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Hycomine Compound (acetaminophen / caffeine / chlorpheniramine / hydrocodone / phenylephrine) Disease Interactions

There are 36 disease interactions with Hycomine Compound (acetaminophen / caffeine / chlorpheniramine / hydrocodone / phenylephrine):

Major

Acetaminophen (Includes Hycomine Compound) ↔ Alcoholism

Severe Potential Hazard, High plausibility

Applies to: Alcoholism

Chronic alcohol abusers may be at increased risk of hepatotoxicity during treatment with acetaminophen (APAP). Severe liver injury, including cases of acute liver failure resulting in liver transplant and death, has been reported in patients using acetaminophen. Therapy with acetaminophen should be administered cautiously, if at all, in patients who consume three or more alcoholic drinks a day. In general, patients should avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure. They should also be advised to seek medical attention if they experience signs and symptoms of liver injury such as fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, and jaundice.

References

  1. Whitcomb DC, Block GD "Association of acetaminopphen hepatotoxicity with fasting and ethanol use." JAMA 272 (1994): 1845-50
  2. Bonkovsky HL "Acetaminophen hepatotoxicity, fasting, and ethanol." JAMA 274 (1995): 301
  3. Kaysen GA, Pond SM, Roper MH, Menke DJ, Marrama MA "Combined hepatic and renal injury in alcoholics during therapeutic use of acetaminophen." Arch Intern Med 145 (1985): 2019-23
View all 11 references
Major

Acetaminophen (Includes Hycomine Compound) ↔ Liver Disease

Severe Potential Hazard, High plausibility

Applies to: Liver Disease

Acetaminophen is primarily metabolized in the liver to inactive forms. However, small quantities are converted by minor pathways to metabolites that can cause hepatotoxicity or methemoglobinemia. Patients with hepatic impairment may be at increased risk of toxicity due to increased minor metabolic pathway activity. Likewise, chronic or overuse of acetaminophen can saturate the primary hepatic enzymes and lead to increased metabolism by minor pathways. Severe liver injury, including cases of acute liver failure resulting in liver transplant and death, has been reported in patients using acetaminophen. Therapy with acetaminophen should be administered cautiously in patients with hepatic insufficiency. Clinical monitoring of hepatic function is recommended. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.

References

  1. Gillette JR "An integrated approach to the study of chemically reactive metabolites of acetaminophen." Arch Intern Med 141 (1981): 375-9
  2. "Product Information. Tylenol (acetaminophen)." McNeil Pharmaceutical, Raritan, NJ.
  3. Clements JA, Critchley JA, Prescott LF "The role of sulphate conjugation in the metabolism and disposition of oral and intravenous paracetamol in man." Br J Clin Pharmacol 18 (1984): 481-5
View all 6 references
Major

Antihistamines (Includes Hycomine Compound) ↔ Anticholinergic Effects

Severe Potential Hazard, Moderate plausibility

Applies to: Gastrointestinal Obstruction, Urinary Retention, Glaucoma/Intraocular Hypertension

Antihistamines often have anticholinergic activity, to which elderly patients are particularly sensitive. Therapy with antihistamines should be administered cautiously, if at all, in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders. Conventional, first-generation antihistamines such as the ethanolamines (bromodiphenhydramine, carbinoxamine, clemastine, dimenhydrinate, diphenhydramine, doxylamine, phenyltoloxamine) tend to exhibit substantial anticholinergic effects. In contrast, the newer, relatively nonsedating antihistamines (e.g., cetirizine, fexofenadine, loratadine) reportedly have low to minimal anticholinergic activity at normally recommended dosages and may be appropriate alternatives.

References

  1. "Product Information. Optimine (azatadine)." Schering Laboratories, Kenilworth, NJ.
  2. "Product Information. Periactin (cyproheptadine)." Merck & Co, Inc, West Point, PA.
  3. "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
View all 20 references
Major

Cns Stimulants (Includes Hycomine Compound) ↔ Cardiac Disease

Severe Potential Hazard, Moderate plausibility

Applies to: Hypertension, Hyperthyroidism, Heart Disease, Pheochromocytoma, Peripheral Arterial Disease

The use of CNS stimulants is contraindicated in patients with significant cardiovascular impairment such as uncompensated heart failure, severe coronary disease, severe hypertension (including that associated with hyperthyroidism or pheochromocytoma), cardiac structural abnormalities, serious arrhythmias, etc. Sudden death has been reported in adults and children taking CNS stimulant treatment. Additionally, stroke, myocardial infarction, chest pain, syncope, arrhythmias and other symptoms have been reported in adults under treatment. A careful assessment of the cardiovascular status should be done in patients being considered for treatment. This includes family history, physical exam and further cardiac evaluation (EKG and echocardiogram). Patients who develop symptoms should have a detailed cardiac evaluation and if needed, treatment should be suspended.

