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Guaifenesin/phenylephrine/pyrilamine Disease Interactions

There are 11 disease interactions with guaifenesin / phenylephrine / pyrilamine.

Major

Anxiolytics/sedatives/hypnotics (applies to guaifenesin/phenylephrine/pyrilamine) depression

Major Potential Hazard, Moderate plausibility.

A variety of abnormal thinking and behavior changes have been reported to occur in association with the use of most anxiolytics, sedatives and hypnotics. Some of these changes include decreased inhibition, aggressiveness, agitation, and hallucinations. These drugs can cause or exacerbate mental depression and cause suicidal behavior and ideation. Therapy with these drugs should be administered cautiously in patients with a history of depression or other psychiatric disorders. Patients should be monitored for any changes in mood or behavior. It may be prudent to refrain from dispensing large quantities of medication to these patients.

References

  1. "Product Information. Buspar (buspirone)." Bristol-Myers Squibb (2002):
  2. "Product Information. Ambien (zolpidem)." sanofi-aventis (2001):
  3. "Product Information. Placidyl (ethchlorvynol)." Abbott Pharmaceutical (2001):
  4. "Product Information. Aquachloral Supprettes (chloral hydrate)." Medisca Inc (2001):
  5. "Product Information. Equanil (meprobamate)." Wallace Laboratories (2001):
  6. "Product Information. Sonata (zaleplon)." Wyeth-Ayerst Laboratories (2001):
  7. "Product Information. Precedex (dexmedetomidine)." Abbott Pharmaceutical (2001):
  8. "Product Information. Xyrem (sodium oxybate)." Orphan Medical (2002):
  9. "Product Information. Lunesta (eszopiclone)." Sepracor Inc (2004):
  10. "Product Information. Rozerem (ramelteon)." Takeda Pharmaceuticals America (2005):
  11. "Product Information. Silenor (doxepin)." Somaxon Pharmaceuticals (2010):
  12. "Product Information. Unisom (doxylamine)." Pfizer U.S. Pharmaceuticals Group (2013):
  13. "Product Information. Hetlioz (tasimelteon)." Vanda Pharmaceuticals Inc (2014):
  14. "Product Information. Belsomra (suvorexant)." Merck & Company Inc (2014):
View all 14 references
Major

Sympathomimetics (applies to guaifenesin/phenylephrine/pyrilamine) cardiovascular disease

