Drug Interaction Report

Using methylergonovine together with pseudoephedrine is generally not recommended. Methylergonovine may cause significant increases in blood pressure by constricting the blood vessels, and the risk for complications may be increased when used with other drugs that also have this effect such as decongestants, stimulants, and certain medications for headache, glaucoma, or eye redness relief. Combining these medications may also reduce blood flow to vital organs and increase the risk of rare but serious side effects such as heart attack, stroke, intestinal problems, and gangrene (death of tissues, usually in the arm or leg, that may require surgical amputation). Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. You should seek immediate medical attention if you experience severe abdominal pain, nausea, vomiting, numbness or tingling, muscle pain or weakness, blue or purple discoloration of fingers or toes, pale or cold skin, chest pain or tightness, severe or throbbing headache, irregular heartbeat, shortness of breath, blurred vision, confusion, and/or slurred speech during treatment with these medications. 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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Talk to your doctor before using dextromethorphan together with DULoxetine. Combining these medications can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should contact your doctor immediately if you experience these symptoms while taking the medications. 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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Using codeine together with dextromethorphan can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucinations, seizures, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should contact your doctor immediately if you experience these symptoms during treatment. In addition, combining these medications may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. 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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Lisinopril and codeine may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. 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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Although acetaZOLAMIDE and lisinopril are frequently combined together, their effects may be additive on lowering your blood pressure. You may need a dose adjustment or special tests to safely take both medications. Contact your doctor if you have a reduced heart rate, dizziness, fainting, or headaches. 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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Using cetirizine together with codeine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid driving, operating machinery, or engaging in potentially hazardous activities requiring mental alertness and motor coordination until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. 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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DULoxetine may affect how well codeine works in your body. You may need a dose adjustment or more frequent monitoring to use the medications together or if DULoxetine is started or stopped while you are receiving therapy with codeine. Let your doctor know if your condition changes, you notice an increase in side effects, or you experience reduced or inadequate relief of your symptoms. 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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Treatment with DULoxetine may occasionally cause blood sodium levels to get too low, a condition known as hyponatremia, and using it with acetaZOLAMIDE can increase that risk. You should seek medical attention if you experience nausea, vomiting, headache, lethargy, irritability, difficulty concentrating, memory impairment, confusion, muscle spasm, weakness or unsteadiness, as these may be symptoms of hyponatremia. More severe cases may lead to hallucination, fainting, seizure, coma, and even death. DULoxetine can also affect your blood pressure and heart rate. You may need a dose adjustment or more frequent monitoring of your blood pressure and pulse to safely use both medications. You should avoid rising abruptly from a sitting or lying position while taking these medications, especially at the beginning of treatment or after an increase in dose. Call your doctor if you experience dizziness, lightheadedness, fainting, or a rapid heart beat. 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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Both DULoxetine and pseudoephedrine can increase blood pressure and heart rate, and combining them may enhance these effects. Talk to your doctor if you have any questions or concerns, particularly if you have a history of high blood pressure, irregular heart rhythm, or heart disease. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. 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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Using cetirizine together with DULoxetine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid driving, operating machinery, or engaging in potentially hazardous activities requiring mental alertness and motor coordination until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. 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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Alcohol can increase the nervous system side effects of dextromethorphan 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 dextromethorphan. Do not use more than the recommended dose of dextromethorphan, 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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Grapefruit juice may increase the blood levels of certain medications such as methylergonovine. You may want to limit your consumption of grapefruit and grapefruit juice during treatment with methylergonovine. However, if you have been regularly consuming grapefruit or grapefruit juice with the medication, then it is advisable for you to talk with your doctor before changing the amounts of these products in your diet, as this may alter the effects of your medication. Contact your doctor if your condition changes or you experience increased side effects. Orange juice is not expected to interact.

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It is recommended that if you are taking lisinopril you should be advised to avoid moderately high or high potassium dietary intake. This can cause high levels of potassium in your blood. Do not use salt substitutes or potassium supplements while taking lisinopril, unless your doctor has told you to.

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Alcohol can increase the nervous system side effects of cetirizine 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 cetirizine. Do not use more than the recommended dose of cetirizine, 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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DULoxetine may cause liver damage, and taking it with alcohol may increase that risk. You should avoid or limit the use of alcohol while being treated with DULoxetine. Call your doctor immediately if you have fever, chills, joint pain or swelling, excessive tiredness or weakness, unusual bleeding or bruising, skin rash or itching, loss of appetite, nausea, vomiting, dark colored urine, or yellowing of the skin or the whites of your eyes, as these may be symptoms of liver damage. 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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Do not use alcohol or medications that contain alcohol while you are receiving treatment with codeine. This may increase nervous system side effects such as drowsiness, dizziness, lightheadedness, difficulty concentrating, and impairment in thinking and judgment. In severe cases, low blood pressure, respiratory distress, fainting, coma, or even death may occur. With certain long-acting formulations of narcotic pain medication, consumption of alcohol may also cause rapid release of the drug, resulting in high blood levels that may be potentially lethal. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. Do not use more than the recommended dose of codeine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medication without first talking to your doctor.

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Lisinopril and ethanol may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. 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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Both pseudoephedrine and caffeine can increase blood pressure and heart rate, and combining them may enhance these effects. Talk to your doctor before using these medications, especially if you have a history of high blood pressure or heart disease. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects. 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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The recommended maximum number of medicines in the 'antihistamines, antitussives and decongestants' category to be taken concurrently is usually three. Your list includes four medicines belonging to the 'antihistamines, antitussives and decongestants' category:

• codeine
• Decongestant Cold Formula (dextromethorphan / pseudoephedrine)
• Mucinex (guaifenesin)
• Zyrtec (cetirizine)

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.