References

  1. "Product Information. Dopram (doxapram)." West-Ward Pharmaceutical Corporation, Eatontown, NJ.
Major

Cns Stimulants (Includes Hycomine Compound) ↔ Hypertension

Severe Potential Hazard, Moderate plausibility

Applies to: Hypertension

CNS stimulant medications have shown to increase blood pressure and their use is contraindicated in patients with severe hypertension. Caution should be used when administering to patients with preexisting high blood pressure and other cardiovascular conditions. All patients under treatment should be regularly monitored for changes in blood pressure and heart rate.

References

  1. "Product Information. Dopram (doxapram)." West-Ward Pharmaceutical Corporation, Eatontown, NJ.
Major

Cns Stimulants (Includes Hycomine Compound) ↔ Liver Disease

Severe Potential Hazard, Moderate plausibility

Applies to: Liver Disease

In general, CNS stimulants are extensively metabolized by the liver. Their plasma clearance may be decreased and their half-life prolonged in patients with impaired hepatic function. Therapy with CNS stimulants should be administered cautiously in patients with moderate to severe liver disease, and the dosage should be adjusted accordingly. Additionally, postmarketing reports have shown that atomoxetine can cause severe liver injury. Laboratory testing should be done at the first sign or symptom of liver dysfunction (jaundice, dark urine, upper quadrant tenderness) and treatment should be discontinued in patients with evidence of liver injury.

References

  1. "Product Information. Provigil (modafinil)." Cephalon, Inc, West Chester, PA.
Major

Cns Stimulants (Includes Hycomine Compound) ↔ Seizure Disorders

Severe Potential Hazard, Moderate plausibility

Applies to: Seizures

Due to general central nervous system stimulation, therapy with CNS stimulant drugs may cause seizures. These drugs may lower the convulsive threshold in patients with prior history of seizures or EEG abnormalities, and very rarely in patients with no previous history of seizures. Therapy with CNS stimulants should be used with caution in patients with or predisposed to seizures. If seizures appear, therapy should be discontinued.

References

  1. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
Major

Methylxanthines (Includes Hycomine Compound) ↔ Pud

Severe Potential Hazard, High plausibility

Applies to: Peptic Ulcer

Methylxanthines are known to stimulate peptic acid secretion. Therapy with products containing methylxanthines should be administered with extreme caution in patients with active peptic ulcer disease. Some manufacturers consider their use to be contraindicated under such circumstance.

References

  1. "Product Information. Theo-Dur (theophylline)." Schering Laboratories, Kenilworth, NJ.
  2. Alterman P, Spiegel D, Feldman J, Yaretzky A "Histamine h2-receptor antagonists and chronic theophylline toxicity." Am Fam Physician 54 (1996): 1473
  3. Stoller JL "Oesophageal ulceration and theophylline." Lancet 2 (1985): 328-9
View all 4 references
Major

Narcotic Analgesics (Includes Hycomine Compound) ↔ Impaired Gi Motility

Severe Potential Hazard, Moderate plausibility

Applies to: Inflammatory Bowel Disease, Constipation, Gastrointestinal Obstruction, Intestinal Anastomoses

Narcotic (opioid) analgesic agents increase smooth muscle tone in the gastrointestinal tract and decrease peristalsis, which can lead to elevated intraluminal pressure, spasm, and constipation following prolonged use. In patients with severe or acute inflammatory bowel disease, the decrease in colonic motility may induce toxic megacolon. Therapy with opioids should be administered cautiously in patients with gastrointestinal obstruction, constipation, inflammatory bowel disease, or recent gastrointestinal tract surgery. Gastrointestinal effects appear to be the most pronounced with morphine.

References

  1. White MJ, Berghausen EJ, Dumont SW, Tsueda K, Schroeder JA, Vogel RL, Heine MF, Huang KC "Side effects during continuous epidural infusion of morphine and fentanyl." Can J Anaesth 39 (1992): 576-82
  2. "Product Information. MS Contin (morphine)." Purdue Frederick Company, Norwalk, CT.
  3. "Product Information. Vicoprofen (hydrocodone-ibuprofen)." Knoll Pharmaceutical Company, Whippany, NJ.
View all 26 references
Major