Major Potential Hazard, High plausibility. Applicable conditions: 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. Humberstone PM "Hypertension from cold remedies." Br Med J 1 (1969): 846
  2. Mariani PJ "Pseudoephedrine-induced hypertensive emergency: treatment with labetalol." Am J Emerg Med 4 (1986): 141-2
  3. Rosen RA "Angina associated with pseudoephedrine ." Ann Emerg Med 10 (1981): 230-1
  4. Wiener I, Palazzolo M, Tilkian AG "Coronary artery spasm and myocardial infarction in a patient with normal coronary arteries: temporal relationship to pseudoephedrine ingestion." Cathet Cardiovasc Diagn 20 (1990): 51-3
  5. Bachmann AW, Ballantine DM, Gordon RD "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
  6. Hamilton JG, Loizou LA, Tsementzis SA "Intracranial haemorrhage in association with pseudoephedrine overdose." J Neurol Neurosurg Psychiatry 45 (1982): 471-2
  7. Bressler R, Dickerson J, Perrier D, Mayersohn M "Dose tolerance and pharmacokinetic studies of L (+) pseudoephedrine capsules in man." Eur J Clin Pharmacol 14 (1978): 253-9
  8. Murphy MJ, Wooten MR, Khangure MS "Intracerebral hemorrhage and vasculitis related to ephedrine abuse." Ann Neurol 13 (1983): 337-40
  9. Rampling D, Cammens I, Sangster JF, To LB "Ephedrine-induced cardiomyopathy." Med J Aust 2 (1980): 35-6
  10. Chapin J, Nolte KB, Bruno A "Stroke associated with ephedrine use." Neurology 43 (1993): 1313-6
  11. Feasby TE, Young GB, Stoessl AJ "Intracerebral haemorrhage and angiographic beading following ingestion of catecholaminergics." Stroke 16 (1985): 734-6
  12. Covington TR, eds., Lawson LC, Young LL "Handbook of Nonprescription Drugs." Washington, DC: American Pharmaceutical Association (1993):
  13. "Product Information. Sudafed (pseudoephedrine)." Glaxo Wellcome (2001):
  14. Kizer KW "Intracranial hemorrhage associated with overdose of decongestant containing phenylpropanolamine" Am J Emerg Med 2 (1984): 180-1
  15. Edwards M, Harwood-Nuss A, Russo L "Cerebral infarction with a single oral dose of phenylpropanolamine." Am J Emerg Med 5 (1987): 163-4
  16. Lake CR, Gallant S, Masson E, Miller P "Adverse drug effects attributed to phenylpropanolamine: a review of 142 case reports." Am J Med 89 (1990): 195-208
  17. Chernow B, Lake CR, Bray J, Rosenberg D, Zaloga G "Transient hypertension after two phenylpropanolamine diet aids and the effects of caffeine: a placebo-controlled follow-up study." Am J Med 86 (1989): 427-32
  18. Chernow B, Clymer R, Quirk RM, Lake CR, Zaloga G "A double dose of phenylpropanolamine causes transient hypertension." Am J Med 85 (1988): 339-43
  19. Bernstein E, Diskant BM "Phenylpropanolamine: a potentially hazardous drug." Ann Emerg Med 11 (1982): 311-5
  20. Kroenke K, Meier NJ, Simmons JO, Omori DM, Wood DR "The safety of phenylpropanolamine in patients with stable hypertension." Ann Intern Med 111 (1989): 1043-4
  21. Mikell FL, Zavoral JH, Pentel PR "Myocardial injury after phenylpropanolamine ingestion." Br Heart J 47 (1982): 51-4
  22. Howrie DL, Wolfson JH "Phenylpropanolamine-induced hypertensive seizures." J Pediatr 102 (1983): 143-5
  23. Christophidis N, Fennessy MR, Howes LG, Louis WJ, Rand MJ, Horowitz JD, Lang WJ "Hypertensive responses induced by phenylpropanolamine in anorectic and decongestant preparations." Lancet 1 (1980): 60-1
  24. Reeves DM, Etter HS, Johnson DA "Stroke and phenylpropanolamine use" Lancet 2 (1983): 970
  25. McEwen J "Phenylpropanolamine-associated hypertension after the use of "over- the-counter" appetite-suppressant products." Med J Aust 2 (1983): 71-3
  26. Elliott CF, Whyte JC "Phenylpropanolamine and hypertension." Med J Aust 1 (1981): 715
  27. Maher LM, Peterson PL, Dela-Cruz C "Postpartum intracranial hemorrhage and phenylpropanolamine use" Neurology 37 (1987): 1686
  28. Foster TE, Girgis GN, Kase CS, Reed JE, Spatz EL "Intracerebral hemorrhage and phenylpropanolamine use." Neurology 37 (1987): 399-404
