Skip to Content

Pyridium Plus (butabarbital / hyoscyamine / phenazopyridine) Disease Interactions

There are 33 disease interactions with Pyridium Plus (butabarbital / hyoscyamine / phenazopyridine):

Major

Anticholinergics (Includes Pyridium Plus) ↔ Autonomic Neuropathy

Severe Potential Hazard, High plausibility

Applies to: Autonomic Neuropathy

Agents with anticholinergic activity can exacerbate many of the manifestations of autonomic neuropathy, including tachycardia, anhidrosis, bladder atony, obstipation, dry mouth and eyes, cycloplegia and blurring of vision, and sexual impotence in males. Therapy with antimuscarinic agents and higher dosages of antispasmodic agents (e.g., dicyclomine or oxybutynin) should be administered cautiously in patients with autonomic neuropathy.

References

  1. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
Major

Anticholinergics (Includes Pyridium Plus) ↔ Gi Obstruction

Severe Potential Hazard, High plausibility

Applies to: Gastrointestinal Obstruction, Esophageal Obstruction

Anticholinergics are contraindicated in patients with obstructive diseases such as achalasia, esophageal stricture or stenosis, pyloroduodenal stenosis, stenosing peptic ulcer, pyloric obstruction, and paralytic ileus. Anticholinergics may further suppress intestinal motility with resultant precipitation or aggravation of toxic megacolon.

References

  1. "Product Information. Antivert (meclizine)." Roerig Division, New York, NY.
  2. Blamoutier J "Comparative trial of two antihistamines, mequitazine and brompheniramine." Curr Med Res Opin 5 (1978): 366-70
  3. "Azatadine (optimine)--a new antihistamine." Med Lett Drugs Ther 19 (1977): 77-9
  4. "Product Information. Chlortrimeton (chlorpheniramine)." Schering-Plough, Liberty Corner, NJ.
  5. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  6. "Product Information. Optimine (azatadine)." Schering Laboratories, Kenilworth, NJ.
  7. "Product Information. Periactin (cyproheptadine)." Merck & Co, Inc, West Point, PA.
  8. "Product Information. Benadryl (diphenhydramine)." Parke-Davis, Morris Plains, NJ.
  9. "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  10. Bantz EW, Dolen WK, Chadwick EW, Nelson HS "Chronic chlorpheniramine therapy: subsensitivity, drug metabolism, and compliance." Ann Allergy 59 (1987): 341-6
  11. "Product Information. Cogentin (benztropine)." Merck & Co, Inc, West Point, PA.
  12. Simons FE, Frith EM, Simons KJ "The pharmacokinetics and antihistaminic effects of brompheniramine." J Allergy Clin Immunol 70 (1982): 458-64
  13. "Product Information. Poly-Histine-D (pyrilamine)." Bock Pharmaceutical Company, St. Louis, MO.
  14. "Product Information. Phenergan (promethazine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  15. "Product Information. Artane (trihexyphenidyl)." Lederle Laboratories, Wayne, NJ.
  16. Mevorach D "Adverse effects of atropine sulfate autoinjection." Ann Pharmacother 26 (1992): 564
  17. "Product Information. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
View all 17 references
Major

Anticholinergics (Includes Pyridium Plus) ↔ Glaucoma

Severe Potential Hazard, High plausibility

Applies to: Glaucoma/Intraocular Hypertension

Anticholinergic agents are contraindicated in patients with primary glaucoma, a tendency toward glaucoma (narrow anterior chamber angle), or adhesions (synechiae) between the iris and lens, as well as for the elderly and others in whom undiagnosed glaucoma or excessive pressure in the eye may be present. Because anticholinergics cause mydriasis, they may exacerbate these conditions.

References

  1. Schuller DE, Turkewitz D "Adverse effects of antihistamines." Postgrad Med 79 (1986): 75-86
  2. "Product Information. Chlortrimeton (chlorpheniramine)." Schering-Plough, Liberty Corner, NJ.
  3. "Product Information. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  4. "Product Information. Moban (molindone)." Gate Pharmaceuticals, Sellersville, PA.
  5. "Product Information. Phenergan (promethazine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  6. Goldstein JH "Effects of drugs on cornea, conjunctiva, and lids." Int Ophthalmol Clin 11 (1971): 13-34
  7. "Product Information. Poly-Histine-D (pyrilamine)." Bock Pharmaceutical Company, St. Louis, MO.
  8. Holland MG "Autonomic drugs in ophthalmology: some problems and promises. Section II: Anticholinergic drugs." Ann Ophthalmol 6 (1974): 661-4
  9. "Product Information. Thorazine (chlorpromazine)." SmithKline Beecham, Philadelphia, PA.
  10. "Product Information. Benadryl (diphenhydramine)." Parke-Davis, Morris Plains, NJ.
  11. O'Connor PS, Mumma JV "Atropine toxicity." Am J Ophthalmol 99 (1985): 613-4
  12. Berdy GJ, Berdy SS, Odin LS, Hirst LW "Angle closure glaucoma precipitated by aerosolized atropine." Arch Intern Med 151 (1991): 1658-60
  13. Pecora JL "Malignant glaucoma worsened by miotics in a postoperative angle- closure glaucoma patient." Ann Ophthalmol 11 (1979): 1412-4
  14. Clearkin LG "Angle closure glaucoma precipitated by atropine." Arch Intern Med 152 (1992): 880
  15. "Product Information. Periactin (cyproheptadine)." Merck & Co, Inc, West Point, PA.
  16. "Product Information. Compazine (prochlorperazine)." SmithKline Beecham, Philadelphia, PA.
  17. "Product Information. Artane (trihexyphenidyl)." Lederle Laboratories, Wayne, NJ.
  18. "Product Information. Orap Tablets (pimozide)." Gate Pharmaceuticals, Sellersville, PA.
  19. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  20. "Product Information. Cogentin (benztropine)." Merck & Co, Inc, West Point, PA.
  21. "Product Information. Optimine (azatadine)." Schering Laboratories, Kenilworth, NJ.
  22. Kanto J "New aspects in the use of atropine." Int J Clin Pharmacol Ther Toxicol 21 (1983): 92-4
  23. "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
View all 23 references
Major