Narcotic Analgesics (Includes Hycomine Compound) ↔ Infectious Diarrhea

Severe Potential Hazard, Moderate plausibility

Applies to: Infectious Diarrhea/Enterocolitis/Gastroenteritis

Narcotic (opioid) analgesic agents may prolong and/or worsen diarrhea associated with organisms that invade the intestinal mucosa, such as toxigenic E. coli, Salmonella, Shigella, and pseudomembranous colitis due to broad-spectrum antibiotics. These agents decrease gastrointestinal motility, which may delay the excretion of infective gastroenteric organisms and/or their toxins. Other symptoms and complications such as fever, shedding of organisms and extraintestinal illness may also be increased or prolonged. Therapy with opioids should be avoided or administered cautiously in patients with infectious diarrhea, particularly that due to pseudomembranous enterocolitis or enterotoxin-producing bacteria or if accompanied by high fever, pus, or blood in the stool.

References

  1. "Product Information. Darvon (propoxyphene)." Lilly, Eli and Company, Indianapolis, IN.
  2. "Product Information. Dalgan (dezocine)." Astra USA, Westborough, MA.
  3. "Product Information. Stadol (butorphanol nasal)." Bristol-Myers Squibb, Princeton, NJ.
View all 26 references
Major

Narcotic Analgesics (Includes Hycomine Compound) ↔ Liver Disease

Severe Potential Hazard, High plausibility

Applies to: Liver Disease

Narcotic (opioid) analgesic agents are extensively metabolized by the liver, and several of them (e.g., codeine, hydrocodone, meperidine, methadone, morphine, propoxyphene) have active metabolites that are further converted to inactive substances. The serum concentrations of these agents and their metabolites may be increased and the half-lives prolonged in patients with impaired hepatic function. Therapy with opioids should be administered cautiously and initiated at reduced dosages in patients with liver disease. Subsequent doses should be titrated based on individual response rather than a fixed dosing schedule.

References

  1. "Product Information. Kadian (morphine)." Zeneca Pharmaceuticals, Wilmington, DE.
  2. "Product Information. Ultiva (remifentanil)." Glaxo Wellcome, Research Triangle Park, NC.
  3. "Product Information. Stadol (butorphanol)." Allscrips Pharmaceutical Company, Vernon Hills, IL.
View all 58 references
Major

Narcotic Analgesics (Includes Hycomine Compound) ↔ Prematurity

Severe Potential Hazard, High plausibility

Applies to: Prematurity/Underweight in Infancy

The use of narcotic (opioid) analgesic agents is contraindicated in premature infants. These agents may cross the immature blood-brain barrier to a greater extent than in adults, resulting in disproportionate respiratory depression.

References

  1. "Product Information. Calcidrine (codeine)." Abbott Pharmaceutical, Abbott Park, IL.
  2. "Multum Information Services, Inc. Expert Review Panel"
Major

Narcotic Analgesics (Includes Hycomine Compound) ↔ Renal Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Although narcotic (opioid) analgesic agents are generally metabolized by the liver, renal impairment can alter the elimination of these agents and their metabolites (some of which are pharmacologically active), resulting in drug accumulation and increased risk of toxicity. Therapy with opioids should be administered cautiously and initiated at reduced dosages in patients with significantly impaired renal function. Subsequent doses should be titrated based on individual response rather than a fixed dosing schedule.

References

  1. Wolff J, Bigler D, Christensen CB, et al "Influence of renal function on the elimination of morphine and morphine glucoronides." Eur J Clin Pharmacol 34 (1988): 353-7
  2. Chan K, Jennings F, Orme ML "Pharmacokinetics of low-dose intravenous pethidine in patients with renal dysfunction." J Clin Pharmacol 27 (1987): 516-22
  3. Aitkenhead AR, Vater M, Achola K, Cooper CM, Smith G "Pharmacokinetics of single-dose i.v. morphine in normal volunteers and patients with end-stage renal failure." Br J Anaesth 56 (1984): 813-9
View all 56 references
Major

Opiate Agonists (Includes Hycomine Compound) ↔ Acute Alcohol Intoxication

Severe Potential Hazard, High plausibility

Applies to: Alcoholism, Acute Alcohol Intoxication

The use of opiate agonists is contraindicated in patients with acute alcohol intoxication exhibiting depressed vital signs. The central nervous system depressant effects of opiate agonists may be additive with those of alcohol. Severe respiratory depression and death may occur. Therapy with opiate agonists should be administered cautiously in patients who might be prone to acute alcohol intake.

