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MHP-A (hyoscyamine / methenamine / methylene blue / phenyl salicylate) Disease Interactions

There are 31 disease interactions with MHP-A (hyoscyamine / methenamine / methylene blue / phenyl salicylate):

Major

Anticholinergics (Includes MHP-A) ↔ 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 MHP-A) ↔ 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. "Azatadine (optimine)--a new antihistamine." Med Lett Drugs Ther 19 (1977): 77-9
  2. "Product Information. Antivert (meclizine)." Roerig Division, New York, NY.
  3. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
View all 17 references
Major

Anticholinergics (Includes MHP-A) ↔ 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. "Product Information. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  2. "Product Information. Chlortrimeton (chlorpheniramine)." Schering-Plough, Liberty Corner, NJ.
  3. "Product Information. Moban (molindone)." Gate Pharmaceuticals, Sellersville, PA.
View all 23 references
Major

Anticholinergics (Includes MHP-A) ↔ 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. "Product Information. Artane (trihexyphenidyl)." Lederle Laboratories, Wayne, NJ.
  2. Schuller DE, Turkewitz D "Adverse effects of antihistamines." Postgrad Med 79 (1986): 75-86
  3. "Product Information. Moban (molindone)." Gate Pharmaceuticals, Sellersville, PA.
View all 21 references
Major

Anticholinergics (Includes MHP-A) ↔ 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. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  2. "Product Information. Antivert (meclizine)." Roerig Division, New York, NY.
  3. "Product Information. Phenergan (promethazine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
View all 5 references
Major

Antimuscarinics (Includes MHP-A) ↔ 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 MHP-A) ↔ 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. Marshall WF Jr, Rosenthal P, Merritt RJ "Atropine therapy and paralytic ileus in an infant." J Pediatr Gastroenterol Nutr 9 (1989): 532-4
  3. "Product Information. Imodium (loperamide)." Janssen Pharmaceutica, Titusville, NJ.
View all 6 references
Major

Methenamine (Includes MHP-A) ↔ Crystalluria

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction, Dehydration

The use of methenamine salts (i.e. methenamine hippurate or mandelate), but not the base, is contraindicated in patients with severe renal impairment or dehydration. Methenamine is excreted by the kidney and concentrated in the urine. In patients with low urinary output, the salts can precipitate and cause crystalluria.

References

  1. "Product Information. Mandelamine (methenamine)." Parke-Davis, Morris Plains, NJ.
  2. Gleckman R, Alvarez S, Joubert D, Matthews S "Drug therapy reviews: methenamine mandelate and methenamine hippurate." Am J Hosp Pharm 36 (1979): 1509-12
  3. Klinge E, Mannisto P, Mantyla R, Lamminsivu U, Ottoila P "Pharmacokinetics of methenamine in healthy volunteers." J Antimicrob Chemother 9 (1982): 209-16
View all 6 references
Major

Methenamine (Includes MHP-A) ↔ Liver Disease

Severe Potential Hazard, High plausibility

Applies to: Liver Disease

The use of methenamine and its salts (i.e. methenamine hippurate or mandelate) is contraindicated in patients with severe hepatic impairment. Methenamine is hydrolyzed to ammonia and formaldehyde in the urine under acidic conditions. Patients with liver disease may already have elevated ammonia levels, which can cause or exacerbate hepatic encephalopathy. Methenamine hippurate has also been associated with isolated cases of transient elevations in serum transaminases. The manufacturer recommends periodic liver function tests during therapy, particularly in patients with preexisting liver dysfunction.

References

  1. Strom J, Jun H "Kinetics of hydrolysis of methenamine." Pharm Bull 23 (1975): 651
  2. "Product Information. Mandelamine (methenamine)." Parke-Davis, Morris Plains, NJ.
  3. Gleckman R, Alvarez S, Joubert D, Matthews S "Drug therapy reviews: methenamine mandelate and methenamine hippurate." Am J Hosp Pharm 36 (1979): 1509-12
View all 5 references
Major

Methylene Blue (Includes MHP-A) ↔ Methemoglobinemia In G-6-Pd

Severe Potential Hazard, High plausibility

Applies to: G-6-PD Deficiency

The use of methylene blue is contraindicated for the treatment of methemoglobinemia in patients with glucose-6-phosphate deficiency (G-6-PD). Methylene blue will not reverse the condition in patients with G-6-PD and may precipitate acute hemolysis in these patients.