Anticholinergics (Includes Pyridium Plus) ↔ Obstructive Uropathy

Severe Potential Hazard, High plausibility

Applies to: Urinary Retention

In general, the use of anticholinergic agents is contraindicated in patients with urinary retention and bladder neck obstruction caused by prostatic hypertrophy. Dysuria may occur and may require catheterization. Also, anticholinergic drugs may aggravate partial obstructive uropathy. Caution is advised even when using agents with mild to moderate anticholinergic activity, particularly in elderly patients.

References

  1. Schuller DE, Turkewitz D "Adverse effects of antihistamines." Postgrad Med 79 (1986): 75-86
  2. "Product Information. Phenergan (promethazine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  3. "Product Information. Artane (trihexyphenidyl)." Lederle Laboratories, Wayne, NJ.
  4. "Product Information. Moban (molindone)." Gate Pharmaceuticals, Sellersville, PA.
  5. "Product Information. Poly-Histine-D (pyrilamine)." Bock Pharmaceutical Company, St. Louis, MO.
  6. Shutt LE, Bowes JB "Atropine and hyoscine." Anaesthesia 34 (1979): 476-90
  7. "Product Information. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  8. "Product Information. Periactin (cyproheptadine)." Merck & Co, Inc, West Point, PA.
  9. "Product Information. Compazine (prochlorperazine)." SmithKline Beecham, Philadelphia, PA.
  10. "Product Information. Benadryl (diphenhydramine)." Parke-Davis, Morris Plains, NJ.
  11. "Product Information. Zyrtec (cetirizine)." Pfizer US Pharmaceuticals, New York, NY.
  12. "Product Information. Chlortrimeton (chlorpheniramine)." Schering-Plough, Liberty Corner, NJ.
  13. Bantz EW, Dolen WK, Chadwick EW, Nelson HS "Chronic chlorpheniramine therapy: subsensitivity, drug metabolism, and compliance." Ann Allergy 59 (1987): 341-6
  14. "Product Information. Antivert (meclizine)." Roerig Division, New York, NY.
  15. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  16. "Product Information. Optimine (azatadine)." Schering Laboratories, Kenilworth, NJ.
  17. "Product Information. Cogentin (benztropine)." Merck & Co, Inc, West Point, PA.
  18. "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  19. "Product Information. Orap Tablets (pimozide)." Gate Pharmaceuticals, Sellersville, PA.
  20. "Product Information. Thorazine (chlorpromazine)." SmithKline Beecham, Philadelphia, PA.
  21. O'Kelly SW, Spargo PM "Postoperative urinary retention in men." BMJ 302 (1991): 1403-4
View all 21 references
Major

Anticholinergics (Includes Pyridium Plus) ↔ Reactive Airway Diseases

Severe Potential Hazard, Moderate plausibility

Applies to: Asthma

The use of systemic anticholinergics is contraindicated in the treatment of lower respiratory tract symptoms including asthma. Muscarinic receptor antagonists reduce bronchial secretions, which can result in decreased fluidity and increased thickening of secretions. However, ipratropium does not produce these effects and can be used safely in treating asthma.

References

  1. "Product Information. Antivert (meclizine)." Roerig Division, New York, NY.
  2. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  3. "Product Information. Phenergan (promethazine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  4. Nahata MC, Clotz MA, Krogg EA "Adverse effects of meperidine, promethazine, and chlorpromazine for sedation in pediatric patients." Clin Pediatr (Phila) 24 (1985): 558-60
  5. "Product Information. Marezine (cyclizine)." Glaxo Wellcome, Research Triangle Park, NC.
View all 5 references
Major

Antimuscarinics (Includes Pyridium Plus) ↔ Myasthenia Gravis

Severe Potential Hazard, Moderate plausibility

Applies to: Myasthenia Gravis

Because antimuscarinic agents have anticholinergic effects, they are contraindicated in patients with myasthenia gravis. Their use may be appropriate to reduce adverse muscarinic effects caused by an anticholinesterase agent.

References

  1. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  2. Shutt LE, Bowes JB "Atropine and hyoscine." Anaesthesia 34 (1979): 476-90
Major

Antiperistaltic Agents (Includes Pyridium Plus) ↔ Infectious Diarrhea

Severe Potential Hazard, High plausibility

Applies to: Infectious Diarrhea/Enterocolitis/Gastroenteritis

The use of drugs with antiperistaltic activity (primarily antidiarrheal and antimuscarinic agents, but also antispasmodic agents such as dicyclomine or oxybutynin at high dosages) is contraindicated in patients with diarrhea due to pseudomembranous enterocolitis or enterotoxin-producing bacteria. These drugs may prolong and/or worsen diarrhea associated with organisms that invade the intestinal mucosa, such as toxigenic E. coli, Salmonella and Shigella, and pseudomembranous colitis due to broad-spectrum antibiotics. Other symptoms and complications such as fever, shedding of organisms and extraintestinal illness may also be increased or prolonged. In general, because antiperistaltic agents decrease gastrointestinal motility, they may delay the excretion of infective gastroenteric organisms or toxins and should be used cautiously in patients with any infectious diarrhea, particularly if accompanied by high fever or pus or blood in the stool. Some cough and cold and other combination products may occasionally include antimuscarinic agents for their drying effects and may, therefore, require careful selection when necessary.