References

  1. "Product Information. Opium Tincture (opium)" Lilly, Eli and Company, Indianapolis, IN.
  2. "Product Information. MS Contin (morphine)." Purdue Frederick Company, Norwalk, CT.
  3. "Product Information. Vicoprofen (hydrocodone-ibuprofen)." Knoll Pharmaceutical Company, Whippany, NJ.
View all 15 references
Major

Opiate Agonists (Includes Hycomine Compound) ↔ Drug Dependence

Severe Potential Hazard, High plausibility

Applies to: Drug Abuse/Dependence, Alcoholism

Opiate agonists have the potential to cause dependence and abuse. Tolerance as well as physical and psychological dependence can develop after prolonged use. Abrupt cessation, reduction in dosage, or administration of an opiate antagonist such as naloxone may precipitate withdrawal symptoms. In patients who have developed tolerance to an opiate agonist, overdosage can still produce respiratory depression and death, and cross-tolerance usually will occur with other agents in the class. Addiction-prone individuals, such as those with a history of alcohol or substance abuse, should be under careful surveillance or medical supervision when treated with opiate agonists. It may be prudent to refrain from dispensing large quantities of medication to these patients. After prolonged use or if dependency is suspected, withdrawal of opiate therapy should be undertaken gradually using a dosage-tapering schedule.

References

  1. Fishbain DA, Goldberg M, Rosomoff RS, Rosomoff H "Atypical withdrawal syndrome (organic delusional syndrome) secondary to oxycodone detoxification ." J Clin Psychopharmacol 8 (1988): 441-2
  2. Strode SW "Propoxyphene dependence and withdrawal." Am Fam Physician 32 (1985): 105-8
  3. "Product Information. Levo-Dromoran (levorphanol)." Roche Laboratories, Nutley, NJ.
View all 26 references
Major

Opiate Agonists (Includes Hycomine Compound) ↔ Hypotension

Severe Potential Hazard, Moderate plausibility

Applies to: Dehydration, Hypotension, Shock

Opiate agonists can induce vasodilation and significant hypotension, particularly when given in high dosages and/or by rapid intravenous administration. Shock and cardiac arrest have occurred. At therapeutic analgesic dosages, ambulatory patients are more likely to experience dizziness and hypotension than patients who are confined to bed. However, orthostatic hypotension may occur in supine patients upon rising. Therapy with opiate agonists should be administered cautiously and initiated at reduced dosages in patients with circulatory shock, hypovolemia, or a predisposition to hypotension. When given by intramuscular or subcutaneous administration, clinicians should also be aware that impaired perfusion in these patients may prevent complete absorption of the drug. With repeated injections, an excessive amount may be absorbed suddenly if normal circulation is reestablished.

References

  1. Cox RG "Hypoxaemia and hypotension after intravenous codeine phosphate." Can J Anaesth 41 (1994): 1211-3
  2. "Product Information. OxyContin (oxycodone)." Purdue Frederick Company, Norwalk, CT.
  3. Sebel PS, Bovill JG, Boekhorst RA, Rog N "Cardiovascular effects of high-dose fentanyl anaesthesia." Acta Anaesthesiol Scand 26 (1982): 308-15
View all 23 references
Major

Opiate Agonists (Includes Hycomine Compound) ↔ Intracranial Pressure

Severe Potential Hazard, Moderate plausibility

Applies to: Brain/Intracranial Tumor, Head Injury, Cerebral Vascular Disorder

The hypoventilation associated with administration of opiate agonists, particularly by the intravenous route, can induce cerebral hypoxia and vasodilatation with resultant increase in intracranial pressure. Unless mechanical ventilation is provided, extreme caution is advised when opiate agonists are given to patients with head injury, intracranial lesions, or a preexisting elevated CSF pressure. Also, clinicians treating such patients should be aware that opiate agonists may interfere with the evaluation of CNS function, especially with respect to consciousness levels, respiratory status, and pupillary changes.

References

  1. "Product Information. Darvon (propoxyphene)." Lilly, Eli and Company, Indianapolis, IN.
  2. "Product Information. Fentanyl Oralet (fentanyl)." Abbott Pharmaceutical, Abbott Park, IL.
  3. "Product Information. OxyContin (oxycodone)." Purdue Frederick Company, Norwalk, CT.
View all 20 references
Major

Opiate Agonists (Includes Hycomine Compound) ↔ Respiratory Depression

Severe Potential Hazard, High plausibility

Applies to: Altered Consciousness, Asphyxia, Brain/Intracranial Tumor, Cerebral Vascular Disorder, Head Injury, Pulmonary Impairment, Sleep Apnea, Respiratory Arrest