  29. Kikta DG, Chandar K, Devereaux MW "Intracranial hemorrhages due to phenylpropanolamine." Stroke 16 (1985): 510-2
  30. Clark JE, Simon WA "Cardiac arrhythmias after phenylpropanolamine ingestion." Drug Intell Clin Pharm 17 (1983): 737-8
  31. Noble R "A controlled clinical trial of the cardiovascular and psychological effects of phenylpropanolamine and caffeine." Drug Intell Clin Pharm 22 (1988): 296-9
  32. Gross CR, O'Connell MB "The effect of multiple doses of phenylpropanolamine on the blood pressure of patients whose hypertension was controlled with beta blockers." Pharmacotherapy 11 (1991): 376-81
  33. Gross CR, O'Connell MB "The effect of single-dose phenylpropanolamine on blood pressure in patients with hypertension controlled by beta blockers." Pharmacotherapy 10 (1990): 85-91
  34. Choy M, Chin C "Cardiomyopathy induced by phenylpropanolamine." J Pediatr 123 (1993): 825-7
  35. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  36. Beilin LJ, Vandongen R, Lee KY "Severe hypertension after ingestion of an appetite suppressant (phenylpropanolamine) with indomethacin." Lancet 1 (1979): 1110-1
  37. Gibson GJ, Warrell DA "Hypertensive crises and phenylpropanolamine." Lancet 2 (1972): 492-3
  38. Frewin DB "Phenylpropanolamine. How safe is it?" Med J Aust 2 (1983): 54-5
  39. Beilin LJ, Vandongen R, Lee KY "Severe hypertension after administration of phenylpropanolamine" Med J Aust 1 (1979): 525-6
  40. McNeil JJ, Louis WJ, Horowitz JD, Mendelsohn FA, Sweet B "Hypertension and postural hypotension induced by phenylpropanolamine (Trimolets)." Med J Aust 1 (1979): 175-6
  41. Frewin ME, Frewin DB, Leonello PP "Hypertension after ingestion of Trimolets." Med J Aust 2 (1978): 497-8
  42. Teh AY "Phenylpropanolamine and hypertension" Med J Aust 2 (1979): 425-6
  43. Shapiro SR "Hypertension due to anorectic agent." N Engl J Med 280 (1969): 1363
  44. Maher LM, Peterson PL, Dela-Cruz C "Postpartum intracranial hemorrhage and phenylpropanolamine use." Neurology 37 (1987): 1886,1890
  45. Fallis RJ, Fisher M "Cerebral vasculitis and hemorrhage associated with phenylpropanolamine." Neurology 35 (1985): 405-7
  46. Caperton E "Raynaud's phenomenon. Role of diet pills and cold remedies." Postgrad Med 73 (1983): 291-2
  47. LeBlanc HJ, McDowell JR "Phenylpropanolamine and cerebral hemorrhage." West J Med 142 (1985): 688-91
  48. Williams DM "Phenylpropanolamine hydrochloride" Am Pharm NS30 (1990): 47-50
  49. Dowse R, Scherzinger SS, Kanfer I "Serum concentrations of phenylpropanolamine and associated effects on blood pressure in normotensive subjects: a pilot-study." Int J Clin Pharmacol Ther Toxicol 28 (1990): 205-10
  50. Aaron C, Paya C, Pentel PR "Therapeutic doses of phenylpropanolamine increase supine systolic blood pressure." Int J Obes 9 (1985): 115-9
  51. Chernow B, Finton CK, Barton M "Possible adverse effects of phenylpropanolamine (diet pills) on sympathetic nervous system function--caveat emptor!" Mil Med 147 (1982): 1072
  52. "Product Information. Adrenalin Chloride Solution (epinephrine)." Parke-Davis, Morris Plains, NJ.
  53. Marcus SM, Hollander JE, Shih RD, Leo PJ "Phenylpropanolamine and associated myocardial injury." Ann Emerg Med 28 (1996): 359-62
  54. Blazevich AJ, Shield A, Gill ND, Weatherby RP, Zhou S "Muscular and cardiorespiratory effects of pseudoephedrine in human athletes." Br J Clin Pharmacol 50 (2000): 205-13
  55. Benowitz NL, Haller CA "Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids." N Engl J Med 343 (2000): 1833-8
  56. Mansoor GA "Herbs and alternative therapies in the hypertension clinic." Am J Hypertens 14(9 Pt 1) (2001): 971-5
  57. Homoud MK, Samenuk D, Link MS, et al. "Adverse cardiovascular events temporally associated with ma huang, an herbal source of ephedrine." Mayo Clin Proc 77 (2002): 12-6
  58. "Product Information. Akovaz (ephedrine)." Eclat Pharmaceuticals (2016):
View all 58 references
Moderate