References

  1. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  2. "Product Information. Imodium (loperamide)." Janssen Pharmaceutica, Titusville, NJ.
  3. Marshall WF Jr, Rosenthal P, Merritt RJ "Atropine therapy and paralytic ileus in an infant." J Pediatr Gastroenterol Nutr 9 (1989): 532-4
  4. "Lomotil for diarrhea in children." Med Lett Drugs Ther 17 (1975): 104
  5. Walley T, Milson D "Loperamide related toxic megacolon in Clostridium difficile colitis." Postgrad Med J 66 (1990): 582
  6. Brown JW "Toxic megacolon associated with loperamide therapy." JAMA 241 (1979): 501-2
View all 6 references
Major

Barbiturates (Includes Pyridium Plus) ↔ Acute Alcohol Intoxication

Severe Potential Hazard, High plausibility

Applies to: Acute Alcohol Intoxication

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

References

  1. "Product Information. Mebaral (mephobarbital)" Sanofi Winthrop Pharmaceuticals, New York, NY.
  2. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company, Indianapolis, IN.
  3. "Product Information. Amytal Sodium (amobarbital)" Lilly, Eli and Company, Indianapolis, IN.
  4. "Product Information. Nembutal Sodium (pentobarbital)" Abbott Pharmaceutical, Abbott Park, IL.
  5. "Product Information. Butisol Sodium (butabarbital)" Wallace Laboratories, Cranbury, NJ.
  6. Plaa GL "Acute toxicity of antiepileptic drugs." Epilepsia 16 (1975): 183-91
  7. "Multum Information Services, Inc. Expert Review Panel"
  8. "Product Information. Seconal Sodium (secobarbital)" Lilly, Eli and Company, Indianapolis, IN.
View all 8 references
Major

Barbiturates (Includes Pyridium Plus) ↔ Drug Dependence

Severe Potential Hazard, High plausibility

Applies to: Drug Abuse/Dependence, Alcoholism

Barbiturates have the potential to cause dependence and abuse. Tolerance as well as physical and psychological dependence can develop, particularly after prolonged use of excessive dosages. Abrupt cessation and/or a reduction in dosage may precipitate withdrawal symptoms. In patients who have developed tolerance to a barbiturate, 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 barbiturates. 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 barbiturates should be undertaken gradually using a dosage-tapering schedule.

References

  1. Boisse NR, Okamoto M "Physical dependence to barbital compared to pentobarbital. II. Tolerance characteristics." J Pharmacol Exp Ther 204 (1978): 507-13
  2. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company, Indianapolis, IN.
  3. "Product Information. Butisol Sodium (butabarbital)" Wallace Laboratories, Cranbury, NJ.
  4. "Product Information. Amytal Sodium (amobarbital)" Lilly, Eli and Company, Indianapolis, IN.
  5. "Product Information. Nembutal Sodium (pentobarbital)" Abbott Pharmaceutical, Abbott Park, IL.
  6. "Product Information. Mebaral (mephobarbital)" Sanofi Winthrop Pharmaceuticals, New York, NY.
  7. "Product Information. Seconal Sodium (secobarbital)" Lilly, Eli and Company, Indianapolis, IN.
  8. Gersema LM, Alexander B, Kunze KE "Major withdrawal symptoms after abrupt discontinuation of phenobarbital." Clin Pharm 6 (1987): 420-2
  9. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
View all 9 references
Major

Barbiturates (Includes Pyridium Plus) ↔ Liver Disease

Severe Potential Hazard, High plausibility

Applies to: Liver Disease

Barbiturates are extensively metabolized by the liver. The plasma clearance of barbiturates may be decreased and the half-lives prolonged in patients with impaired hepatic function. Therapy with barbiturates should be administered cautiously and initiated at reduced dosages in patients with liver disease. Barbiturates are not recommended for use in patients with cirrhosis, hepatic failure, hepatic coma, or other severe hepatic impairment.

References

  1. Kallberg N, Agurell S, Ericsson O, et al "Quantitation of phenobarbital and its main metabolites in human urine." Eur J Clin Pharmacol 9 (1975): 161-8
  2. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company, Indianapolis, IN.
  3. Whyte MP, Dekaban "Metabolic fate of phenobarbital: a quantitative study of p-hydroxyphenobarbital elimination in man." Drug Metab Dispos 5 (1977): 63-9
  4. "Product Information. Seconal Sodium (secobarbital)" Lilly, Eli and Company, Indianapolis, IN.
  5. "Product Information. Amytal Sodium (amobarbital)" Lilly, Eli and Company, Indianapolis, IN.
  6. "Product Information. Butisol Sodium (butabarbital)" Wallace Laboratories, Cranbury, NJ.
  7. "Product Information. Mebaral (mephobarbital)" Sanofi Winthrop Pharmaceuticals, New York, NY.
  8. "Product Information. Nembutal Sodium (pentobarbital)" Abbott Pharmaceutical, Abbott Park, IL.
  9. Alvin J, McHorse T, Hoyumpa A, et al "The effect of liver disease in man on the disposition of phenobarbital." J Pharmacol Exp Ther 192 (1975): 224-35
View all 9 references
Major

Barbiturates (Includes Pyridium Plus) ↔ Porphyria

Severe Potential Hazard, High plausibility

Applies to: Porphyria

The use of barbiturates is contraindicated in patients with a history of porphyria. Barbiturates may exacerbate acute intermittent porphyria or porphyria variegata by inducing the enzymes responsible for porphyrin synthesis.

