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Hyoscyamine / methenamine / methylene blue / sodium biphosphate Disease Interactions

There are 29 disease interactions with hyoscyamine / methenamine / methylene blue / sodium biphosphate:

Major

Anticholinergics (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) autonomic neuropathy

Major Potential Hazard, High plausibility.

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 (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) GI obstruction

Major Potential Hazard, High plausibility. Applicable conditions: 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. Blamoutier J "Comparative trial of two antihistamines, mequitazine and brompheniramine." Curr Med Res Opin 5 (1978): 366-70
  2. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  3. "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  4. "Product Information. Periactin (cyproheptadine)." Merck & Co, Inc, West Point, PA.
  5. "Product Information. Benadryl (diphenhydramine)." Parke-Davis, Morris Plains, NJ.
  6. "Product Information. Antivert (meclizine)." Roerig Division, New York, NY.
  7. "Product Information. Phenergan (promethazine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  8. Simons FE, Frith EM, Simons KJ "The pharmacokinetics and antihistaminic effects of brompheniramine." J Allergy Clin Immunol 70 (1982): 458-64
  9. "Product Information. Poly-Histine-D (pyrilamine)." Bock Pharmaceutical Company, St. Louis, MO.
  10. "Azatadine (optimine)--a new antihistamine." Med Lett Drugs Ther 19 (1977): 77-9
  11. "Product Information. Chlortrimeton (chlorpheniramine)." Schering-Plough, Liberty Corner, NJ.
  12. "Product Information. Optimine (azatadine)." Schering Laboratories, Kenilworth, 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. Cogentin (benztropine)." Merck & Co, Inc, West Point, 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 (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) glaucoma

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

Anticholinergics (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) obstructive uropathy

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

Anticholinergics (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) reactive airway diseases

Major Potential Hazard, Moderate plausibility. Applicable conditions: 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 (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) myasthenia gravis

Major Potential Hazard, Moderate plausibility.

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 (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) infectious diarrhea

Major Potential Hazard, High plausibility. Applicable conditions: 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.
  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

Laxatives (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) inflammatory bowel disease

Major Potential Hazard, Moderate plausibility.

The use of laxatives is contraindicated in patients with inflammatory bowel disease. Patients with inflammatory bowel disease may experience colonic perforation with use of stimulant laxatives.

References

  1. "Product Information. Fleet Bisacodyl Enema (bisacodyl)." Fleet, Lynchburg, VA.
  2. "Product Information. Dulcolax (bisacodyl)." Ciba Self-Medication Inc, Woodbridge, NJ.
Major

Laxatives (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) intestinal obstruction disorders

Major Potential Hazard, Moderate plausibility. Applicable conditions: Gastrointestinal Obstruction

The use of laxatives is contraindicated in patients with intestinal obstruction disorders. Patients with intestinal obstruction disorders may need their underlying condition treated to correct the constipation. Some laxatives require reduction in the colon to their active form to be effective which may be a problem in patients with intestinal obstruction.

References

  1. "Product Information. Kondremul (mineral oil)." Bristol-Myers Squibb, Princeton, NJ.
  2. "Product Information. Fleet Bisacodyl Enema (bisacodyl)." Fleet, Lynchburg, VA.
  3. "Product Information. Dulcolax (bisacodyl)." Ciba Self-Medication Inc, Woodbridge, NJ.
  4. "Product Information. Fleet Mineral Oil Enema (mineral oil)." Fleet, Lynchburg, VA.
  5. "Product Information. Fleet Babylax (glycerin)." Alcon Laboratorries Inc, Fort Worth, TX.
View all 5 references
Major

Methenamine (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) crystalluria

Major Potential Hazard, High plausibility. Applicable conditions: 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. Klinge E, Mannisto P, Mantyla R, Lamminsivu U, Ottoila P "Pharmacokinetics of methenamine in healthy volunteers." J Antimicrob Chemother 9 (1982): 209-16
  2. Australian Drug Evaluation Committee "Adverse effects of drugs commonly used in the treatment of urinary tract infection." Med J Aust 1 (1972): 435-8
  3. "Product Information. Hiprex (methenamine)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  4. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
  5. "Product Information. Mandelamine (methenamine)." Parke-Davis, Morris Plains, NJ.
  6. 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 6 references
Major

Methenamine (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) gout

Major Potential Hazard, Moderate plausibility.

Methenamine mandelate (salts), should be avoided in patients with gout as it may precipitate urate crystals in their urine. A similar situation may arise in patients with a predisposition to the formation of uric acid stones.

Major

Methenamine (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) liver disease

Major Potential Hazard, High plausibility.

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. 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. "Product Information. Mandelamine (methenamine)." Parke-Davis, Morris Plains, NJ.
  4. "Product Information. Hiprex (methenamine)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  5. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
View all 5 references
Major

Methylene blue (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) methemoglobinemia in G-6-PD

Major Potential Hazard, High plausibility. Applicable conditions: 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

Phosphates (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) hypocalcemia

Major Potential Hazard, High plausibility. Applicable conditions: Pancreatitis

The use of phosphates is in general contraindicated in conditions where high potassium, high phosphate, or low calcium may be encountered such as hypoparathyroidism, osteomalacia, acute pancreatitis, or chronic renal disease.