References

  1. "Product Information. Urised Tablets (methylene blue)." Polymedica Pharmaceuticals USA Inc, Woburn, MA.
Major

Salicylates (Includes MHP-A) ↔ Gi Toxicity

Severe Potential Hazard, High plausibility

Applies to: Peptic Ulcer, Duodenitis/Gastritis, Gastrointestinal Hemorrhage, Gastrointestinal Perforation, History - Peptic Ulcer, Alcoholism, Colitis/Enteritis (Noninfectious), Colonic Ulceration

Salicylates, particularly aspirin, can cause dose-related gastrointestinal bleeding and mucosal damage, which may occur independently of each other. Occult, often asymptomatic GI blood loss is quite common with usual dosages of aspirin and stems from the drug's local effect on the GI mucosa. During chronic therapy, this type of bleeding may occasionally produce iron deficiency anemia. In contrast, major upper GI bleeding rarely occurs except in patients with active peptic ulcers or recent GI bleeding. However, these patients generally do not experience greater occult blood loss than healthy patients following small doses of aspirin. Mucosal damage associated with the use of salicylates may lead to development of peptic ulcers with or without bleeding, reactivation of latent ulcers, and ulcer perforation. Therapy with salicylates and related agents such as salicylamide should be considered and administered cautiously in patients with a history of GI disease or alcoholism, particularly if they are elderly and/or debilitated, since such patients may be more susceptible to the GI toxicity of these drugs and seem to tolerate ulceration and bleeding less well than other individuals. Extreme caution and thorough assessment of risks and benefits are warranted in patients with active or recent GI bleeding or lesions. Whenever possible, especially if prolonged use is anticipated, treatment with non-ulcerogenic agents should be attempted first. If salicylates are used, close monitoring for toxicity is recommended. Some adverse GI effects may be minimized by administration with high dosages of antacids, use of enteric-coated or extended-release formulations, and/or concurrent use of a histamine H2-receptor antagonist or a cytoprotective agent such as misoprostol. Patients with active peptic ulceration or GI bleeding treated with salicylates should generally be administered a concomitant anti-ulcer regimen.

References

  1. Lanas A, Serrano P, Bajador E, Esteva F, Benito R, Sainz R "Evidence of aspirin use in both upper and lower gastrointestinal perforation." Gastroenterology 112 (1997): 683-9
  2. Savon JJ, Allen ML, Dimarino AJ, Hermann GA, Krum RP "Gastrointestinal blood loss with low dose (325 mg) plain and enteric-coated aspirin administration." Am J Gastroenterol 90 (1995): 581-5
  3. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
View all 19 references
Major

Salicylates (Includes MHP-A) ↔ Renal Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Salicylate and its metabolites are eliminated almost entirely by the kidney. Therapy with salicylate drugs should be administered cautiously in patients with renal impairment, especially if it is severe. Reduced dosages may be necessary to avoid drug accumulation. Clinical monitoring of renal function is recommended during prolonged therapy, since the use of salicylate drugs has rarely been associated with renal toxicities, including elevations in serum creatinine, renal papillary necrosis, and acute tubular necrosis with renal failure. Most of the data have been derived from experience with aspirin but may apply to other salicylates as well. In patients with impaired renal function, aspirin has caused reversible and sometimes marked decreases in renal blood flow and glomerular filtration rate. Adverse renal effects have usually reversed rapidly following withdrawal of aspirin therapy.

References

  1. "Product Information. Ecotrin (aspirin)." SmithKline Beecham, Philadelphia, PA.
  2. "Product Information. Rexolate (sodium thiosalicylate)" Hyrex Pharmaceuticals, Memphis, TN.
  3. Carmichael J, Shankel SW "Effects of nonsteroidal anti-inflammatory drugs on prostaglandins and renal function." Am J Med 78 (1985): 992-1000
View all 11 references
Major

Salicylates (Includes MHP-A) ↔ Reye's Syndrome

Severe Potential Hazard, High plausibility

Applies to: Influenza, Varicella-Zoster

The use of salicylates, primarily aspirin, in children with varicella infections or influenza-like illnesses has been associated with an increased risk of Reye's syndrome. Although a causal relationship has not been established, the majority of evidence to date seems to support the association. Most authorities, including the American Academy of Pediatrics Committee on Infectious Diseases, recommend avoiding the use of salicylates in children and teenagers with known or suspected varicella or influenza and during presumed outbreaks of influenza. If antipyretic or analgesic therapy is indicated under these circumstances, acetaminophen may be an appropriate alternative. The same precautions should also be observed with related agents such as salicylamide or diflunisal because of their structural and pharmacological similarities to salicylate.