References

  1. "Product Information. Nembutal Sodium (pentobarbital)" Abbott Pharmaceutical, Abbott Park, IL.
  2. "Product Information. Butisol Sodium (butabarbital)" Wallace Laboratories, Cranbury, NJ.
  3. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  4. "Product Information. Seconal Sodium (secobarbital)" Lilly, Eli and Company, Indianapolis, IN.
  5. Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, eds. "Harrison's Principles of Internal Medicine. 14th ed." New York, NY: McGraw-Hill Health Professionals Division (1998):
  6. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company, Indianapolis, IN.
  7. "Product Information. Mebaral (mephobarbital)" Sanofi Winthrop Pharmaceuticals, New York, NY.
  8. "Product Information. Amytal Sodium (amobarbital)" Lilly, Eli and Company, Indianapolis, IN.
View all 8 references
Major

Barbiturates (Includes Pyridium Plus) ↔ Rash

Severe Potential Hazard, High plausibility

Applies to: Dermatitis - Drug-Induced

Skin eruptions may precede rare but potentially fatal barbiturate-induced reactions such as systemic lupus erythematosus and exfoliative dermatitis, the latter of which may be accompanied by hepatitis and jaundice. Therapy with barbiturates should be administered cautiously in patients with preexisting drug-induced dermatitis, since it may delay the recognition of a potential reaction to barbiturates. Barbiturate therapy should be withdrawn promptly at the first sign of a dermatologic adverse effect. However, cutaneous reactions may proceed to an irreversible stage even after cessation of medication due to the slow rate of metabolism and excretion of barbiturates. Patients should be advised to promptly report signs that may indicate impending development of barbiturate-related cutaneous lesions, including high fever, severe headache, stomatitis, conjunctivitis, rhinitis, urethritis, and balanitis. Rashes may be more likely to occur with phenobarbital and mephobarbital.

References

  1. "Product Information. Amytal Sodium (amobarbital)" Lilly, Eli and Company, Indianapolis, IN.
  2. "Product Information. Mebaral (mephobarbital)" Sanofi Winthrop Pharmaceuticals, New York, NY.
  3. Pagliaro L, Campesi G, Aguglia F "Barbiturate jaundice. Report of a case due to a barbital-containing drug, with positive rechallenge to phenobarbital." Gastroenterology 56 (1969): 938-43
  4. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company, Indianapolis, IN.
  5. Pelekanos J, Camfield P, Camfield C, Gordon K "Allergic rash due to antiepileptic drugs: clinical features and management." Epilepsia 32 (1991): 554-9
  6. "Product Information. Seconal Sodium (secobarbital)" Lilly, Eli and Company, Indianapolis, IN.
  7. Stuttgen G "Toxic epidermal necrolysis provoked by barbiturates." Br J Dermatol 88 (1973): 291-3
  8. "Product Information. Nembutal Sodium (pentobarbital)" Abbott Pharmaceutical, Abbott Park, IL.
  9. Shear NH, Spielberg SP "Anticonvulsant hypersensitivity syndrome. In vitro assessment of risk." J Clin Invest 82 (1988): 1826-32
  10. "Product Information. Butisol Sodium (butabarbital)" Wallace Laboratories, Cranbury, NJ.
  11. Fernandez de Corres L, Leanizbarrutia I, Munoz D "Eczematous drug reaction from phenobarbitone." Contact Dermatitis 11 (1984): 319
  12. Dourmishev AL, Rahman MA "Phenobarbital-induced pemphigus vulgaris." Dermatologica 173 (1986): 256-8
View all 12 references
Major

Barbiturates (Includes Pyridium Plus) ↔ Respiratory Depression

Severe Potential Hazard, High plausibility

Applies to: Pulmonary Impairment, Asphyxia, Respiratory Arrest

Barbiturates may produce severe respiratory depression, apnea, laryngospasm, bronchospasm and cough, particularly during rapid intravenous administration. In usual hypnotic dosages, the degree of respiratory depression produced is similar to that which occurs during physiologic sleep, while at higher dosages, the rate, depth and volume of respiration may be markedly decreased. However, some patients may be susceptible at commonly used dosages, including the elderly, debilitated or severely ill patients, those receiving other CNS depressants, and those with limited ventilatory reserve, chronic pulmonary insufficiency or other respiratory disorders. Therapy with barbiturates should be administered cautiously in these patients. Appropriate monitoring and individualization of dosage are particularly important, and equipment for resuscitation should be immediately available if the parenteral route is used. Barbiturates, especially injectable formulations, should generally be avoided in patients with sleep apnea, hypoxia, or severe pulmonary diseases in which dyspnea or obstruction is evident.

