Drug Interactions between tromethamine and Tussadur-HD
This report displays the potential drug interactions for the following 2 drugs:
- tromethamine
- Tussadur-HD (guaifenesin/hydrocodone/pseudoephedrine)
Interactions between your drugs
tromethamine pseudoephedrine
Applies to: tromethamine and Tussadur-HD (guaifenesin / hydrocodone / pseudoephedrine)
MONITOR: Alkalization of the urine decreases the urinary excretion increases the elimination half-life of ephedrine, pseudoephedrine, and related drugs. According to one report, an increase in pH from 5.1 to 7.1 increased the half-life of pseudoephedrine from 5 to 16 hours. Toxicity from long-term use of pseudoephedrine has been demonstrated in patients with persistently alkaline urine.
MANAGEMENT: Patients should be monitored for toxic effects such as tremor, anxiety, insomnia, irritability, or nervousness. Dosage reductions may be required.
References
- Brater DC, Kaojarern S, Benet LZ, et al. (1980) "Renal excretion of pseudoephedrine." Clin Pharmacol Ther, 28, p. 690-4
- Wilkinson GR, Beckett AH (1968) "Absorption metabolism and excretion of the ephedrines in man. I. The influence of urinary pH and urine volume output." J Pharmacol Exp Ther, 162, p. 139-47
- Kuntzman RG, Tsai I, Brand L, Mark LC (1971) "The influence of urinary pH on the plasma half-life of pseudoephedrine in man and dog and a sensitive assay for its determination in human plasma." Clin Pharmacol Ther, 12, p. 62-7
Drug and food interactions
HYDROcodone food
Applies to: Tussadur-HD (guaifenesin / hydrocodone / pseudoephedrine)
GENERALLY AVOID: Alcohol may potentiate the central nervous system (CNS) depressant effects of opioid analgesics including hydrocodone. Concomitant use may result in additive CNS depression and impairment of judgment, thinking, and psychomotor skills. In more severe cases, hypotension, respiratory depression, profound sedation, coma, or even death may occur.
GENERALLY AVOID: Consumption of alcohol while taking some sustained-release formulations of hydrocodone may cause rapid release of the drug, resulting in high systemic levels of hydrocodone that may be potentially lethal. Alcohol apparently can disrupt the release mechanism of some sustained-release formulations. In study subjects, the rate of absorption of hydrocodone from an extended-release formulation was found to be affected by coadministration with 40% alcohol in the fasted state, as demonstrated by an average 2.4-fold (up to 3.9-fold in one subject) increase in hydrocodone peak plasma concentration and a decrease in the time to peak concentration. Alcohol also increased the extent of absorption by an average of 1.2-fold (up to 1.7-fold in one subject).
GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of hydrocodone. The proposed mechanism is inhibition of CYP450 3A4-mediated metabolism of hydrocodone by certain compounds present in grapefruit. Increased hydrocodone concentrations could conceivably increase or prolong adverse drug effects and may cause potentially fatal respiratory depression.
MANAGEMENT: Patients taking sustained-release formulations of hydrocodone should not consume alcohol or use medications that contain alcohol. In general, potent narcotics such as hydrocodone should not be combined with alcohol. Patients should also avoid consumption of grapefruit or grapefruit juice during treatment with hydrocodone.
References
- (2013) "Product Information. Zohydro ER (hydrocodone)." Zogenix, Inc
pseudoephedrine food
Applies to: Tussadur-HD (guaifenesin / hydrocodone / pseudoephedrine)
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
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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