Drug Interactions between furazolidone and Uni-Tuss DM
This report displays the potential drug interactions for the following 2 drugs:
- furazolidone
- Uni-Tuss DM (chlorpheniramine/dextromethorphan/phenylephrine)
Interactions between your drugs
dextromethorphan furazolidone
Applies to: Uni-Tuss DM (chlorpheniramine / dextromethorphan / phenylephrine) and furazolidone
CONTRAINDICATED: By inhibiting serotonin metabolism, monoamine oxidase inhibitors (MAOIs) may potentiate the pharmacologic activity of serotonergic agents such as serotonin reuptake inhibitors, 5-HT1 receptor agonists, ergot alkaloids, buspirone, dextromethorphan, and most antidepressants. The result may be an increased risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Symptoms of the serotonin syndrome may include mental status changes such as irritability, altered consciousness, confusion, hallucinations, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea.
MANAGEMENT: In general, serotonergic agents should not be used concurrently with MAOIs or other agents that possess MAOI activity (e.g., furazolidone, methylene blue, procarbazine). At least 14 days should elapse between discontinuation of MAOI therapy and initiation of treatment with serotonergic agents. A washout period of 5 to 14 days is usually recommended when switching from another antidepressant to an MAOI; however, the individual product labeling should be consulted.
References
- Pettinger WA, Soyangco FG, Oates JA (1968) "Inhibition of monoamine oxidase in man by furazolidone." Clin Pharmacol Ther, 9, p. 442-7
- Schulz R, Antonin KH, Hoffmann E, et al. (1989) "Tyramine kinetics and pressor sensitivity during monoamine oxidase inhibition by selegiline." Clin Pharmacol Ther, 46, p. 528-36
- Sternbach H (1988) "Danger of MAOI therapy after fluoxetine withdrawal." Lancet, 2, p. 850-1
- Sovner R, Wolfe J (1988) "Interaction between dextromethorphan and monoamine oxidase inhibitor therapy with isocarboxazid ." N Engl J Med, 319, p. 1671
- Bem JL, Peck R (1992) "Dextromethorphan. An overview of safety issues." Drug Saf, 7, p. 190-9
- Nierenberg DW, Semprebon M (1993) "The central nervous system serotonin syndrome." Clin Pharmacol Ther, 53, p. 84-8
- Graham PM, Potter JM, Paterson J (1982) "Combination monoamine oxidase inhibitor/tricyclic antidepressants interaction." Lancet, 2, p. 440
- Spiker DG, Pugh DD (1976) "Combining tricyclic and monoamine oxidase inhibitor antidepressants." Arch Gen Psychiatry, 33, p. 828-30
- White K, Pistole T, Boyd JL (1980) "Combined monoamine oxidase inhibitor-tricyclic antidepressant treatment: a pilot study." Am J Psychiatry, 137, p. 1422-5
- White K, Simpson G (1981) "Combined MAOI-tricyclic antidepressant treatment: a reevaluation." J Clin Psychopharmacol, 1, p. 264-82
- Rivers N, Horner B (1970) "Possible lethal reaction between nardil and dextromethorphan." Can Med Assoc J, 103, p. 85
- (2002) "Product Information. D.H.E. 45 (dihydroergotamine)." Sandoz Pharmaceuticals Corporation
- Sternbach H (1991) "The serotonin syndrome." Am J Psychiatry, 148, p. 705-13
- Feighner JP, Boyer WF, Tyler DL, Neborsky RJ (1990) "Adverse consequences of fluoxetine-MAOI combination therapy." J Clin Psychiatry, 51, p. 222-5