Antihistamines (applies to guaifenesin/phenylephrine/pyrilamine) anticholinergic effects

Moderate Potential Hazard, Low plausibility. Applicable conditions: 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. Schuller DE, Turkewitz D "Adverse effects of antihistamines." Postgrad Med 79 (1986): 75-86
  2. "Product Information. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories (2002):
  3. "Product Information. Chlortrimeton (chlorpheniramine)." Schering-Plough, Liberty Corner, NJ.
  4. "Product Information. Periactin (cyproheptadine)." Merck & Company Inc (2002):
  5. "Product Information. Benadryl (diphenhydramine)." Parke-Davis (2002):
  6. "Product Information. Phenergan (promethazine)." Wyeth-Ayerst Laboratories (2001):
  7. "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation (2001):
  8. "Product Information. Antivert (meclizine)." Roerig Division (2001):
  9. "Product Information. Marezine (cyclizine)." Glaxo Wellcome (2001):
  10. "Product Information. Optimine (azatadine)." Schering Corporation (2001):
  11. "Product Information. Semprex-D (acrivastine-pseudoephedrine)." Endo Laboratories LLC (2001):
  12. "Product Information. Zyrtec (cetirizine)." Pfizer U.S. Pharmaceuticals (2001):
  13. "Product Information. Drixoral (dextromethorphan)." Schering-Plough (2001):
  14. "Product Information. Poly-Histine-D (pyrilamine)." Bock Pharmacal Company (2001):
  15. Alehan FK, Epstein CE, Watemberg NM, Roth KS "Central anticholinergic syndrome on therapeutic doses of cyproheptadine." Pediatrics 103 (1999): 158-60
  16. "Product Information. Vistaril (hydroxyzine)." Pfizer U.S. Pharmaceuticals (2001):
  17. "Product Information. Dramamine (dimenhydrinate)." Pharmacia and Upjohn (2001):
  18. "Product Information. Tacaryl (methdilazine)." Westwood Squibb Pharmaceutical Corporation (2001):
  19. "Product Information. Temaril (trimeprazine)." Allergan Inc (2001):
  20. Talbert RL, Yee GC, DiPiro JT, Matzke GR, Posey LM, Wells BG "Pharmacotherapy: A Pathophysiologic Approach" Stamford, CT: Appleton & Lange (1999):
View all 20 references
Moderate

Antihistamines (applies to guaifenesin/phenylephrine/pyrilamine) asthma/COPD

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: 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. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories (2002):
  2. "Product Information. Chlortrimeton (chlorpheniramine)." Schering-Plough, Liberty Corner, NJ.
  3. "Product Information. Periactin (cyproheptadine)." Merck & Company Inc (2002):
  4. "Product Information. Benadryl (diphenhydramine)." Parke-Davis (2002):
  5. "Product Information. Phenergan (promethazine)." Wyeth-Ayerst Laboratories (2001):
  6. Maddox DE, Reed CE "Clinical pharmacodynamics of antihistamines." Ann Allergy 59 (1987): 43-8
  7. "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation (2001):
  8. "Product Information. Antivert (meclizine)." Roerig Division (2001):
  9. "Product Information. Marezine (cyclizine)." Glaxo Wellcome (2001):
  10. "Product Information. Optimine (azatadine)." Schering Corporation (2001):
  11. "Product Information. Semprex-D (acrivastine-pseudoephedrine)." Endo Laboratories LLC (2001):
  12. "Product Information. Drixoral (dextromethorphan)." Schering-Plough (2001):
  13. "Product Information. Poly-Histine-D (pyrilamine)." Bock Pharmacal Company (2001):
  14. "Product Information. Vistaril (hydroxyzine)." Pfizer U.S. Pharmaceuticals (2001):
  15. "Product Information. Dramamine (dimenhydrinate)." Pharmacia and Upjohn (2001):
  16. "Product Information. Tacaryl (methdilazine)." Westwood Squibb Pharmaceutical Corporation (2001):
  17. "Product Information. Temaril (trimeprazine)." Allergan Inc (2001):
View all 17 references
Moderate