Opiate agonists may produce significant central nervous system and respiratory depression of varying duration, particularly when given in high dosages and/or by rapid intravenous administration. Apnea may result from decreased respiratory drive as well as increased airway resistance, and rigidity of respiratory muscles may occur during rapid IV administration or when these agents are used in the induction of anesthesia. At therapeutic analgesic dosages, the respiratory effects are usually not clinically important except in patients with preexisting pulmonary impairment. Therapy with opiate agonists should be avoided or administered with extreme caution and initiated at reduced dosages in patients with severe CNS depression; sleep apnea; hypoxia, anoxia, or hypercapnia; upper airway obstruction; chronic pulmonary insufficiency; a limited ventilatory reserve; or other respiratory disorders. In the presence of excessive respiratory secretions, the use of opiate agonists may also be problematic because they decrease ciliary activity and reduce the cough reflex. Caution is also advised in patients who may be at increased risk for respiratory depression, such as comatose patients or those with head injury, intracranial lesions, or intracranial hypertension. Clinical monitoring of pulmonary function is recommended, and equipment for resuscitation should be immediately available if parenteral or neuraxial routes are used. Naloxone may be administered to reverse clinically significant respiratory depression, which may be prolonged depending on the opioid agent, cumulative dose, and route of administration.

References

  1. Redpath JB, Pleuvry BJ "Double-blind comparison of the respiratory and sedative effects of codeine phosphate and (+/-)-glaucine phosphate in human volunteers." Br J Clin Pharmacol 14 (1982): 555-8
  2. "Product Information. Dilaudid (hydromorphone)." Knoll Pharmaceutical Company, Whippany, NJ.
  3. "Product Information. Numorphan (oxymorphone)" Endo Laboratories LLC, Chadds Ford, PA.
View all 44 references
Major

Sympathomimetics (Includes Hycomine Compound) ↔ Cardiovascular Disease

Severe Potential Hazard, High plausibility

Applies to: Cardiovascular Disease, Cerebrovascular Insufficiency, Hyperthyroidism, Pheochromocytoma

Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta-1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.

References

  1. Covington TR, Lawson LC, Young LL, eds. "Handbook of Nonprescription Drugs. 10th ed." Washington, DC: American Pharmaceutical Association (1993):
  2. Horowitz JD, Lang WJ, Howes LG, Fennessy MR, Christophidis N, Rand MJ, Louis WJ "Hypertensive responses induced by phenylpropanolamine in anorectic and decongestant preparations." Lancet 1 (1980): 60-1
  3. Gordon RD, Ballantine DM, Bachmann AW "Effects of repeated doses of pseudoephedrine on blood pressure and plasma catecholamines in normal subjects and in patients with phaeochromocytoma." Clin Exp Pharmacol Physiol 19 (1992): 287-90
View all 56 references
Moderate

Acetaminophen (Includes Hycomine Compound) ↔ Pku

Moderate Potential Hazard, High plausibility

Applies to: Phenylketonuria

Several oral acetaminophen and acetaminophen-combination products, particularly flavored chewable tablets, contain the artificial sweetener, aspartame (NutraSweet). Aspartame is converted to phenylalanine in the gastrointestinal tract following ingestion. Chewable and effervescent formulations of acetaminophen products may also contain phenylalanine. The aspartame/phenylalanine content should be considered when these products are used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics).

References

  1. "Product Information. Tylenol (acetaminophen)." McNeil Pharmaceutical, Raritan, NJ.
Moderate

Antihistamines (Includes Hycomine Compound) ↔ Asthma/Copd

Moderate Potential Hazard, Moderate plausibility

Applies to: Asthma, Chronic Obstructive Pulmonary Disease

It has been suggested that the anticholinergic effect of antihistamines may reduce the volume and cause thickening of bronchial secretions, resulting in obstruction of respiratory tract. Some manufacturers and clinicians recommend that therapy with antihistamines be administered cautiously in patients with asthma or chronic obstructive pulmonary disease.

References

  1. "Product Information. Temaril (trimeprazine)" Allergan Inc, Irvine, CA.
  2. "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  3. "Product Information. Periactin (cyproheptadine)." Merck & Co, Inc, West Point, PA.
View all 17 references
Moderate

Antihistamines (Includes Hycomine Compound) ↔ Cardiovascular

Moderate Potential Hazard, Moderate plausibility

Applies to: Cardiovascular Disease, Hyperthyroidism, Hypotension

Antihistamines may infrequently cause cardiovascular adverse effects related to their anticholinergic and local anesthetic (quinidine-like) activities. Tachycardia, palpitation, ECG changes, arrhythmias, hypotension, and hypertension have been reported. Although these effects are uncommon and usually limited to overdosage situations, the manufacturers and some clinicians recommend that therapy with antihistamines be administered cautiously in patients with cardiovascular disease, hypertension, and/or hyperthyroidism.

