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Drug Interactions between Combivent and pilocarpine

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

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Interactions between your drugs

Moderate

ipratropium pilocarpine

Applies to: Combivent (albuterol / ipratropium) and pilocarpine

GENERALLY AVOID: Anticholinergic agents and other agents with significant anticholinergic activity (e.g., clozapine, class IA antiarrhythmics especially disopyramide) may antagonize the effects of direct-acting cholinergic agents such as bethanechol, carbachol, cevimeline, and pilocarpine. This interaction is sometimes desirable and is the basis for using atropine in the treatment of excessive muscarinic side effects and cholinergic crisis induced by cholinergic overdose. Conversely, cholinergic agents may also counteract the pharmacologic effects of anticholinergic agents and other agents that rely partially on their anticholinergic activity for therapeutic effects (e.g., some antiparkinsonian and antiemetic/antivertigo agents). The mechanism of interaction involves opposing pharmacodynamic action on muscarinic receptor sites.

MANAGEMENT: It may be appropriate to avoid concomitant use of anticholinergic agents and cholinergic agents, depending on the needs of the patient. If concurrent use is necessary, the patient should be monitored for reduced pharmacologic effects of both drugs.

References

  1. Benjamin KW (1979) "Toxicity of ocular medications." Int Ophthalmol Clin, 19, p. 199-255
  2. "Product Information. Salagen (pilocarpine)." Boehringer-Ingelheim

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Drug and food interactions

Moderate

albuterol food

Applies to: Combivent (albuterol / ipratropium)

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.

See also

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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.

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