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Drug Interactions between methylene blue and Symbicort

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

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Interactions between your drugs

Moderate

methylene blue formoterol

Applies to: methylene blue and Symbicort (budesonide / formoterol)

MONITOR: Monoamine oxidase inhibitors (MAOIs) can potentiate the cardiovascular adverse effects of beta-2 adrenergic agonists such as hypertension, palpitation, tachycardia, and chest pain.

MANAGEMENT: Cardiovascular status should be closely monitored when beta-2 agonists are coadministered with MAOIs or other agents that possess MAOI activity (e.g., furazolidone, linezolid, methylene blue, procarbazine). Preferably, at least 14 days should elapse between discontinuation of MAOI therapy and initiation of treatment with beta-2 agonists.

References

  1. Finch JS (1981) "Cardiovascular toxicity: clinical evaluation of albuterol, isoproterenol and placebo in rising dose tolerance trial." Ann Allergy, 47, p. 402-4
  2. (1985) "Adverse effects and complications of treatment with beta-adrenergic agonist drugs. Committee on drugs, the American Academy of Allergy and Immunology." J Allergy Clin Immunol, 75, p. 443-9
  3. (2002) "Product Information. Proventil (albuterol)." Schering Corporation
  4. (2001) "Product Information. Brethaire (terbutaline)." Novartis Pharmaceuticals
  5. (2001) "Product Information. Isuprel (isoproterenol)." Sanofi Winthrop Pharmaceuticals
  6. "Product Information. Serevent (salmeterol)." Glaxo Wellcome
  7. (2001) "Product Information. Maxair (pirbuterol)." 3M Pharmaceuticals
  8. 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
  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
  10. (2001) "Product Information. Alupent (metaproterenol)." Boehringer-Ingelheim
  11. (2022) "Product Information. Tornalate (bitolterol)." Apothecon Inc
  12. (2001) "Product Information. Xopenex (levalbuterol)." Sepracor Inc
  13. (2001) "Product Information. Foradil (formoterol)." Novartis Pharmaceuticals
  14. (2006) "Product Information. Brovana (arformoterol)." Sepracor Inc
  15. (2010) "Product Information. S2 Inhalant (racepinephrine)." Nephron Pharmaceuticals
  16. (2011) "Product Information. Arcapta Neohaler (indacaterol)." Novartis Pharmaceuticals
  17. (2013) "Product Information. Breo Ellipta (fluticasone-vilanterol)." GlaxoSmithKline
  18. (2014) "Product Information. Striverdi Respimat (olodaterol)." Boehringer Ingelheim
View all 18 references

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Minor

budesonide formoterol

Applies to: Symbicort (budesonide / formoterol) and Symbicort (budesonide / formoterol)

Although they are often combined in clinical practice, the concomitant use of beta-2 adrenergic agonists and corticosteroids may result in additive hypokalemic effects. Since beta-2 agonists can sometimes cause QT interval prolongation, the development of hypokalemia may potentiate the risk of ventricular arrhythmias including torsade de pointes. However, clinical data are limited, and the potential significance is unknown. Patients who are receiving systemic or nebulized formulations of beta-2 agonists, high dosages of inhaled beta-2 agonists, or systemic corticosteroid therapy may be at a greater risk of developing hypokalemia.

References

  1. (2001) "Product Information. Foradil (formoterol)." Novartis Pharmaceuticals
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  3. Cerner Multum, Inc. "Australian Product Information."
  4. Agencia Española de Medicamentos y Productos Sanitarios Healthcare (2008) Centro de información online de medicamentos de la AEMPS - CIMA. https://cima.aemps.es/cima/publico/home.html
View all 4 references

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Drug and food interactions

Moderate

budesonide food

Applies to: Symbicort (budesonide / formoterol)

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations and systemic effects of orally administered budesonide. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. According to the manufacturer, the systemic exposure of oral budesonide approximately doubles after extensive intake of grapefruit juice.

MANAGEMENT: Patients receiving budesonide should avoid the regular consumption of grapefruits and grapefruit juice to prevent undue increases in plasma budesonide levels and systemic effects.

References

  1. (2001) "Product Information. Entocort (budesonide)." AstraZeneca Pharma Inc

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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

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