References

  1. Belay ED, Bresee JS, Holman RC, Khan AS, Shahriari A, Schonberger LB "Reye's syndrome in the United States from 1981 through 1997." N Engl J Med 340 (1999): 1377-82
  2. "Product Information. Salflex (salsalate)." Carnrick Laboratories Inc, Cedar Knolls, NJ.
  3. "Product Information. Rexolate (sodium thiosalicylate)" Hyrex Pharmaceuticals, Memphis, TN.
View all 9 references
Moderate

Anticholinergics (Includes MHP-A) ↔ 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. Horgan J "Atropine and ventricular tachyarrhythmia." JAMA 223 (1973): 693
View all 16 references
Moderate

Anticholinergics (Includes MHP-A) ↔ 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 MHP-A) ↔ 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
View all 4 references
Moderate

Antimuscarinics (Includes MHP-A) ↔ 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. 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
  3. 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
View all 4 references
Moderate

Antimuscarinics (Includes MHP-A) ↔ 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. Howells TH "The administration of metoclopramide with atropine." Anaesthesia 32 (1977): 677
View all 6 references
Moderate

Antimuscarinics (Includes MHP-A) ↔ 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. Famewo CE "A re-evaluation of anticholergic premedication." Can Anaesth Soc J 24 (1977): 39-41
  2. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  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 MHP-A) ↔ 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 MHP-A) ↔ 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

Methylene Blue (Includes MHP-A) ↔ Renal Dysfunction

Moderate Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Methylene blue is reduced in tissues to leukomethylene blue, and both are excreted by the kidney. The serum concentrations of methylene blue and leukomethylene blue may be increased in patients with impaired renal function. Therapy with methylene blue should be avoided in patients with severe renal impairment and administered cautiously in patients with mild to moderate renal impairment. Dosage adjustments may be necessary.

References

  1. "Product Information. Urised Tablets (methylene blue)." Polymedica Pharmaceuticals USA Inc, Woburn, MA.
Moderate

Salicylates (Includes MHP-A) ↔ Anemia

Moderate Potential Hazard, Moderate plausibility

Applies to: Anemia

Occult, often asymptomatic GI blood loss occurs quite frequently with the use of normal dosages of aspirin and stems from the drug's local effect on the GI mucosa. During chronic therapy, this type of bleeding may occasionally produce iron deficiency anemia. Other salicylates reportedly cause little or no GI blood loss at usual dosages, but may do so at high dosages. Prolonged therapy with salicylates, particularly aspirin, should be administered cautiously in patients with or predisposed to anemia. Periodic monitoring of hematocrit is recommended. The same precautions should also be observed with the use of related agents such as salicylamide because of their structural and pharmacological similarities to salicylate.

References

  1. Naschitz JE, Yeshurun D, Odeh M, Bassan H, Rosner I, Stermer E, Levy N "Overt gastrointestinal bleeding in the course of chronic low-dose aspirin administration for secondary prevention of arterial occlusive disease." Am J Gastroenterol 85 (1990): 408-11
  2. Savon JJ, Allen ML, Dimarino AJ, Hermann GA, Krum RP "Gastrointestinal blood loss with low dose (325 mg) plain and enteric-coated aspirin administration." Am J Gastroenterol 90 (1995): 581-5
  3. "Product Information. Salflex (salsalate)." Carnrick Laboratories Inc, Cedar Knolls, NJ.
View all 8 references
Moderate

Salicylates (Includes MHP-A) ↔ Coagulation

Moderate Potential Hazard, Moderate plausibility

Applies to: Bleeding, Coagulation Defect, Thrombocytopathy, Thrombocytopenia, Vitamin K Deficiency

All salicylates can interfere with the action of vitamin K and induce a dose-dependent alteration in hepatic synthesis of coagulation factors VII, IX and X. At usual recommended dosages, a slight increase in prothrombin time (PT) may occur. Therapy with salicylates, especially if given in high dosages, should be administered cautiously in patients with significant active bleeding or a hemorrhagic diathesis, including hemostatic and/or coagulation defects associated with hemophilia, vitamin K deficiency, hypoprothombinemia, thrombocytopenia, thrombocytopathy, or severe hepatic impairment. The same precaution should also be observed with the use of related agents such as salicylamide because of their structural and pharmacological similarities to salicylate.

