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Extendryl PSE Disease Interactions

There are 23 disease interactions with Extendryl PSE (methscopolamine / pseudoephedrine).

Major

Anticholinergics (applies to Extendryl PSE) 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 (atropine)." ESI Lederle Generics (2022):
Major

Anticholinergics (applies to Extendryl PSE) GI obstruction

Major Potential Hazard, High plausibility. Applicable conditions: Esophageal Obstruction, Gastrointestinal 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. Bantz EW, Dolen WK, Chadwick EW, Nelson HS "Chronic chlorpheniramine therapy: subsensitivity, drug metabolism, and compliance." Ann Allergy 59 (1987): 341-6
  2. Simons FE, Frith EM, Simons KJ "The pharmacokinetics and antihistaminic effects of brompheniramine." J Allergy Clin Immunol 70 (1982): 458-64
  3. Blamoutier J "Comparative trial of two antihistamines, mequitazine and brompheniramine." Curr Med Res Opin 5 (1978): 366-70
  4. "Azatadine (optimine)--a new antihistamine." Med Lett Drugs Ther 19 (1977): 77-9
  5. "Product Information. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories PROD (2002):
  6. "Product Information. Chlor-Trimeton (chlorpheniramine)." Schering-Plough PROD
  7. "Product Information. Periactin (cyproheptadine)." Merck & Co., Inc PROD (2002):
  8. "Product Information. Benadryl (diphenhydramine)." Parke-Davis PROD (2002):
  9. "Product Information. Phenergan (promethazine)." Wyeth-Ayerst Laboratories PROD (2001):
  10. "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation PROD (2001):
  11. "Product Information. Antivert (meclizine)." Roerig Division PROD (2001):
  12. "Product Information. Optimine (azatadine)." Schering Corporation PROD (2001):
  13. Mevorach D "Adverse effects of atropine sulfate autoinjection." Ann Pharmacother 26 (1992): 564
  14. "Product Information. Atropine Sulfate (atropine)." ESI Lederle Generics (2022):
  15. "Product Information. Artane (trihexyphenidyl)." Lederle Laboratories PROD (2001):
  16. "Product Information. Poly-Histine-D (pyrilamine)." Bock Pharmacal Company PROD (2001):
View all 16 references
Major

Anticholinergics (applies to Extendryl PSE) 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. Schuller DE, Turkewitz D "Adverse effects of antihistamines." Postgrad Med 79 (1986): 75-86
  2. "Product Information. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories PROD (2002):
  3. "Product Information. Chlor-Trimeton (chlorpheniramine)." Schering-Plough PROD
  4. "Product Information. Thorazine (chlorpromazine)." SmithKline Beecham PROD (2002):
  5. "Product Information. Periactin (cyproheptadine)." Merck & Co., Inc PROD (2002):
  6. "Product Information. Benadryl (diphenhydramine)." Parke-Davis PROD (2002):
  7. "Product Information. Phenergan (promethazine)." Wyeth-Ayerst Laboratories PROD (2001):
  8. "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation PROD (2001):
  9. "Product Information. Optimine (azatadine)." Schering Corporation PROD (2001):
  10. O'Connor PS, Mumma JV "Atropine toxicity." Am J Ophthalmol 99 (1985): 613-4
  11. Clearkin LG "Angle closure glaucoma precipitated by atropine." Arch Intern Med 152 (1992): 880
  12. Berdy GJ, Berdy SS, Odin LS, Hirst LW "Angle closure glaucoma precipitated by aerosolized atropine." Arch Intern Med 151 (1991): 1658-60
  13. Pecora JL "Malignant glaucoma worsened by miotics in a postoperative angle- closure glaucoma patient." Ann Ophthalmol 11 (1979): 1412-4
  14. Holland MG "Autonomic drugs in ophthalmology: some problems and promises. Section II: Anticholinergic drugs." Ann Ophthalmol 6 (1974): 661-4
  15. Kanto J "New aspects in the use of atropine." Int J Clin Pharmacol Ther Toxicol 21 (1983): 92-4
  16. "Product Information. Atropine Sulfate (atropine)." ESI Lederle Generics (2022):
  17. "Product Information. Compazine (prochlorperazine)." SmithKline Beecham PROD (2001):
  18. Goldstein JH "Effects of drugs on cornea, conjunctiva, and lids." Int Ophthalmol Clin 11 (1971): 13-34
  19. "Product Information. Cogentin (benztropine)." Merck & Co., Inc PROD (2001):
  20. "Product Information. Artane (trihexyphenidyl)." Lederle Laboratories PROD (2001):
  21. "Product Information. Moban (molindone)." Gate Pharmaceuticals PROD (2001):
  22. "Product Information. Orap (pimozide)." Gate Pharmaceuticals PROD
  23. "Product Information. Poly-Histine-D (pyrilamine)." Bock Pharmacal Company PROD (2001):
View all 23 references
Major