- Graham PM, Ilett KF (1988) "Danger of MAOI therapy after fluoxetine withdrawal." Lancet, 2, p. 1255-6
- Bhatara VS, Bandettini FC (1993) "Possible interaction between sertraline and tranylcypromine." Clin Pharm, 12, p. 222-5
- Suchowersky O, deVries JD (1990) "Interaction of fluoxetine and selegiline." Can J Psychiatry, 35, p. 571-2
- (2001) "Product Information. Effexor (venlafaxine)." Wyeth-Ayerst Laboratories
- Brannan SK, Talley BJ, Bowden CL (1994) "Sertraline and isocarboxazid cause a serotonin syndrome." J Clin Psychopharmacol, 14, p. 144-5
- Graber MA, Hoehns TB, Perry PJ (1994) "Sertraline-phenelzine drug interaction: a serotonin syndrome reaction." Ann Pharmacother, 28, p. 732-5
- Cetaruk EW, Aaron CK (1994) "Hazards of nonprescription medications." Emerg Med Clin North Am, 12, p. 483-510
- Diamond S (1995) "The use of sumatriptan in patients on monoamine oxidase inhibitors." Neurology, 45, p. 1039-40
- Phillips SD, Ringo P (1995) "Phenelzine and venlafaxine interaction." Am J Psychiatry, 152, p. 1400-1
- Klysner R, Larsen JK, Sorensen P, Hyllested M, Pedersen BD (1995) "Toxic interaction of venlafaxine and isocarboxazide." Lancet, 346, p. 1298-9
- Darcy PF, Griffin JP (1995) "Interactions with drugs used in the treatment of depressive illness." Adverse Drug React Toxicol Rev, 14, p. 211-31
- Heisler MA, Guidry JR, Arnecke B (1996) "Serotonin syndrome induced by administration of venlafaxine and phenelzine." Ann Pharmacother, 30, p. 84
- De Vita VT, Hahn MA, Oliverio VT (1965) "Monoamine oxidase inhibition by a new carcinostatic agent, n-isopropyl-a-(2-methylhydrazino)-p-toluamide (MIH). (30590)." Proc Soc Exp Biol Med, 120, p. 561-5
- Fischer P (1995) "Serotonin syndrome in the elderly after antidepressive monotherapy." J Clin Psychopharmacol, 15, p. 440-2
- Corkeron MA (1995) "Serotonin syndrome - a potentially fatal complication of antidepressant therapy." Med J Aust, 163, p. 481-2
- Thomas JM, Rubin EH (1984) "Case report of a toxic reaction from a combination of tryptophan and phenelzine." Am J Psychiatry, 141, p. 281-3
- Pope HG Jr, Jonas JM, Hudson JI, Kafka MP (1985) "Toxic reactions to the combination of monoamine oxidase inhibitors and tryptophan." Am J Psychiatry, 142, p. 491-2
- Alvine G, Black DW, Tsuang D (1990) "Case of delirium secondary to phenelzine/L-tryptophan combination." J Clin Psychiatry, 51, p. 311
- Staufenberg EF, Tantam D (1989) "Malignant hyperpyrexia syndrome in combined treatment." Br J Psychiatry, 154, p. 577-8
- Levy AB, Bucher P, Votolato N (1985) "Myoclonus, hyperreflexia and diaphoresis in patients on phenelzine- tryptophan combination treatment." Can J Psychiatry, 30, p. 434-6
- Beasley CM Jr, Masica DN, Heiligenstein JH, Wheadon DE, Zerbe RL (1993) "Possible monoamine oxidase inhibitor-serotonin uptake inhibitor interaction: fluoxetine clinical data and preclinical findings." J Clin Psychopharmacol, 13, p. 312-20
- Mills KC (1997) "Serotonin syndrome: A clinical update." Crit Care Clin, 13, p. 763
- Gardner DM, Lynd LD (1998) "Sumatriptan contraindications and the serotonin syndrome." Ann Pharmacother, 32, p. 33-8