References

  1. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company, Indianapolis, IN.
  2. "Product Information. Amytal Sodium (amobarbital)" Lilly, Eli and Company, Indianapolis, IN.
  3. "Product Information. Mebaral (mephobarbital)" Sanofi Winthrop Pharmaceuticals, New York, NY.
  4. "Product Information. Nembutal Sodium (pentobarbital)" Abbott Pharmaceutical, Abbott Park, IL.
  5. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  6. "Product Information. Butisol Sodium (butabarbital)" Wallace Laboratories, Cranbury, NJ.
  7. Lund A, Gormsen H "The role of antiepileptics in sudden death in epilepsy." Acta Neurol Scand 72 (1985): 444-6
  8. Plaa GL "Acute toxicity of antiepileptic drugs." Epilepsia 16 (1975): 183-91
  9. "Product Information. Seconal Sodium (secobarbital)" Lilly, Eli and Company, Indianapolis, IN.
View all 9 references
Major

Phenazopyridine (Includes Pyridium Plus) ↔ G-6-Pd Deficiency

Severe Potential Hazard, Moderate plausibility

Applies to: G-6-PD Deficiency

Patients with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency may be at increased risk for phenazopyridine-induced methemoglobinemia and hemolytic anemia. These conditions have occurred rarely in other patients, except due to acute phenazopyridine overdose or impaired renal function. Therapy with phenazopyridine should be administered cautiously in patients with G-6-PD deficiency.

References

  1. "Product Information. Pyridium (phenazopyridine)." Warner Chilcott Laboratories, Rockaway, NJ.
Major

Phenazopyridine (Includes Pyridium Plus) ↔ Hepatitis

Severe Potential Hazard, Moderate plausibility

Applies to: Liver Disease

The use of phenazopyridine is contraindicated in patients with severe hepatitis. Rare cases of hepatotoxicity have been associated with phenazopyridine, usually at overdose levels. Hypersensitivity hepatitis has also been reported. Therapy with phenazopyridine should be administered cautiously in patients with impaired hepatic function.

References

  1. "Product Information. Pyridium (phenazopyridine)." Warner Chilcott Laboratories, Rockaway, NJ.
Major

Phenazopyridine (Includes Pyridium Plus) ↔ Renal Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction

The use of phenazopyridine is contraindicated in patients with impaired renal function. Phenazopyridine is primarily eliminated unchanged by the kidney and may accumulate to toxic levels during prolonged administration in such patients. Reported cases of toxicity due to overdosage have resulted in acute renal failure and methemoglobinemia. Likewise, administration of phenazopyridine to patients with preexisting renal failure has led to methemoglobinemia and hemolytic anemia. Phenazopyridine toxicity may be associated with a yellowish tinge of the skin or sclera.

References

  1. "Product Information. Pyridium (phenazopyridine)." Warner Chilcott Laboratories, Rockaway, NJ.
Moderate

Anticholinergics (Includes Pyridium Plus) ↔ Cardiac Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Cardiovascular Disease

Anticholinergics block vagal inhibition of the SA nodal pacemaker. Therapy with anticholinergics should be administered cautiously to patients with tachycardia, congestive heart failure, or coronary artery disease. Premature ventricular depolarization, ventricular tachycardia, and fibrillation associated with anticholinergics are rare.

References

  1. Knoebel SB, McHenry PL, Phillips JF, Widlansky S "Atropine-induced cardioacceleration and myocardial blood flow in subjects with and without coronary artery disease." Am J Cardiol 33 (1974): 327-32
  2. Lazzari JO, Benchuga EG, Elizari MV, Rosenbaum MB "Ventricular fibrillation after intravenous atropine in a patient with atrioventricular block." Pacing Clin Electrophysiol 5 (1982): 196-200
  3. Massumi RA, Mason DT, Amsterdam EA, DeMaria A, Miller RR, Scheinman MM, Zelis R "Ventricular fibrillation and tachycardia after intravenous atropine for treatment of bradycardias." N Engl J Med 287 (1972): 336-8
  4. "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  5. Bradshaw EG "Dysrhythmias associated with oral surgery." Anaesthesia 31 (1976): 13-7
  6. Valentin N, Staffeldt H, Kyst A "Effect of i.v. atropine on cardiac rhythm, heart rate, blood pressure and airway secretion during isoflurane anaesthesia." Acta Anaesthesiol Scand 28 (1984): 621-4
  7. "Product Information. Antivert (meclizine)." Roerig Division, New York, NY.
  8. Schuller DE, Turkewitz D "Adverse effects of antihistamines." Postgrad Med 79 (1986): 75-86
  9. Horgan J "Atropine and ventricular tachyarrhythmia." JAMA 223 (1973): 693
  10. Zsigmond EK, Matsuki A, Sharafabadi C "Atropine and cardiac arrhythmia." N Engl J Med 288 (1973): 635
  11. Das G, Talmers FN, Weissler AM "New observations on the effects of atropine on the sinoatrial and atrioventricular nodes in man." Am J Cardiol 36 (1975): 281-5
  12. Lunde P "Ventricular fibrillation after intravenous atropine for treatment of sinus bradycardia." Acta Med Scand 199 (1976): 369-71
  13. Cooper MJ, Abinader EG "Atropine-induced ventricular fibrillation: case report and review of the literature." Am Heart J 97 (1979): 225-8
  14. Lowenthal DT, Reidenberg MM "The heart rate response to atropine in uremic patients, obese subjects before and during fasting, and patients with other chronic illnesses." Proc Soc Exp Biol Med 139 (1972): 390-3
  15. "Product Information. Benadryl (diphenhydramine)." Parke-Davis, Morris Plains, NJ.
  16. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
View all 16 references
Moderate

Anticholinergics (Includes Pyridium Plus) ↔ Tachycardia

Moderate Potential Hazard, Moderate plausibility

Applies to: Arrhythmias

Anticholinergics block vagal inhibition of the SA nodal pacemaker. Therapy with anticholinergics should be administered cautiously in patients with tachycardia, congestive heart failure, or coronary artery disease. Premature ventricular depolarization or ventricular tachycardia or fibrillation associated with anticholinergics is rare.