References

  1. "Product Information. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  2. "Product Information. Chlortrimeton (chlorpheniramine)." Schering-Plough, Liberty Corner, NJ.
  3. "Product Information. Optimine (azatadine)." Schering Laboratories, Kenilworth, NJ.
View all 15 references
Moderate

Antihistamines (Includes Hycomine Compound) ↔ Renal/Liver Disease

Moderate Potential Hazard, High plausibility

Applies to: Liver Disease, Renal Dysfunction

Limited pharmacokinetic data are available for the older, first-generation antihistamines. Many appear to be primarily metabolized by the liver, and both parent drugs and metabolites are excreted in the urine. Patients with renal and/or liver disease may be at greater risk for adverse effects from antihistamines due to drug and metabolite accumulation. Therapy with antihistamines should be administered cautiously in such patients. Lower initial dosages may be appropriate.

References

  1. Paton DM, Webster DR "Clinical pharmacokinetics of H1-receptor antagonists (the antihistamines)." Clin Pharmacokinet 10 (1985): 477-97
  2. Rumore MM "Clinical pharmacokinetics of chlorpheniramine." Drug Intell Clin Pharm 18 (1984): 701-7
  3. Simons FE, Frith EM, Simons KJ "The pharmacokinetics and antihistaminic effects of brompheniramine." J Allergy Clin Immunol 70 (1982): 458-64
View all 15 references
Moderate

Caffeine (Includes Hycomine Compound) ↔ Cardiotoxicity

Moderate Potential Hazard, Moderate plausibility

Applies to: Tachyarrhythmia, Myocardial Infarction, Post MI Syndrome, Hypertension, Hyperthyroidism, Angina Pectoris

Like other methylxanthines, caffeine at high dosages may be associated with positive inotropic and chronotropic effects on the heart. Caffeine may also produce an increase in systemic vascular resistance, resulting in elevation of blood pressure. Therapy with products containing caffeine should be administered cautiously in patients with severe cardiac disease, hypertension, hyperthyroidism, or acute myocardial injury. Some clinicians recommend avoiding caffeine in patients with symptomatic cardiac arrhythmias and/or palpitations and during the first several days to weeks after an acute myocardial infarction.

References

  1. "Multum Information Services, Inc. Expert Review Panel"
Moderate

Cns Stimulants (Includes Hycomine Compound) ↔ Psychiatric Disorders

Moderate Potential Hazard, Moderate plausibility

Applies to: Psychosis, Bipolar Disorder, Depression, Mania

The use of CNS stimulants can cause psychotic or maniac symptoms, suicidal ideation, aggression and can exacerbate symptoms of behavior disturbance and thought disorder. Psychiatric symptoms have been reported in patients with and without history of psychiatric disorders, and all patients should be monitored closely, specially during treatment initiation and at times of dose changes. Extreme caution should be exercised when CNS stimulants are given to patients with a history of psychosis, depression, mania, or bipolar disorder. All patients receiving treatment should be screened for bipolar disease prior to initiation. If any psychiatric symptoms emerge or are exacerbated, treatment suspension should be considered. CNS stimulants are contraindicated in patients with marked agitation or anxiety.

References

  1. "Product Information. Provigil (modafinil)." Cephalon, Inc, West Chester, PA.
Moderate

Cns Stimulants (Includes Hycomine Compound) ↔ Renal Dysfunction

Moderate Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

Overall CNS stimulants should be administered with caution in patients with significantly impaired renal function as the reduction in the rate of elimination may alter the therapeutic response. The dosage should be adjusted accordingly.

References

  1. "Product Information. Provigil (modafinil)." Cephalon, Inc, West Chester, PA.
Moderate

Methylxanthines (Includes Hycomine Compound) ↔ Gerd

Moderate Potential Hazard, High plausibility

Applies to: Gastroesophageal Reflux Disease

Methylxanthines increase gastric acidity and may also relax lower esophageal sphincter, which can lead to gastric reflux into the esophagus. Therapy with products containing methylxanthines should be administered cautiously in patients with significant gastroesophageal reflux.

References

  1. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  2. Stoller JL "Oesophageal ulceration and theophylline." Lancet 2 (1985): 328-9
  3. Alterman P, Spiegel D, Feldman J, Yaretzky A "Histamine h2-receptor antagonists and chronic theophylline toxicity." Am Fam Physician 54 (1996): 1473
View all 4 references
Moderate

Narcotic Analgesics (Includes Hycomine Compound) ↔ Adrenal Insufficiency

Moderate Potential Hazard, Moderate plausibility

Applies to: Adrenal Insufficiency

Patients with Addison's disease may have increased risk of respiratory depression and prolonged CNS depression associated with the use of narcotic (opioid) analgesic agents. Conversely, these agents may cause or potentiate adrenal insufficiency. Therapy with opioids should be administered cautiously and initiated at reduced dosages in patients with adrenocortical insufficiency. Subsequent doses should be titrated based on individual response rather than a fixed dosing schedule.