- Mathew NT, Tietjen GE, Lucker C (1996) "Serotonin syndrome complicating migraine pharmacotherapy." Cephalalgia, 16, p. 323-7
- Weiner LA, Smythe M, Cisek J (1998) "Serotonin syndrome secondary to phenelzine-venlafaxine interaction." Pharmacotherapy, 18, p. 399-403
- Diamond S, Pepper BJ, Diamond ML, Freitag FG, Urban GJ, Erdemoglu AK (1998) "Serotonin syndrome induced by transitioning from phenelzine to venlafaxine: four patient reports." Neurology, 51, p. 274-6
- Chan BSH, Graudins A, Whyte IM, Dawson AH, Braitberg G, Duggin GG (1998) "Serotonin syndrome resulting from drug interactions." Med J Aust, 169, p. 523-5
- Brubacher JR, Hoffman RS, Lurin MJ (1996) "Serotonin syndrome from venlafaxine-tranylcypromine interaction." Vet Hum Toxicol, 38, p. 358-61
- Miller LG (1998) "Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions." Arch Intern Med, 158, p. 2200-11
- Martin TG (1996) "Serotonin syndrome." Ann Emerg Med, 28, p. 520-6
- Jacob JE, Wagner ML, Sage JI (2003) "Safety of selegiline with cold medications." Ann Pharmacother, 37, p. 438-41
- (2004) "Product Information. Cymbalta (duloxetine)." Lilly, Eli and Company
- (2005) "Product Information. Manerix (moclobemide)." Hoffmann-La Roche Limited
- Gillman PK (2005) "Monoamine oxidase inhibitors, opioid analgesics and serotonin toxicity." Br J Anaesth
- Bodner RA, Lynch T, Lewis L, Kahn D (1995) "Serotonin syndrome." Neurology, 45, p. 219-23
- Jimenez-Genchi A (2006) "Immediate switching from moclobemide to duloxetine may induce serotonin syndrome." J Clin Psychiatry, 67, p. 1821-1822
- (2008) "Product Information. Pristiq (desvenlafaxine)." Wyeth Laboratories
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- (2011) "Product Information. Viibryd (vilazodone)." Trovis Pharmaceuticals LLC
- (2013) "Product Information. Fetzima (levomilnacipran)." Forest Pharmaceuticals
furazolidone phenylephrine
Applies to: furazolidone and Uni-Tuss DM (chlorpheniramine / dextromethorphan / phenylephrine)
CONTRAINDICATED: Indirect- or mixed-acting sympathomimetic amines may precipitate severe hypertensive reactions and hyperpyrexia in patients treated with monoamine oxidase inhibitors (MAOIs). Death has occurred in some reported cases. The mechanism involves a synergistic sympathomimetic effect due to enhanced norepinephrine storage in adrenergic neurons (MAOI activity) and increased liberation of catecholamines (indirect sympathomimetic activity). Although the interaction has primarily involved nonselective MAOIs, hypertensive crisis has been reported in a patient taking ephedrine with the recommended dosage of a selective MAO-B inhibitor.
MANAGEMENT: In general, indirect- and mixed-acting sympathomimetic agents should not be used concurrently with MAOIs or other agents that possess MAOI activity (e.g., furazolidone, methylene blue, procarbazine). At least 14 days should elapse between discontinuation of MAOI therapy and initiation of treatment with sympathomimetic agents.
References
- Pettinger WA, Soyangco FG, Oates JA (1968) "Inhibition of monoamine oxidase in man by furazolidone." Clin Pharmacol Ther, 9, p. 442-7
- Schulz R, Antonin KH, Hoffmann E, et al. (1989) "Tyramine kinetics and pressor sensitivity during monoamine oxidase inhibition by selegiline." Clin Pharmacol Ther, 46, p. 528-36
