Nuedexta (dextromethorphan / quinidine) Disease Interactions
There are 4 disease interactions with Nuedexta (dextromethorphan / quinidine):
Antiarrhythmics (Includes Nuedexta) ↔ Cardiovascular Dysfunction
Severe Potential Hazard, Moderate plausibility
Applies to: Hypotension, Congestive Heart Failure
Antiarrhythmic agents can induce severe hypotension (particularly with IV administration) or induce or worsen congestive heart failure (CHF). Patients with primary cardiomyopathy or inadequately compensated CHF are at increased risk. Antiarrhythmic agents should be administered cautiously and dosage and/or frequency of administration modified in patients with hypotension or adequately compensated CHF. Alternative therapy should be considered unless these conditions are secondary to cardiac arrhythmia.
- Halkin H, Meffin P, Melmon KL, Rowland M "Influence of congestive heart failure on blood levels of lidocaine and its active monodeethylated metabolite." Clin Pharmacol Ther 17 (1975): 669-76
- Crouthamel WG "The effect of congestive heart failure on quinidine pharmacokinetics." Am Heart J 90 (1975): 335-9
- "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
Antiarrhythmics (Includes Nuedexta) ↔ Proarrhythmic Effects
Severe Potential Hazard, High plausibility
Applies to: Arrhythmias, Abnormal Electrocardiogram
Antiarrhythmic agents can induce or worsen ventricular arrhythmias. Ventricular tachycardia, ventricular fibrillation, and torsades de pointes have occurred in some patients. Patients with underlying cardiac dysfunction, bradycardia, hypokalemia, hypomagnesemia, or high antiarrhythmic serum concentrations are at increased risk for drug-induced arrhythmias. Therapy with antiarrhythmics should be used with extreme caution in patients with or predisposed to arrhythmias. Evidence of improved survival is lacking for use of antiarrhythmic therapy in asymptomatic, non-life-threatening arrhythmias. Therapy with antiarrhythmic agents should be reserved for patients with life-threatening arrhythmias.
- "Product Information. Tambocor (flecainide)." 3M Pharmaceuticals, St. Paul, MN.
- "Product Information. Adenocard (adenosine)." Fujisawa, Deerfield, IL.
- Andrivet P, Beaslay V, Canh VD "Torsades de pointe with flecainide-amiodarone therapy." Intensive Care Med 16 (1990): 342-3
Antiarrhythmics (Includes Nuedexta) ↔ Electrolyte Imbalance
Moderate Potential Hazard, High plausibility
Applies to: Hyperkalemia, Hypokalemia, Magnesium Imbalance
Electrolyte imbalance can alter the therapeutic effectiveness of antiarrhythmic agents. Hypokalemia and hypomagnesemia can reduce the effectiveness of antiarrhythmic agents. In some cases, these disorders can exaggerate the degree of QTc prolongation and increase the potential for torsades de pointes. Hyperkalemia can potentiate the toxic effects of antiarrhythmic agents. Electrolyte imbalance should be corrected prior to initiating antiarrhythmic therapy. Clinical monitoring of cardiac function and electrolyte concentrations is recommended.
- "Product Information. Tonocard (tocainide)." Merck & Co, Inc, West Point, PA.
- "Product Information. Norpace (disopyramide)." Searle, Skokie, IL.
- "Product Information. Quinidex (quinidine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
Antitussives (Includes Nuedexta) ↔ Psychiatric Conditions
Moderate Potential Hazard, Moderate plausibility
Applies to: Depression, Psychosis, Parkinsonism
Caution should be used when prescribing antitussives such as dextromethorphan and benzonatate in patients with psychiatric or emotional conditions. Isolated instances of bizarre behavior, including mental confusion and visual hallucinations have been reported in patients taking antitussives, specially when combined with other prescribed drugs such as monoamine oxidase inhibitors.
Nuedexta (dextromethorphan / quinidine) drug Interactions
There are 1077 drug interactions with Nuedexta (dextromethorphan / quinidine)
Nuedexta (dextromethorphan / quinidine) alcohol/food Interactions
There are 2 alcohol/food interactions with Nuedexta (dextromethorphan / quinidine)
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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