References

  1. Fausa O "Salicylate-induced hypoprothrombinemia: a report of four cases." Acta Med Scand 188 (1970): 403-8
  2. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  3. "Product Information. Pepto-Bismol (bismuth subsalicylate)." Procter and Gamble Pharmaceuticals, Cincinnati, OH.
View all 5 references
Moderate

Salicylates (Includes MHP-A) ↔ Dialysis

Moderate Potential Hazard, High plausibility

Applies to: hemodialysis

Salicylate and its metabolites are readily removed by hemodialysis and, to a lesser extent, by peritoneal dialysis. Doses should either be scheduled for administration after dialysis or supplemental doses be given after dialysis.

References

  1. "Product Information. Salflex (salsalate)." Carnrick Laboratories Inc, Cedar Knolls, NJ.
  2. "Product Information. Ecotrin (aspirin)." SmithKline Beecham, Philadelphia, PA.
  3. "Product Information. Rexolate (sodium thiosalicylate)" Hyrex Pharmaceuticals, Memphis, TN.
Moderate

Salicylates (Includes MHP-A) ↔ G-6-Pd Deficiency

Moderate Potential Hazard, Low plausibility

Applies to: G-6-PD Deficiency

Salicylates, particularly aspirin, may cause or aggravate hemolysis in patients with pyruvate kinase or glucose-6-phosphate dehydrogenase (G-6-PD) deficiency. However, this effect has not been clearly established. Until more data are available, therapy with salicylates should be administered cautiously in patients with G-6-PD deficiency. The same precaution should also be observed with the use of related agents such as salicylamide because of their structural and pharmacological similarities to salicylate.

References

  1. "Product Information. Salflex (salsalate)." Carnrick Laboratories Inc, Cedar Knolls, NJ.
  2. "Product Information. Rexolate (sodium thiosalicylate)" Hyrex Pharmaceuticals, Memphis, TN.
  3. "Product Information. Ecotrin (aspirin)." SmithKline Beecham, Philadelphia, PA.
Moderate

Salicylates (Includes MHP-A) ↔ Hepatotoxicity

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease

The use of salicylates has occasionally been associated with acute, reversible hepatotoxicity, primarily manifested as elevations of serum transaminases, alkaline phosphatase and/or, rarely, bilirubin. Hepatic injury consistent with chronic active hepatitis has also been reported in a few patients, which resulted rarely in encephalopathy or death. Salicylate-induced hepatotoxicity appears to be dependent on serum salicylate concentration (> 25 mg/dL) and has occurred most frequently in patients with juvenile arthritis, active systemic lupus erythematosus, rheumatic fever, or preexisting hepatic impairment. Therapy with salicylates, particularly when given in high dosages, should be administered cautiously in these patients, and periodic monitoring of liver function is recommended. The same precautions should also be observed with the use of related agents such as salicylamide because of their structural and pharmacological similarities to salicylate. A dosage reduction may be necessary if liver function abnormalities develop and serum salicylate concentration exceeds 25 mg/dL, although serum transaminase elevations may sometimes be transient and return to pretreatment values despite continued therapy without dosage adjustment.

References

  1. "Product Information. Rexolate (sodium thiosalicylate)" Hyrex Pharmaceuticals, Memphis, TN.
  2. Wolfe JD, Metzger AL, Goldstein RC "Aspirin hepatitis." Ann Intern Med 80 (1974): 74-6
  3. "Product Information. Salflex (salsalate)." Carnrick Laboratories Inc, Cedar Knolls, NJ.
View all 8 references
Moderate

Anticholinergics (Includes MHP-A) ↔ 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. Benadryl (diphenhydramine)." Parke-Davis, Morris Plains, NJ.
  3. "Product Information. Cogentin (benztropine)." Merck & Co, Inc, West Point, PA.
View all 7 references
Moderate

Anticholinergics (Includes MHP-A) ↔ 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.
View all 8 references
Moderate

Antimuscarinics (Includes MHP-A) ↔ 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 MHP-A) ↔ 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.
View all 6 references

MHP-A (hyoscyamine / methenamine / methylene blue / phenyl salicylate) drug Interactions

There are 1114 drug interactions with MHP-A (hyoscyamine / methenamine / methylene blue / phenyl salicylate)

MHP-A (hyoscyamine / methenamine / methylene blue / phenyl salicylate) alcohol/food Interactions

There are 2 alcohol/food interactions with MHP-A (hyoscyamine / methenamine / methylene blue / phenyl salicylate)

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.

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