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Drug Interactions between Sonahist and tirzepatide

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

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Interactions between your drugs

Moderate

chlorpheniramine tirzepatide

Applies to: Sonahist (chlorpheniramine / phenylephrine) and tirzepatide

Consumer information for this interaction is not currently available.

MONITOR: Additive increases in heart rate may occur when tirzepatide is coadministered with other drugs that can also increase heart rate. The mechanism by which tirzepatide may affect heart rate is unknown. In placebo-controlled trials, treatment with tirzepatide resulted in an average increase in heart rate of 2 to 4 beats per minute (bpm) compared to an average increase of 1 bpm in patients receiving placebo. The incidence of patients who had a change in heart rate of greater than 20 bpm from baseline for 2 or more consecutive visits was 2.1%, 3.8% and 2.9% for tirzepatide 5 mg, 10 mg and 15 mg, respectively, compared with 2.1% for placebo. Episodes of sinus tachycardia, associated with a concomitant increase in heart rate of greater than or equal to 15 bpm from baseline, were reported in 4.3%, 4.6%, 5.9% and 10% of subjects treated with placebo or tirzepatide 5 mg, 10 mg and 15 mg, respectively. For patients enrolled in Japan, the reported frequencies of these episodes were 7% (3/43), 7.1% (3/42), 9.3% (4/43) and 23% (10/43), respectively.

MANAGEMENT: Although the clinical relevance of the effects on heart rate is not currently known, some authorities suggest observing caution when tirzepatide is coadministered with other drugs that can increase heart rate such as those with sympathomimetic or anticholinergic activity. Advise patients of the potential risk of tachycardia and to contact their healthcare provider if it occurs in the absence of a known cause (i.e., at rest).

References

  1. "Product Information. Mounjaro (tirzepatide)." Eli Lilly and Company Ltd (2023):
  2. "Product Information. Mounjaro (tirzepatide)." Lilly, Eli and Company (2023):
  3. Eli Lilly Canada Inc. "Product monograph including patient medication information MOUNJARO tirzepatide injection. https://pdf.hres.ca/dpd_pm/00068421.PDF" (2023):
Moderate

phenylephrine tirzepatide

Applies to: Sonahist (chlorpheniramine / phenylephrine) and tirzepatide

Phenylephrine may interfere with blood glucose control and reduce the effectiveness of tirzepatide and other diabetic medications. Monitor your blood sugar levels closely. You may need a dose adjustment of your diabetic medications during and after treatment with phenylephrine. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Drug and food interactions

Moderate

chlorpheniramine food

Applies to: Sonahist (chlorpheniramine / phenylephrine)

Alcohol can increase the nervous system side effects of chlorpheniramine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with chlorpheniramine. Do not use more than the recommended dose of chlorpheniramine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

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Moderate

tirzepatide food

Applies to: tirzepatide

Tirzepatide may affect the absorption of other medications that you take by mouth. In some cases, this may affect how well and/or how fast those medications work, or it may make no difference. Talk to a healthcare provider if you have any questions or concerns, and contact your doctor if your symptoms worsen or your condition changes. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

phenylephrine food

Applies to: Sonahist (chlorpheniramine / phenylephrine)

Consumer information for this interaction is not currently available.

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

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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