References

  1. "Product Information. Antivert (meclizine)." Roerig Division, New York, NY.
Moderate

Antimuscarinics (Includes Pyridium Plus) ↔ Coronary Artery Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Arrhythmias, Ischemic Heart Disease

Antimuscarinic agents block vagal inhibition of the SA nodal pacemaker. These agents should be administered cautiously in patients with tachycardia, congestive heart failure, or coronary artery disease. Premature ventricular depolarization or ventricular tachycardia or fibrillation associated with antimuscarinic drugs is rare.

References

  1. Lunde P "Ventricular fibrillation after intravenous atropine for treatment of sinus bradycardia." Acta Med Scand 199 (1976): 369-71
  2. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  3. Richman S "Adverse effect of atropine during myocardial infarction. Enchancement of ischemia following intravenously administered atropine." JAMA 228 (1974): 1414-6
  4. Knoebel SB, McHenry PL, Phillips JF, Widlansky S "Atropine-induced cardioacceleration and myocardial blood flow in subjects with and without coronary artery disease." Am J Cardiol 33 (1974): 327-32
View all 4 references
Moderate

Antimuscarinics (Includes Pyridium Plus) ↔ Gastric Ulcer

Moderate Potential Hazard, Low plausibility

Applies to: Bleeding

Antimuscarinic agents may cause a delay in gastric emptying and possibly antral stasis in patients with gastric ulcer. Therapy with antimuscarinic agents should be administered cautiously to patients with gastric ulcer.

References

  1. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  2. Chernish SM, Brunelle RR, Rosenak BD, Ahmadzai S "Comparison of the effects of glucagon and atropine sulfate on gastric emptying." Am J Gastroenterol 70 (1978): 581-6
  3. Cotton BR, Smith G "Single and combined effects of atropine and metoclopramide on the lower oesophageal sphincter pressure." Br J Anaesth 53 (1981): 869-74
  4. Mevorach D "Adverse effects of atropine sulfate autoinjection." Ann Pharmacother 26 (1992): 564
View all 4 references
Moderate

Antimuscarinics (Includes Pyridium Plus) ↔ Gastroesophageal Reflux

Moderate Potential Hazard, Moderate plausibility

Applies to: Gastroesophageal Reflux Disease

Antimuscarinic agents decrease gastric motility and relax the lower esophageal sphincter which promotes gastric retention and can aggravate reflux. These drugs should be administered cautiously in patients with gastroesophageal reflux or hiatal hernia associated with reflux esophagitis.

References

  1. Cotton BR, Smith G "Single and combined effects of atropine and metoclopramide on the lower oesophageal sphincter pressure." Br J Anaesth 53 (1981): 869-74
  2. Chernish SM, Brunelle RR, Rosenak BD, Ahmadzai S "Comparison of the effects of glucagon and atropine sulfate on gastric emptying." Am J Gastroenterol 70 (1978): 581-6
  3. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  4. Howells TH "The administration of metoclopramide with atropine." Anaesthesia 32 (1977): 677
  5. Dow TG, Brock-Utne JG, Rubin J, Welman S, Dimopoulos GE, Moshal MG "The effect of atropine on the lower esophageal sphincter in late pregnancy." Obstet Gynecol 51 (1978): 426-30
  6. Brock-Utne JG, Rubin J, Downing JW, Dimopoulos GE, Moshal MG, Naicker M "The administration of metoclopramide with atropine. A drug interaction effect on the gastro-oesophageal sphincter in man." Anaesthesia 31 (1976): 1186-90
View all 6 references
Moderate

Antimuscarinics (Includes Pyridium Plus) ↔ Ulcerative Colitis

Moderate Potential Hazard, Moderate plausibility

Applies to: Ulcerative Colitis

Antimuscarinic agents may suppress intestinal motility and produce paralytic ileus with resultant precipitation of toxic megacolon. These drugs should be administered cautiously to patients with ulcerative colitis.

References

  1. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  2. Famewo CE "A re-evaluation of anticholergic premedication." Can Anaesth Soc J 24 (1977): 39-41
  3. Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, eds. "Harrison's Principles of Internal Medicine. 14th ed." New York, NY: McGraw-Hill Health Professionals Division (1998):
Moderate

Atropine-Like Agents (Includes Pyridium Plus) ↔ Liver Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease

Atropine-like agents undergo significant hepatic metabolism. Therapy with atropine-like agents should be administered cautiously to patients with liver disease.

References

  1. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
Moderate

Atropine-Like Agents (Includes Pyridium Plus) ↔ Renal Failure

Moderate Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

Atropine-like agents are primarily eliminated by the kidney. Therapy with atropine-like agents should be administered cautiously to patients with renal disease.

References

  1. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
Moderate

Barbiturates (Includes Pyridium Plus) ↔ Adrenal Insufficiency

Moderate Potential Hazard, High plausibility

Applies to: Adrenal Insufficiency, Panhypopituitarism

Barbiturates, especially phenobarbital, secobarbital and butabarbital, may diminish the systemic effects of exogenous and endogenous corticosteroids via induction of hepatic microsomal enzymes, thereby accelerating the metabolism of corticosteroids. In addition, barbiturates may interfere with pituitary corticotropin production. Therapy with barbiturates should be administered cautiously in patients with adrenal insufficiency. Patients with borderline hypoadrenalism should be monitored closely, and patients receiving steroid supplementation may require an adjustment in dosage when barbiturates are added to or withdrawn from their medication regimen.