- Elis J, Laurence DR, Mattie H, Prichard BN (1967) "Modification by monoamine oxidase inhibitors of the effect of some sympathomimetics on blood pressure." Br Med J, 2, p. 75-8
- Davies B, Bannister R, Sever P (1978) "Pressor amines and monoamine-oxidase inhibitors for treatment of postural hypotension in autonomic failure: limitations and hazards." Lancet, 1, p. 172-5
- Goldberg LI (1964) "Monoamine oxidase inhibitors: adverse reactions and possible mechanisms." JAMA, 190, p. 456-62
- Horler AR, Wynne NA (1965) "Hypertensive crisis due to pargyline and metaraminol." Br Med J, 5459, p. 460-1
- Sjoqvist F (1965) "Psychotropic drugs (2) interaction between monoamine oxidase (MAO) inhibitors and other substances." Proc R Soc Med, 58, p. 967-78
- Harrison WM, McGrath PJ, Stewart JW, Quitkin F (1989) "MAOIs and hypertensive crises: the role of OTC drugs." J Clin Psychiatry, 50, p. 64-5
- Cuthbert MF, Greenberg MP, Morley SW (1969) "Cough and cold remedies: a potential danger to patients on monoamine oxidase inhibitors." Br Med J, 1, p. 404-6
- Humberstone PM (1969) "Hypertension from cold remedies." Br Med J, 1, p. 846
- Wright SP (1978) "Hazards with monoamine-oxidase inhibitors: a persistent problem." Lancet, 1, p. 284-5
- Schildkraut JJ, Klerman GL, Friend DG, Greenblatt M (1963) "Biochemical and pressor effects of oral d,l-dihydroxyphenylalanine in patients pretreated with antidepressant drugs." Ann N Y Acad Sci, 107, p. 1005-15
- Smookler S, Bermudez AJ (1982) "Hypertensive crisis resulting from an MAO inhibitor and an over-the-counter appetite suppressant." Ann Intern Med, 11, p. 482-4
- Mason AM, Buckle RM (1969) ""Cold" cures and monoamine-oxidase inhibitors." Br Med J, 1, p. 845-6
- Boakes AJ, Laurence DR, Teoh PC, Barar FS, Benedikter LT, Prichard BN (1973) "Interactions between sympathomimetic amines and antidepressant agents in man." Br Med J, 1, p. 311-5
- Goulet JP, Perusse R, Turcotte JY (1992) "Contraindications to vasoconstrictors in dentistry: Part III. Pharmacologic interactions." Oral Surg Oral Med Oral Pathol, 74, p. 692-7
- Ban TA (1975) "Drug interactions with psychoactive drugs." Dis Nerv Syst, 36, p. 164-6
- Lefebvre H, Noblet C, Morre N, Wolf LM (1995) "Pseudo-phaeochromocytoma after multiple drug interactions involving the selective monoamine oxidase inhibitor selegiline." Clin Endocrinol (Oxf), 42, p. 95-8
- Darcy PF, Griffin JP (1995) "Interactions with drugs used in the treatment of depressive illness." Adverse Drug React Toxicol Rev, 14, p. 211-31
- De Vita VT, Hahn MA, Oliverio VT (1965) "Monoamine oxidase inhibition by a new carcinostatic agent, n-isopropyl-a-(2-methylhydrazino)-p-toluamide (MIH). (30590)." Proc Soc Exp Biol Med, 120, p. 561-5
- Kraft KE, Dore FH (1996) "Computerized drug interaction programs: how reliable?." JAMA, 275, p. 1087
chlorpheniramine dextromethorphan
Applies to: Uni-Tuss DM (chlorpheniramine / dextromethorphan / phenylephrine) and Uni-Tuss DM (chlorpheniramine / dextromethorphan / phenylephrine)
MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients. Sedation and impairment of attention, judgment, thinking, and psychomotor skills may increase.
MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Cautious dosage titration may be required, particularly at treatment initiation. Ambulatory patients should be counseled to avoid hazardous activities requiring 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
- Hamilton MJ, Bush M, Smith P, Peck AW (1982) "The effects of bupropion, a new antidepressant drug, and diazepam, and their interaction in man." Br J Clin Pharmacol, 14, p. 791-7
- Stambaugh JE, Lane C (1983) "Analgesic efficacy and pharmacokinetic evaluation of meperidine and hydroxyzine, alone and in combination." Cancer Invest, 1, p. 111-7
- Sotaniemi EA, Anttila M, Rautio A, et al. (1981) "Propranolol and sotalol metabolism after a drinking party." Clin Pharmacol Ther, 29, p. 705-10
- Grabowski BS, Cady WJ, Young WW, Emery JF (1980) "Effects of acute alcohol administration on propranolol absorption." Int J Clin Pharmacol Ther Toxicol, 18, p. 317-9
- Lemberger L, Rowe H, Bosomworth JC, Tenbarge JB, Bergstrom RF (1988) "The effect of fluoxetine on the pharmacokinetics and psychomotor responses of diazepam." Clin Pharmacol Ther, 43, p. 412-9
- MacLeod SM, Giles HG, Patzalek G, Thiessen JJ, Sellers EM (1977) "Diazepam actions and plasma concentrations following ethanol ingestion." Eur J Clin Pharmacol, 11, p. 345-9
- Divoll M, Greenblatt DJ, Lacasse Y, Shader RI (1981) "Benzodiazepine overdosage: plasma concentrations and clinical outcome." Psychopharmacology (Berl), 73, p. 381-3
- Naylor GJ, McHarg A (1977) "Profound hypothermia on combined lithium carbonate and diazepam treatment." Br Med J, 2, p. 22
- Stovner J, Endresen R (1965) "Intravenous anaesthesia with diazepam." Acta Anaesthesiol Scand, 24, p. 223-7
- Driessen JJ, Vree TB, Booij LH, van der Pol FM, Crul JF (1984) "Effect of some benzodiazepines on peripheral neuromuscular function in the rat in-vitro hemidiaphragm preparation." J Pharm Pharmacol, 36, p. 244-7
- Feldman SA, Crawley BE (1970) "Interaction of diazepam with the muscle-relaxant drugs." Br Med J, 1, p. 336-8
- Ochs HR, Greenblatt DJ, Verburg-Ochs B (1984) "Propranolol interactions with diazepam, lorazepam and alprazolam." Clin Pharmacol Ther, 36, p. 451-5
- Desager JP, Hulhoven R, Harvengt C, Hermann P, Guillet P, Thiercelin JF (1988) "Possible interactions between zolpidem, a new sleep inducer and chlorpromazine, a phenothiazine neuroleptic." Psychopharmacology (Berl), 96, p. 63-6
- Tverskoy M, Fleyshman G, Ezry J, Bradley EL, Jr Kissin I (1989) "Midazolam-morphine sedative interaction in patients." Anesth Analg, 68, p. 282-5
- "Product Information. Iopidine (apraclonidine ophthalmic)." Alcon Laboratories Inc
- Greiff JMC, Rowbotham D (1994) "Pharmacokinetic drug interactions with gastrointestinal motility modifying agents." Clin Pharmacokinet, 27, p. 447-61
- Greb WH, Buscher G, Dierdorf HD, Koster FE, Wolf D, Mellows G (1989) "The effect of liver enzyme inhibition by cimetidine and enzyme induction by phenobarbitone on the pharmacokinetics of paroxetine." Acta Psychiatr Scand, 80 Suppl, p. 95-8
- Markowitz JS, Wells BG, Carson WH (1995) "Interactions between antipsychotic and antihypertensive drugs." Ann Pharmacother, 29, p. 603-9
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- (2001) "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals
- (2001) "Product Information. Meridia (sibutramine)." Knoll Pharmaceutical Company
- (2001) "Product Information. Tasmar (tolcapone)." Valeant Pharmaceuticals
- Miller LG (1998) "Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions." Arch Intern Med, 158, p. 2200-11
- (2001) "Product Information. Precedex (dexmedetomidine)." Abbott Pharmaceutical
- (2001) "Product Information. Trileptal (oxcarbazepine)." Novartis Pharmaceuticals
- Ferslew KE, Hagardorn AN, McCormick WF (1990) "A fatal interaction of methocarbamol and ethanol in an accidental poisoning." J Forensic Sci, 35, p. 477-82
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- (2014) "Product Information. Belsomra (suvorexant)." Merck & Co., Inc
- (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
chlorpheniramine furazolidone
Applies to: Uni-Tuss DM (chlorpheniramine / dextromethorphan / phenylephrine) and furazolidone
GENERALLY AVOID: Coadministration of monoamine oxidase inhibitors (MAOIs) and antihistamines may result in additive central nervous system depressant effects. In addition, limited data suggest that MAOIs may potentiate and prolong the anticholinergic effects of antihistamines due to inhibition of catecholamine degradation, which may lead to overstimulation of the sympathetic nervous system. In one published report, a woman who had been on phenelzine 30 mg/day for six months developed irritability and visual hallucinations two months following the addition of cyproheptadine 2 mg at bedtime to treat phenelzine-induced anorgasmia. The hallucinations cleared over 48 hours following the discontinuation of her medications. In another published report, a patient developed delirium with symptoms of aggression, paranoia, and vivid auditory as well as visual hallucinations after two days of receiving diphenhydramine 300 mg/day and linezolid 600 mg every 12 hours. The patient also had tachycardia, very warm skin, and possibly blurred vision (as evidenced by constant squinting). Central anticholinergic intoxication and dopaminergic hyperactivity were suspected. Symptoms subsided over four days following the discontinuation of diphenhydramine, while linezolid was continued with no subsequent sequelae. In a third report, a patient developed visual hallucinations associated with confusion and disorientation after nine days of linezolid and antihistamine therapy, including dexchlorpheniramine and cetirizine for the first four days and hydroxyzine for the next five. Physical examination did not reveal any focal neurological signs, myoclonus or ataxia, and cerebral CT scan and EEG were within normal limits. Symptoms resolved two days after linezolid was discontinued.