Antihistamines (applies to guaifenesin/phenylephrine/pyrilamine) cardiovascular

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: 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. Schuller DE, Turkewitz D "Adverse effects of antihistamines." Postgrad Med 79 (1986): 75-86
  2. "Product Information. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories (2002):
  3. "Product Information. Chlortrimeton (chlorpheniramine)." Schering-Plough, Liberty Corner, NJ.
  4. "Product Information. Periactin (cyproheptadine)." Merck & Company Inc (2002):
  5. "Product Information. Benadryl (diphenhydramine)." Parke-Davis (2002):
  6. "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation (2001):
  7. "Product Information. Antivert (meclizine)." Roerig Division (2001):
  8. "Product Information. Optimine (azatadine)." Schering Corporation (2001):
  9. Smith SJ "Cardiovascular toxicity of antihistamines." Otolaryngol Head Neck Surg 111 Suppl (1994): 348-54
  10. "Product Information. Zyrtec (cetirizine)." Pfizer U.S. Pharmaceuticals (2001):
  11. Woosley RL "Cardiac actions of antihistamines." Annu Rev Pharmacol Toxicol 36 (1996): 233-52
  12. "Product Information. Drixoral (dextromethorphan)." Schering-Plough (2001):
  13. "Product Information. Poly-Histine-D (pyrilamine)." Bock Pharmacal Company (2001):
  14. "Product Information. Vistaril (hydroxyzine)." Pfizer U.S. Pharmaceuticals (2001):
  15. "Product Information. Dramamine (dimenhydrinate)." Pharmacia and Upjohn (2001):
View all 15 references
Moderate

Antihistamines (applies to guaifenesin/phenylephrine/pyrilamine) renal/liver disease

Moderate Potential Hazard, High plausibility. Applicable conditions: 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. Glazko AJ, Dill WA, Ogilvie RI, Young RM, Smith TC "Metabolic disposition of diphenhydramine." Clin Pharmacol Ther 16 (1974): 1066-76
  2. Paton DM, Webster DR "Clinical pharmacokinetics of H1-receptor antagonists (the antihistamines)." Clin Pharmacokinet 10 (1985): 477-97
  3. Rumore MM "Clinical pharmacokinetics of chlorpheniramine." Drug Intell Clin Pharm 18 (1984): 701-7
  4. Athanikar NK, Huang SM, Sridhar K, Chiou WL, Huang YC "Pharmacokinetics of chlorpheniramine after intravenous and oral administration in normal adults." Eur J Clin Pharmacol 22 (1982): 359-65
  5. Frith EM, Simons KJ, Luciuk GH, Simons FE "Urinary excretion of chlorpheniramine and its metabolites in children." J Pharm Sci 73 (1984): 595-9
  6. Madhavan SV, Christian CD Jr, Johnson RF, Meredith CG, Schenker S "Diphenhydramine disposition in chronic liver disease." Clin Pharmacol Ther 35 (1984): 474-9
  7. Blyden GT, Shader RI, Greenblatt DJ, Scavone JM "Pharmacokinetics of diphenhydramine and a demethylated metabolite following intravenous and oral administration." J Clin Pharmacol 26 (1986): 529-33
  8. Albert KS, Hallmark MR, Sakmar E, Weidler DJ, Wagner JG "Pharmacokinetics of diphenhydramine in man." J Pharmacokinet Biopharm 3 (1975): 159-70
  9. Frith EM, Simons KJ, Simons FE "The pharmacokinetics and antihistaminic effects of brompheniramine." J Allergy Clin Immunol 70 (1982): 458-64
  10. Newman JH, Pitts JE, Turnbull LB, Bruce RB "Metabolism of brompheniramine." J Med Chem 11 (1968): 1031-4
  11. Arison BH, Porter CC, Titus DC, Gruber VF, Vandenheuvel WJ "Human metabolism of cyproheptadine." Drug Metab Dispos 3 (1975): 189-97
  12. Fischer LJ, Hintze KL, Wold JS "Disposition of cyproheptadine in rats, mice, and humans and identification of a stable epoxide metabolite." Drug Metab Dispos 3 (1975): 1-9
  13. Maddox DE, Reed CE "Clinical pharmacodynamics of antihistamines." Ann Allergy 59 (1987): 43-8
  14. Frith EM, Simons KJ, Simons FE "The pharmacokinetics and antihistaminic of the H1 receptor antagonist hydroxyzine." J Allergy Clin Immunol 73 (1984): 69-75
  15. Minuk GY, Simons KJ, Watson WT, Chen XY, Simons FE "The pharmacokinetics and pharmacodynamics of hydroxyzine in patients with primary biliary cirrhosis." J Clin Pharmacol 29 (1989): 809-15
View all 15 references
Moderate

Anxiolytics/sedatives/hypnotics (applies to guaifenesin/phenylephrine/pyrilamine) glaucoma

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Glaucoma/Intraocular Hypertension, Urinary Retention

Some hypnotic drugs can have an anticholinergic effect and should be used with caution in patients with glaucoma, and trouble urinating due to retention or enlarged prostate.