References

  1. "Product Information. Seconal Sodium (secobarbital)" Lilly, Eli and Company, Indianapolis, IN.
  2. "Product Information. Amytal Sodium (amobarbital)" Lilly, Eli and Company, Indianapolis, IN.
  3. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company, Indianapolis, IN.
  4. "Product Information. Nembutal Sodium (pentobarbital)" Abbott Pharmaceutical, Abbott Park, IL.
  5. "Product Information. Mebaral (mephobarbital)" Sanofi Winthrop Pharmaceuticals, New York, NY.
  6. "Product Information. Butisol Sodium (butabarbital)" Wallace Laboratories, Cranbury, NJ.
View all 6 references
Moderate

Barbiturates (Includes Pyridium Plus) ↔ Depression

Moderate Potential Hazard, High plausibility

Applies to: Depression

Barbiturates depress the central nervous system and may cause or exacerbate mental depression. Therapy with barbiturates should be administered cautiously in patients with a history of depression or suicidal tendencies. It may be prudent to refrain from dispensing large quantities of medication to these patients.

References

  1. "Multum Information Services, Inc. Expert Review Panel"
  2. "Product Information. Butisol Sodium (butabarbital)" Wallace Laboratories, Cranbury, NJ.
  3. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company, Indianapolis, IN.
  4. "Product Information. Seconal Sodium (secobarbital)" Lilly, Eli and Company, Indianapolis, IN.
  5. "Product Information. Nembutal Sodium (pentobarbital)" Abbott Pharmaceutical, Abbott Park, IL.
  6. "Product Information. Mebaral (mephobarbital)" Sanofi Winthrop Pharmaceuticals, New York, NY.
  7. "Product Information. Amytal Sodium (amobarbital)" Lilly, Eli and Company, Indianapolis, IN.
View all 7 references
Moderate

Barbiturates (Includes Pyridium Plus) ↔ Hematologic Toxicity

Moderate Potential Hazard, Low plausibility

Applies to: Bone Marrow Depression/Low Blood Counts

Hematologic toxicity, including agranulocytosis, thrombocytopenic purpura and megaloblastic anemia, has been reported rarely during use of barbiturates. Therapy with barbiturates should be administered cautiously in patients with preexisting blood dyscrasias or bone marrow suppression. Blood counts are recommended prior to and periodically during long-term therapy, and patients should be instructed to immediately report any signs or symptoms suggestive of blood dyscrasia such as fever, sore throat, local infection, easy bruising, petechiae, bleeding, pallor, dizziness, or jaundice. Barbiturate therapy should be discontinued if blood dyscrasias occur.

References

  1. "Product Information. Nembutal Sodium (pentobarbital)" Abbott Pharmaceutical, Abbott Park, IL.
  2. Iivanainen M, Savolainen H "Side effects of phenobarbital and phenytoin during long-term treatment of epilepsy." Acta Neurol Scand Suppl 97 (1983): 49-67
  3. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company, Indianapolis, IN.
  4. "Product Information. Mebaral (mephobarbital)" Sanofi Winthrop Pharmaceuticals, New York, NY.
  5. "Product Information. Amytal Sodium (amobarbital)" Lilly, Eli and Company, Indianapolis, IN.
  6. "Product Information. Seconal Sodium (secobarbital)" Lilly, Eli and Company, Indianapolis, IN.
  7. Kiorboe E, Plum CM "Megaloblastic anaemia developing during treatment of epilepsy." Acta Med Scand Suppl 445 (1966): 349-57
  8. "Product Information. Butisol Sodium (butabarbital)" Wallace Laboratories, Cranbury, NJ.
  9. Van Hoof A, Chamone DA, Vermylen J "Platelet aggregation and anaesthesia." Lancet 2 (1980): 373
View all 9 references
Moderate

Barbiturates (Includes Pyridium Plus) ↔ Osteomalacia

Moderate Potential Hazard, Low plausibility

Applies to: Vitamin D Deficiency

Rickets and osteomalacia have rarely been reported following prolonged use of barbiturates, possibly due to increased metabolism of vitamin D as a result of enzyme induction by barbiturates. Long-term therapy with barbiturates should be administered cautiously in patients with vitamin D deficiency.

References

  1. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company, Indianapolis, IN.
  2. Zerwekh JE, Homan R, Tindall R, Pak CY "Decreased serum 24,25-dihydroxyvitamin D concentration during long- term anticonvulsant therapy in adult epileptics." Ann Neurol 12 (1982): 184-6
  3. Sotaniemi EA, Hakkarainen HK, Puranen JA, Lahti RO "Radiologic bone changes and hypocalcemia with anticonvulsant therapy in epilepsy." Ann Intern Med 77 (1972): 389-94
  4. Doriguzzi C, Mongini T, Jeantet A, Monga G "Tubular aggregates in a case of osteomalacic myopathy due to anticonvulsant drugs." Clin Neuropathol 3 (1984): 42-5
  5. Marsden CD, Reynolds EH, Parsons V, Harris R, Duchen L "Myopathy associated with anticonvulsant osteomalacia." Br Med J 4 (1973): 526-7
  6. Iivanainen M, Savolainen H "Side effects of phenobarbital and phenytoin during long-term treatment of epilepsy." Acta Neurol Scand Suppl 97 (1983): 49-67
View all 6 references
Moderate

Barbiturates (Includes Pyridium Plus) ↔ Paradoxical Reactions

Moderate Potential Hazard, Moderate plausibility

Applies to: Hyperkinetic Syndrome of Childhood

Paradoxical reactions characterized by excitability and restlessness may occur in pediatric patients with hyperactive aggressive disorders. Such patients should be monitored for signs of paradoxical stimulation during therapy with barbiturates.