References

  1. "Product Information. Orlaam (levomethadyl acetate)" Roxanne Laboratories Inc, Columbus, OH.
  2. "Product Information. Fentanyl Oralet (fentanyl)." Abbott Pharmaceutical, Abbott Park, IL.
  3. "Product Information. Roxanol (morphine)." Roxane Laboratories Inc, Columbus, OH.
View all 26 references
Moderate

Narcotic Analgesics (Includes Hycomine Compound) ↔ Biliary Spasm

Moderate Potential Hazard, Moderate plausibility

Applies to: Biliary Obstruction, Gallbladder Disease

Narcotic (opioid) analgesic agents increase smooth muscle tone in the biliary tract, which can lead to spasm and elevated biliary tract pressure, especially in the sphincter of Oddi. Biliary effects appear to be the most pronounced with morphine, although they do not always occur with therapeutic doses. Therapy with opioids should be administered cautiously in patients with biliary or gallbladder disease.

References

  1. "Product Information. Dalgan (dezocine)." Astra USA, Westborough, MA.
  2. "Product Information. Opium Tincture (opium)" Lilly, Eli and Company, Indianapolis, IN.
  3. "Product Information. MS Contin (morphine)." Purdue Frederick Company, Norwalk, CT.
View all 30 references
Moderate

Narcotic Analgesics (Includes Hycomine Compound) ↔ Hypothyroidism

Moderate Potential Hazard, Moderate plausibility

Applies to: Hypothyroidism, Panhypopituitarism

Patients with hypothyroidism may have increased risk of respiratory depression and prolonged CNS depression associated with the use of narcotic (opioid) analgesic agents. These agents may also exacerbate the effects of hypothyroidism such as lethargy, impaired mentation, depression, and constipation. Therapy with opioids should be administered cautiously and initiated at reduced dosages in patients with uncontrolled hypothyroidism or myxedema. Subsequent doses should be titrated based on individual response rather than a fixed dosing schedule.

References

  1. "Product Information. Numorphan (oxymorphone)" Endo Laboratories LLC, Chadds Ford, PA.
  2. "Product Information. Talwin NX (pentazocine)." Sanofi Winthrop Pharmaceuticals, New York, NY.
  3. "Product Information. Demerol (meperidine)." Sanofi Winthrop Pharmaceuticals, New York, NY.
View all 25 references
Moderate

Narcotic Analgesics (Includes Hycomine Compound) ↔ Seizure Disorders

Moderate Potential Hazard, Low plausibility

Applies to: Seizures

Narcotic (opioid) analgesic agents may exacerbate seizures in patients with seizure disorders and, at higher dosages, have been reported to induce seizures in patients without previous history of seizures. The proconvulsant activity may be the greatest with meperidine, the active metabolite of which is thought to be responsible. Therapy with opioids should be administered cautiously in patients with or predisposed to seizures.

References

  1. Strong WE, Matson M "Probable seizure after alfentanil." Anesth Analg 68 (1989): 692-3
  2. Armstrong PJ, Bersten A "Normeperidine toxicity." Anesth Analg 65 (1986): 536-8
  3. "Product Information. Dalgan (dezocine)." Astra USA, Westborough, MA.
View all 43 references
Moderate

Narcotic Analgesics (Includes Hycomine Compound) ↔ Urinary Retention

Moderate Potential Hazard, Moderate plausibility

Applies to: Urinary Retention

Narcotic (opioid) analgesic agents may inhibit the urinary voiding reflex and increase the tone of the vesical sphincter in the bladder. Acute urinary retention requiring catheterization may occur, particularly in patients with prostatic hypertrophy or urethral stricture and in elderly patients. These agents may also decrease urine production via direct effects on the kidney and central stimulation of the release of vasopressin. Therapy with opioids should be administered cautiously in patients with or predisposed to urinary retention and/or oliguria. The effects on smooth muscle tone appear to be the most pronounced with morphine.