MANAGEMENT: Prescribing antihistamines in combination with MAOIs or other agents that possess MAOI activity (e.g., furazolidone, linezolid, procarbazine) should generally be avoided. If concomitant treatment is unavoidable, patients should be counseled to avoid hazardous activities requiring 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. It may be appropriate to monitor some patients for increased anticholinergic effects (e.g., constipation, urinary retention, fever, heat intolerance, blurred vision, confusion, hallucinations, dizziness, palpitations, arrhythmias, syncope), since certain populations such as the elderly and those with underlying organic brain disease tend to be more sensitive to these effects and may be susceptible to anticholinergic intoxication. It should be noted that the manufacturers of many of the sedating antihistamines (e.g., chlorpheniramine, dexchlorpheniramine, diphenhydramine, pheniramine, promethazine) consider their use within 14 days of MAOIs to be contraindicated.
References
- Kahn DA (1987) "Possible toxic interaction between cyproheptadine and phenelzine." Am J Psychiatry, 144, p. 1242-3
- (2002) "Product Information. Periactin (cyproheptadine)." Merck & Co., Inc
- (2002) "Product Information. Benadryl (diphenhydramine)." Parke-Davis
- (2001) "Product Information. Matulane (procarbazine)." Roche Laboratories
- Serio RN (2004) "Acute delirium associated with combined diphenhydramine and linezolid use." Ann Pharmacother, 38, p. 62-5
- Ferry T, Ponceau B, Simon M, et al. (2005) "Possibly linezolid-induced peripheral and central neurotoxicity: report of four cases." Infection, 33, p. 151-4
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- Canadian Pharmacists Association (2006) e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink
- Cerner Multum, Inc. "Australian Product Information."
Drug and food interactions
furazolidone food
Applies to: furazolidone
CONTRAINDICATED: Foods that contain large amounts of tyramine may precipitate a hypertensive crisis in patients treated with monoamine oxidase inhibitors (MAOIs). The mechanism is inhibition of MAO-A, the enzyme responsible for metabolizing exogenous amines such as tyramine in the gut and preventing them from being absorbed intact. Once absorbed, tyramine is metabolized to octopamine, a substance that is believed to displace norepinephrine from storage granules.
GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of MAOIs. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.
MANAGEMENT: In general, patients treated with MAOIs or other agents that possess MAOI activity (e.g., furazolidone, linezolid, procarbazine) should avoid consumption of products that contain large amounts of amines and protein foods in which aging or breakdown of protein is used to increase flavor. These foods include cheese (particularly strong, aged or processed cheeses), sour cream, wine (particularly red wine), champagne, beer, pickled herring, anchovies, caviar, shrimp paste, liver (particularly chicken liver), dry sausage, salamis, figs, raisins, bananas, avocados, chocolate, soy sauce, bean curd, sauerkraut, yogurt, papaya products, meat tenderizers, fava bean pods, protein extracts, yeast extracts, and dietary supplements. Caffeine may also precipitate hypertensive crisis so its intake should be minimized as well. At least 14 days should elapse following discontinuation of MAOI therapy before these foods may be consumed. Specially designed reference materials and dietary consultation are recommended so that an appropriate and safe diet can be planned. Patients should be advised to promptly seek medical attention if they experience potential signs and symptoms of a hypertensive crisis such as severe headache, visual disturbances, difficulty thinking, stupor or coma, seizures, chest pain, unexplained nausea or vomiting, and stroke-like symptoms. Patients should also be counseled not to use MAOIs with alcohol, and to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them.