References

  1. "Product Information. K-Phos Neutral (potassium phosphate)." Beach Pharmaceuticals, Tampa, FL.
  2. "Product Information. Fleet Enema (sodium biphosphate-sodium phosphate)." Fleet, Lynchburg, VA.
Major

Phosphates (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) phosphate imbalance

Major Potential Hazard, High plausibility. Applicable conditions: Hypoparathyroidism, Renal Dysfunction

Therapy with phosphates should be administered with extreme caution in patients with hyperphosphatemia (hypoparathyroidism or severe renal impairment). Elevated serum concentrations of phosphate and calcium can exceed the solubility level and result in calcium-phosphate precipitates that deposit in vascular and renal systems as well as other soft tissues of the body. Clinical monitoring of serum calcium and phosphate concentrations is necessary.

References

  1. "Product Information. Fleet Enema (sodium biphosphate-sodium phosphate)." Fleet, Lynchburg, VA.
  2. "Product Information. K-Phos Neutral (potassium phosphate)." Beach Pharmaceuticals, Tampa, FL.
Major

Sodium phosphate (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) electrolyte imbalance

Major Potential Hazard, High plausibility. Applicable conditions: Dehydration, Congestive Heart Failure, Phosphate Imbalance, Gastrointestinal Obstruction, Inflammatory Bowel Disease

The use of sodium phosphates is contraindicated in patients with congenital megacolon, intestinal obstruction, imperforate anus, active inflammatory disease or congestive heart failure. Serious, potentially life-threatening electrolyte imbalance such as hypocalcemia and hyperphosphatemia can result with prolonged or excessive use of phosphate laxatives. Hypernatremia and dehydration can occur due to improper dilution of hypertonic saline laxatives. Therapy with sodium phosphates should be administered cautiously and frequency of administration limited in patients with renal dysfunction, colostomy, cardiac dysfunction, or electrolyte imbalance. Clinical monitoring of electrolyte concentrations is recommended.

References

  1. "Product Information. Fleet Enema (sodium biphosphate-sodium phosphate)." Fleet, Lynchburg, VA.
  2. "Product Information. Magnesium Sulfate (magnesium sulfate)." Abbott Pharmaceutical, Abbott Park, IL.
Moderate

Anticholinergics (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) cardiac disease

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: 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. Horgan J "Atropine and ventricular tachyarrhythmia." JAMA 223 (1973): 693
  5. Zsigmond EK, Matsuki A, Sharafabadi C "Atropine and cardiac arrhythmia." N Engl J Med 288 (1973): 635
  6. "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  7. Bradshaw EG "Dysrhythmias associated with oral surgery." Anaesthesia 31 (1976): 13-7
  8. 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
  9. Lunde P "Ventricular fibrillation after intravenous atropine for treatment of sinus bradycardia." Acta Med Scand 199 (1976): 369-71
  10. Cooper MJ, Abinader EG "Atropine-induced ventricular fibrillation: case report and review of the literature." Am Heart J 97 (1979): 225-8
  11. 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
  12. "Product Information. Antivert (meclizine)." Roerig Division, New York, NY.
  13. Schuller DE, Turkewitz D "Adverse effects of antihistamines." Postgrad Med 79 (1986): 75-86
  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 (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) tachycardia

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: 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 (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) coronary artery disease

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: 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. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  2. 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
  3. Lunde P "Ventricular fibrillation after intravenous atropine for treatment of sinus bradycardia." Acta Med Scand 199 (1976): 369-71
  4. 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 (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) gastric ulcer

Moderate Potential Hazard, Low plausibility. Applicable conditions: 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. 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
  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. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  4. Mevorach D "Adverse effects of atropine sulfate autoinjection." Ann Pharmacother 26 (1992): 564
View all 4 references
Moderate

Antimuscarinics (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) gastroesophageal reflux

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: 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. Howells TH "The administration of metoclopramide with atropine." Anaesthesia 32 (1977): 677
  3. "Product Information. Atropine Sulfate Injection, USP (atropine)." ESI Lederle Generics, Philadelphia, PA.
  4. 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
  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 (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) ulcerative colitis

Moderate Potential Hazard, Moderate plausibility.

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 (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) liver disease

Moderate Potential Hazard, Moderate plausibility.

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 (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) renal failure

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: 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 (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) renal dysfunction

Moderate Potential Hazard, High plausibility.

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.
Minor

Anticholinergics (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) hypertension

Minor Potential Hazard, Low plausibility.

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.
  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
Minor

Anticholinergics (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) hyperthyroidism

Minor Potential Hazard, Low plausibility.

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
Minor

Antimuscarinics (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) diarrhea

Minor Potential Hazard, Moderate plausibility.

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

Atropine-like agents (applies to hyoscyamine/methenamine/methylene blue/sodium biphosphate) fever

Minor Potential Hazard, Low plausibility.

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

Hyoscyamine / methenamine / methylene blue / sodium biphosphate drug interactions

There are 605 drug interactions with hyoscyamine / methenamine / methylene blue / sodium biphosphate

Hyoscyamine / methenamine / methylene blue / sodium biphosphate alcohol/food interactions

There are 3 alcohol/food interactions with hyoscyamine / methenamine / methylene blue / sodium biphosphate

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.