References

  1. "Product Information. Calcidrine (codeine)." Abbott Pharmaceutical, Abbott Park, IL.
  2. "Product Information. Talwin NX (pentazocine)." Sanofi Winthrop Pharmaceuticals, New York, NY.
  3. "Product Information. Demerol (meperidine)." Sanofi Winthrop Pharmaceuticals, New York, NY.
View all 29 references
Moderate

Opiate Agonists (Includes Hycomine Compound) ↔ Arrhythmias

Moderate Potential Hazard, Low plausibility

Applies to: Arrhythmias

Opiate agonists have cholinergic activity. Large doses and/or rapid intravenous administration may produce bradycardia and arrhythmia via stimulation of medullary vagal nuclei. Unlike other agents in the class, meperidine also has anticholinergic activity and may cause either bradycardia or tachycardia. Therapy with opiate agonists should be administered cautiously in patients with a history of arrhythmias. Clinical monitoring of cardiovascular status is recommended during therapy. Bradycardia and other cholinergic effects produced by these agents may be controlled with atropine.

References

  1. "Product Information. Opium Tincture (opium)" Lilly, Eli and Company, Indianapolis, IN.
  2. "Product Information. Duragesic Transdermal System (fentanyl)." Janssen Pharmaceutica, Titusville, NJ.
  3. "Product Information. Alfenta (alfentanil)." Janssen Pharmaceutica, Titusville, NJ.
View all 21 references
Moderate

Sympathomimetics (Includes Hycomine Compound) ↔ Bph

Moderate Potential Hazard, High plausibility

Applies to: Benign Prostatic Hyperplasia, Prostate Tumor

Sympathomimetic agents may cause or worsen urinary difficulty in patients with prostate enlargement due to smooth muscle contraction in the bladder neck via stimulation of alpha-1 adrenergic receptors. Therapy with sympathomimetic agents should be administered cautiously in patients with hypertrophy or neoplasm of the prostate.

References

  1. "Product Information. Sudafed (pseudoephedrine)." Glaxo Wellcome, Research Triangle Park, NC.
  2. Covington TR, Lawson LC, Young LL, eds. "Handbook of Nonprescription Drugs. 10th ed." Washington, DC: American Pharmaceutical Association (1993):
  3. Williams DM "Phenylpropanolamine hydrochloride" Am Pharm NS30 (1990): 47-50
Moderate

Sympathomimetics (Includes Hycomine Compound) ↔ Diabetes

Moderate Potential Hazard, Moderate plausibility

Applies to: Diabetes Mellitus

Sympathomimetic agents may cause increases in blood glucose concentrations. These effects are usually transient and slight but may be significant with dosages higher than those normally recommended. Therapy with sympathomimetic agents should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate.

References

  1. "Product Information. Sudafed (pseudoephedrine)." Glaxo Wellcome, Research Triangle Park, NC.
  2. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  3. Covington TR, Lawson LC, Young LL, eds. "Handbook of Nonprescription Drugs. 10th ed." Washington, DC: American Pharmaceutical Association (1993):
View all 4 references
Moderate

Sympathomimetics (Includes Hycomine Compound) ↔ Glaucoma

Moderate Potential Hazard, Moderate plausibility

Applies to: Glaucoma/Intraocular Hypertension, Glaucoma (Narrow Angle)

Sympathomimetic agents can induce transient mydriasis via stimulation of alpha-1 adrenergic receptors. In patients with anatomically narrow angles or narrow-angle glaucoma, pupillary dilation can provoke an acute attack. In patients with other forms of glaucoma, mydriasis may occasionally increase intraocular pressure. Therapy with sympathomimetic agents should be administered cautiously in patients with or predisposed to glaucoma, particularly narrow-angle glaucoma.

References

  1. Covington TR, Lawson LC, Young LL, eds. "Handbook of Nonprescription Drugs. 10th ed." Washington, DC: American Pharmaceutical Association (1993):
  2. Fraunfelder FT, Fraunfelder FW; Randall JA "Drug-Induced Ocular Side Effects 5th" Boston, MA: Butterworth-Heinemann (2001):
  3. "Product Information. Sudafed (pseudoephedrine)." Glaxo Wellcome, Research Triangle Park, NC.

Hycomine Compound (acetaminophen / caffeine / chlorpheniramine / hydrocodone / phenylephrine) drug Interactions

There are 1055 drug interactions with Hycomine Compound (acetaminophen / caffeine / chlorpheniramine / hydrocodone / phenylephrine)

Hycomine Compound (acetaminophen / caffeine / chlorpheniramine / hydrocodone / phenylephrine) alcohol/food Interactions

There are 7 alcohol/food interactions with Hycomine Compound (acetaminophen / caffeine / chlorpheniramine / hydrocodone / phenylephrine)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

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.

Do not stop taking any medications without consulting your healthcare provider.

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