References
- Pettinger WA, Soyangco FG, Oates JA (1968) "Inhibition of monoamine oxidase in man by furazolidone." Clin Pharmacol Ther, 9, p. 442-7
- Goldberg LI (1964) "Monoamine oxidase inhibitors: adverse reactions and possible mechanisms." JAMA, 190, p. 456-62
- Nuessle WF, Norman FC, Miller HE (1965) "Pickled herring and tranylcypromine reaction." JAMA, 192, p. 142-3
- Sweet RA, Liebowitz MR, Holt CS, Heimberg RG (1991) "Potential interactions between monoamine oxidase inhibitors and prescribed dietary supplements." J Clin Psychopharmacol, 11, p. 331-2
- Walker JI, Davidson J, Zung WWK (1984) "Patient compliance with MAO Inhibitor therapy." J Clin Psychiatry, 45, p. 78-80
- Ban TA (1975) "Drug interactions with psychoactive drugs." Dis Nerv Syst, 36, p. 164-6
- Darcy PF, Griffin JP (1995) "Interactions with drugs used in the treatment of depressive illness." Adverse Drug React Toxicol Rev, 14, p. 211-31
- Maxwell MB (1980) "Reexamining the dietary restrictions with procarbazine (an MAOI)." Cancer Nurs, 3, p. 451-7
- (2001) "Product Information. Matulane (procarbazine)." Roche Laboratories
- De Vita VT, Hahn MA, Oliverio VT (1965) "Monoamine oxidase inhibition by a new carcinostatic agent, n-isopropyl-a-(2-methylhydrazino)-p-toluamide (MIH). (30590)." Proc Soc Exp Biol Med, 120, p. 561-5
- Zetin M, Plon L, DeAntonio M (1987) "MAOI reaction with powdered protein dietary supplement." J Clin Psychiatry, 48, p. 499
- Domino EF, Selden EM (1984) "Red wine and reactions." J Clin Psychopharmacol, 4, p. 173-4
- Tailor SA, Shulman KI, Walker SE, Moss J, Gardner D (1994) "Hypertensive episode associated with phenelzine and tap beer--a reanalysis of the role of pressor amines in beer." J Clin Psychopharmacol, 14, p. 5-14
- Pohl R, Balon R, Berchou R (1988) "Reaction to chicken nuggets in a patient taking an MAOI." Am J Psychiatry, 145, p. 651
- (2001) "Product Information. Furoxone (furazolidone)." Roberts Pharmaceutical Corporation
- (2001) "Product Information. Nardil (phenelzine)." Parke-Davis
- (2001) "Product Information. Marplan (isocarboxazid)." Roche Laboratories
- (2001) "Product Information. Zyvox (linezolid)." Pharmacia and Upjohn
- Martin TG (1996) "Serotonin syndrome." Ann Emerg Med, 28, p. 520-6
chlorpheniramine food
Applies to: Uni-Tuss DM (chlorpheniramine / dextromethorphan / phenylephrine)
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
- Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
- 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.
- (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
- (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
dextromethorphan food
Applies to: Uni-Tuss DM (chlorpheniramine / dextromethorphan / phenylephrine)
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
- Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
- 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.
- (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
- (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
phenylephrine food
Applies to: Uni-Tuss DM (chlorpheniramine / dextromethorphan / phenylephrine)
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
- 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
- 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
- (2001) "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc
- (2001) "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals
- (2001) "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals
- (2001) "Product Information. Focalin (dexmethylphenidate)." Mikart Inc
- (2002) "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company
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
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
No interaction information available. |
Further information
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