. Arrhythmogenic effects may be potentiated by thyroid hormones, antihistamines, cardiac glycosides and diuretics.

MANAGEMENT: Immunotherapy with allergenic extracts may not be appropriate in patients receiving MAOIs, tricyclic antidepressants, COMT inhibitors, thyroid hormone, antihistamines and cardiac glycosides as these patients may experience an exaggerated response to the usual doses of epinephrine required to reverse a systemic reaction.

References

  1. (2014) "Product Information. Grastek (timothy grass pollen allergen extract)." Merck & Co., Inc
  2. (2014) "Product Information. Ragwitek (ragweed pollen allergen extract)." Merck & Co., Inc
  3. (2014) "Product Information. Oralair (mixed grass pollens allergen extract)." Greer Laboratories Inc
  4. Cerner Multum, Inc. (2015) "Canadian Product Information."
  5. (2023) "Product Information. Palforzia (peanut allergen extract)." Aimmune Therapeutics
  6. (2022) "Product Information. Palforzia Level 1 (peanut allergen extract)." Aimmune Therapeutics UK Ltd
View all 6 references

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Drug and food interactions

Moderate

chlorpheniramine food

Applies to: Ana-Kit (chlorpheniramine / epinephrine)

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
  3. (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
  4. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
View all 4 references

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Moderate

timothy grass pollen allergen extract food

Applies to: timothy grass pollen allergen extract

ADJUST DOSING INTERVAL: Since sublingual preparations of allergenic extracts are meant to be absorbed directly from tissues under the tongue into the blood stream, consuming food or beverage during or immediately after administration may reduce the systemic bioavailability of the medication.

MONITOR: Coadministration of allergenic extracts for allergy immunotherapy with alcohol may potentiate the risk of allergic reactions, including anaphylaxis. According to some studies, alcohol is an augmenting factor influencing immunological mechanisms that can induce more severe allergic reactions and is involved in up to 15% of cases of anaphylactic reactions. Proposed mechanisms include an increase in allergen absorption from altered permeability of the intestinal epithelial barrier, enhancing mast cell and basophil activation, and an increase in serum IgE concentrations. A causal relationship with all allergenic extracts has not been established.

MANAGEMENT: Food or beverage should not be taken with, or for at least 5 minutes after, the administration of sublingual allergenic extracts. Patients should also avoid swallowing for about 1 minute following placement of the allergen extract under the tongue. Caution is advised if allergenic extracts for immunotherapy are used concomitantly with alcohol. Some manufacturers of peanut allergen extract recommend alcohol not be consumed for 2 hours before, or 2 hours after taking peanut allergen extract and if alcohol use cannot be avoided, that withholding or decreasing peanut allergen dosage should be considered. Individual prescribing information should be consulted for further guidance and clinical monitoring may be considered.

References

  1. (2014) "Product Information. Grastek (timothy grass pollen allergen extract)." Merck & Co., Inc
  2. (2014) "Product Information. Ragwitek (ragweed pollen allergen extract)." Merck & Co., Inc
  3. (2014) "Product Information. Oralair (mixed grass pollens allergen extract)." Greer Laboratories Inc
  4. Cerner Multum, Inc. (2015) "Canadian Product Information."
  5. (2023) "Product Information. Palforzia (peanut allergen extract)." Aimmune Therapeutics
  6. (2022) "Product Information. Palforzia Level 1 (peanut allergen extract)." Aimmune Therapeutics UK Ltd
  7. Munoz-Cano R, Pascal M, Araujo G, et al. (2023) Mechanisms, Cofactors, and Augmenting Factors Involved in Anaphylaxis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5623009/pdf/fimmu-08-01193.pdf
  8. (2023) "Product Information. Odactra (house dust mite allergen extract)." ALK-Abello Inc
View all 8 references

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Moderate

EPINEPHrine food

Applies to: Ana-Kit (chlorpheniramine / epinephrine)

MONITOR: Coadministration of two or more sympathomimetic agents may increase the risk of adverse effects such as nervousness, irritability, and increased heart rate. Central nervous system (CNS) stimulants, particularly amphetamines, can potentiate the adrenergic response to vasopressors and other sympathomimetic agents. Additive increases in blood pressure and heart rate may occur due to enhanced peripheral sympathetic activity.

MANAGEMENT: Caution is advised if two or more sympathomimetic agents are coadministered. Pulse and blood pressure should be closely monitored.

References

  1. Rosenblatt JE, Lake CR, van Kammen DP, Ziegler MG, Bunney WE Jr (1979) "Interactions of amphetamine, pimozide, and lithium on plasma norepineophrine and dopamine-beta-hydroxylase in schizophrenic patients." Psychiatry Res, 1, p. 45-52
  2. Cavanaugh JH, Griffith JD, Oates JA (1970) "Effect of amphetamine on the pressor response to tyramine: formation of p-hydroxynorephedrine from amphetamine in man." Clin Pharmacol Ther, 11, p. 656
  3. (2001) "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc
  4. (2001) "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals
  5. (2001) "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals
  6. (2001) "Product Information. Focalin (dexmethylphenidate)." Mikart Inc
  7. (2002) "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company
View all 7 references

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.