References

  1. Mayhew LA, Hanzel TE, Ferron FR, Kalachnik JE, Harder SR "Phenobarbital exacerbation of self-injurious behavior." J Nerv Ment Dis 180 (1992): 732-3
  2. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  3. "Product Information. Nembutal Sodium (pentobarbital)" Abbott Pharmaceutical, Abbott Park, IL.
  4. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company, Indianapolis, IN.
  5. Sylvester CE, Marchlewski A, Manaligod JM "Primidone or phenobarbital use complicating disruptive behavior disorders." Clin Pediatr (Phila) 33 (1994): 252-3
  6. "Product Information. Butisol Sodium (butabarbital)" Wallace Laboratories, Cranbury, NJ.
  7. "Product Information. Seconal Sodium (secobarbital)" Lilly, Eli and Company, Indianapolis, IN.
  8. "Product Information. Amytal Sodium (amobarbital)" Lilly, Eli and Company, Indianapolis, IN.
  9. "Product Information. Mebaral (mephobarbital)" Sanofi Winthrop Pharmaceuticals, New York, NY.
View all 9 references
Moderate

Anticholinergics (Includes Pyridium Plus) ↔ Hypertension

Minor Potential Hazard, Low plausibility

Applies to: Hypertension

Cardiovascular effects of anticholinergics may exacerbate hypertension. Therapy with anticholinergic agents should be administered cautiously in patients with hypertension.

References

  1. "Product Information. Marezine (cyclizine)." Glaxo Wellcome, Research Triangle Park, NC.
  2. "Product Information. Cogentin (benztropine)." Merck & Co, Inc, West Point, PA.
  3. "Product Information. Benadryl (diphenhydramine)." Parke-Davis, Morris Plains, NJ.
  4. "Product Information. Artane (trihexyphenidyl)." Lederle Laboratories, Wayne, NJ.
  5. Valentin N, Staffeldt H, Kyst A "Effect of i.v. atropine on cardiac rhythm, heart rate, blood pressure and airway secretion during isoflurane anaesthesia." Acta Anaesthesiol Scand 28 (1984): 621-4
  6. "Product Information. Antivert (meclizine)." Roerig Division, New York, NY.
  7. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
View all 7 references
Moderate

Anticholinergics (Includes Pyridium Plus) ↔ Hyperthyroidism

Minor Potential Hazard, Low plausibility

Applies to: Hyperthyroidism

In general, agents with anticholinergic activity may exacerbate hyperthyroidism. Therapy with anticholinergics should be administered cautiously in patients with hyperthyroidism. Thyroid levels should be monitored if usage is prolonged.

References

  1. "Product Information. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  2. "Product Information. Poly-Histine-D (pyrilamine)." Bock Pharmaceutical Company, St. Louis, MO.
  3. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  4. "Product Information. Periactin (cyproheptadine)." Merck & Co, Inc, West Point, PA.
  5. "Product Information. Optimine (azatadine)." Schering Laboratories, Kenilworth, NJ.
  6. "Product Information. Antivert (meclizine)." Roerig Division, New York, NY.
  7. "Product Information. Chlortrimeton (chlorpheniramine)." Schering-Plough, Liberty Corner, NJ.
  8. "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
View all 8 references
Moderate

Antimuscarinics (Includes Pyridium Plus) ↔ Diarrhea

Minor Potential Hazard, Moderate plausibility

Applies to: Diarrhea

Diarrhea may be a symptom of incomplete intestinal obstruction, especially in patients with ileostomy or colostomy. Antimuscarinic agents may further aggravate the diarrhea. Therefore, these drugs should be administered cautiously in patients with diarrhea.

References

  1. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  2. "Lomotil for diarrhea in children." Med Lett Drugs Ther 17 (1975): 104
Moderate

Atropine-Like Agents (Includes Pyridium Plus) ↔ Fever

Minor Potential Hazard, Low plausibility

Applies to: Fever

Atropine-like agents may increase the risk of hyperthermia in patients with fever by producing anhidrosis. Therapy with atropine-like agents should be administered cautiously in febrile patients.

References

  1. Sarnquist F, Larson CP Jr "Drug-induced heat stroke." Anesthesiology 39 (1973): 348-50
  2. Lee BS "Possibility of hyperpyrexia with antipsychotic and anticholinergic drugs." J Clin Psychiatry 47 (1986): 571
  3. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  4. Stadnyk AN, Glezos JD "Drug-induced heat stroke." Can Med Assoc J 128 (1983): 957-9
  5. "Product Information. Cogentin (benztropine)." Merck & Co, Inc, West Point, PA.
  6. Forester D "Fatal drug-induced heat stroke." JACEP 7 (1978): 243-4
View all 6 references

Pyridium Plus (butabarbital / hyoscyamine / phenazopyridine) drug Interactions

There are 1133 drug interactions with Pyridium Plus (butabarbital / hyoscyamine / phenazopyridine)

Pyridium Plus (butabarbital / hyoscyamine / phenazopyridine) alcohol/food Interactions

There are 2 alcohol/food interactions with Pyridium Plus (butabarbital / hyoscyamine / phenazopyridine)

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.
Unknown No information available.

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

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2018 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

Hide