References

  1. "Product Information. Benadryl (diphenhydramine)." Parke-Davis (2002):
  2. "Product Information. Unisom (doxylamine)." Pfizer U.S. Pharmaceuticals Group (2013):
Moderate

Anxiolytics/sedatives/hypnotics (applies to guaifenesin/phenylephrine/pyrilamine) liver disease

Moderate Potential Hazard, Moderate plausibility.

In general, anxiolytics, sedatives and hypnotics 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 these drugs should be administered cautiously in patients with liver disease (some are not recommended in severe liver impairment), and the dosage should be adjusted accordingly. Laboratory testing is recommended prior and during treatment.

References

  1. "Product Information. Buspar (buspirone)." Bristol-Myers Squibb (2002):
  2. "Product Information. Placidyl (ethchlorvynol)." Abbott Pharmaceutical (2001):
  3. "Product Information. Aquachloral Supprettes (chloral hydrate)." Medisca Inc (2001):
  4. "Product Information. Equanil (meprobamate)." Wallace Laboratories (2001):
  5. "Product Information. Sonata (zaleplon)." Wyeth-Ayerst Laboratories (2001):
  6. "Product Information. Precedex (dexmedetomidine)." Abbott Pharmaceutical (2001):
  7. "Product Information. Xyrem (sodium oxybate)." Orphan Medical (2002):
  8. "Product Information. Lunesta (eszopiclone)." Sepracor Inc (2004):
  9. "Product Information. Rozerem (ramelteon)." Takeda Pharmaceuticals America (2005):
  10. "Product Information. Silenor (doxepin)." Somaxon Pharmaceuticals (2010):
  11. "Product Information. Intermezzo (zolpidem)." Purdue Pharma LP (2011):
  12. "Product Information. Hetlioz (tasimelteon)." Vanda Pharmaceuticals Inc (2014):
  13. "Product Information. Belsomra (suvorexant)." Merck & Company Inc (2014):
View all 13 references
Moderate

Sympathomimetics (applies to guaifenesin/phenylephrine/pyrilamine) BPH

Moderate Potential Hazard, High plausibility. Applicable conditions: 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. Covington TR, eds., Lawson LC, Young LL "Handbook of Nonprescription Drugs." Washington, DC: American Pharmaceutical Association (1993):
  2. "Product Information. Sudafed (pseudoephedrine)." Glaxo Wellcome (2001):
  3. Williams DM "Phenylpropanolamine hydrochloride" Am Pharm NS30 (1990): 47-50
  4. "Product Information. Akovaz (ephedrine)." Eclat Pharmaceuticals (2016):
View all 4 references
Moderate

Sympathomimetics (applies to guaifenesin/phenylephrine/pyrilamine) diabetes

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: 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. Covington TR, eds., Lawson LC, Young LL "Handbook of Nonprescription Drugs." Washington, DC: American Pharmaceutical Association (1993):
  2. "Product Information. Sudafed (pseudoephedrine)." Glaxo Wellcome (2001):
  3. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  4. Williams DM "Phenylpropanolamine hydrochloride" Am Pharm NS30 (1990): 47-50
  5. "Product Information. Adrenalin Chloride Solution (epinephrine)." Parke-Davis, Morris Plains, NJ.
  6. "Product Information. Akovaz (ephedrine)." Eclat Pharmaceuticals (2016):
View all 6 references
Moderate

Sympathomimetics (applies to guaifenesin/phenylephrine/pyrilamine) glaucoma

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Glaucoma/Intraocular Hypertension

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

Guaifenesin/phenylephrine/pyrilamine drug interactions

There are 518 drug interactions with guaifenesin / phenylephrine / pyrilamine.

Guaifenesin/phenylephrine/pyrilamine alcohol/food interactions

There is 1 alcohol/food interaction with guaifenesin / phenylephrine / pyrilamine.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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 interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.