Anticholinergics (applies to Extendryl PSE) 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. Bantz EW, Dolen WK, Chadwick EW, Nelson HS "Chronic chlorpheniramine therapy: subsensitivity, drug metabolism, and compliance." Ann Allergy 59 (1987): 341-6
  2. Schuller DE, Turkewitz D "Adverse effects of antihistamines." Postgrad Med 79 (1986): 75-86
  3. "Product Information. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories PROD (2002):
  4. "Product Information. Chlor-Trimeton (chlorpheniramine)." Schering-Plough PROD
  5. "Product Information. Thorazine (chlorpromazine)." SmithKline Beecham PROD (2002):
  6. "Product Information. Periactin (cyproheptadine)." Merck & Co., Inc PROD (2002):
  7. "Product Information. Benadryl (diphenhydramine)." Parke-Davis PROD (2002):
  8. "Product Information. Phenergan (promethazine)." Wyeth-Ayerst Laboratories PROD (2001):
  9. "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation PROD (2001):
  10. "Product Information. Antivert (meclizine)." Roerig Division PROD (2001):
  11. "Product Information. Optimine (azatadine)." Schering Corporation PROD (2001):
  12. Shutt LE, Bowes JB "Atropine and hyoscine." Anaesthesia 34 (1979): 476-90
  13. O'Kelly SW, Spargo PM "Postoperative urinary retention in men." BMJ 302 (1991): 1403-4
  14. "Product Information. Atropine Sulfate (atropine)." ESI Lederle Generics (2022):
  15. "Product Information. Compazine (prochlorperazine)." SmithKline Beecham PROD (2001):
  16. "Product Information. Zyrtec (cetirizine)." Pfizer U.S. Pharmaceuticals PROD (2001):
  17. "Product Information. Artane (trihexyphenidyl)." Lederle Laboratories PROD (2001):
  18. "Product Information. Moban (molindone)." Gate Pharmaceuticals PROD (2001):
  19. "Product Information. Orap (pimozide)." Gate Pharmaceuticals PROD
  20. "Product Information. Poly-Histine-D (pyrilamine)." Bock Pharmacal Company PROD (2001):
View all 20 references
Major

Anticholinergics (applies to Extendryl PSE) 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. 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
  2. "Product Information. Phenergan (promethazine)." Wyeth-Ayerst Laboratories PROD (2001):
  3. "Product Information. Antivert (meclizine)." Roerig Division PROD (2001):
  4. "Product Information. Marezine (cyclizine)." Glaxo Wellcome PROD (2001):
  5. "Product Information. Atropine Sulfate (atropine)." ESI Lederle Generics (2022):
View all 5 references
Major

Antimuscarinics (applies to Extendryl PSE) 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. Shutt LE, Bowes JB "Atropine and hyoscine." Anaesthesia 34 (1979): 476-90
  2. "Product Information. Atropine Sulfate (atropine)." ESI Lederle Generics (2022):
  3. "Product Information. Bentyl (dicyclomine)." Aventis Pharmaceuticals (2002):
Major

Antiperistaltic agents (applies to Extendryl PSE) 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. Brown JW "Toxic megacolon associated with loperamide therapy." JAMA 241 (1979): 501-2
  2. Walley T, Milson D "Loperamide related toxic megacolon in Clostridium difficile colitis." Postgrad Med J 66 (1990): 582
  3. "Product Information. Imodium (loperamide)." Janssen Pharmaceuticals PROD (2001):
  4. Marshall WF Jr, Rosenthal P, Merritt RJ "Atropine therapy and paralytic ileus in an infant." J Pediatr Gastroenterol Nutr 9 (1989): 532-4
  5. "Lomotil for diarrhea in children." Med Lett Drugs Ther 17 (1975): 104
  6. "Product Information. Atropine Sulfate (atropine)." ESI Lederle Generics (2022):
View all 6 references
Major

Sympathomimetics (applies to Extendryl PSE) 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, Tilkian AG, Palazzolo M "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. Gordon RD, Ballantine DM, Bachmann AW "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. Loizou LA, Hamilton JG, Tsementzis SA "Intracranial haemorrhage in association with pseudoephedrine overdose." J Neurol Neurosurg Psychiatry 45 (1982): 471-2
  7. Dickerson J, Perrier D, Mayersohn M, Bressler R "Dose tolerance and pharmacokinetic studies of L (+) pseudoephedrine capsules in man." Eur J Clin Pharmacol 14 (1978): 253-9
  8. Wooten MR, Khangure MS, Murphy MJ "Intracerebral hemorrhage and vasculitis related to ephedrine abuse." Ann Neurol 13 (1983): 337-40
  9. To LB, Sangster JF, Rampling D, Cammens I "Ephedrine-induced cardiomyopathy." Med J Aust 2 (1980): 35-6
  10. Bruno A, Nolte KB, Chapin J "Stroke associated with ephedrine use." Neurology 43 (1993): 1313-6
  11. Stoessl AJ, Young GB, Feasby TE "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 PROD (2001):
  14. Kizer KW "Intracranial hemorrhage associated with overdose of decongestant containing phenylpropanolamine" Am J Emerg Med 2 (1984): 180-1
  15. Edwards M, Russo L, Harwood-Nuss A "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. Lake CR, Zaloga G, Bray J, Rosenberg D, Chernow B "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. Lake CR, Zaloga G, Clymer R, Quirk RM, Chernow B "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, Omori DM, Simmons JO, Wood DR, Meier NJ "The safety of phenylpropanolamine in patients with stable hypertension." Ann Intern Med 111 (1989): 1043-4
  21. Pentel PR, Mikell FL, Zavoral JH "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. Horowitz JD, Lang WJ, Howes LG, Fennessy MR, Christophidis N, Rand MJ, Louis WJ "Hypertensive responses induced by phenylpropanolamine in anorectic and decongestant preparations." Lancet 1 (1980): 60-1
  24. Johnson DA, Etter HS, Reeves DM "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. Kase CS, Foster TE, Reed JE, Spatz EL, Girgis GN "Intracerebral hemorrhage and phenylpropanolamine use." Neurology 37 (1987): 399-404
  29. Kikta DG, Devereaux MW, Chandar K "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. O'Connell MB, Gross CR "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. O'Connell MB, Gross CR "The effect of single-dose phenylpropanolamine on blood pressure in patients with hypertension controlled by beta blockers." Pharmacotherapy 10 (1990): 85-91
  34. Chin C, Choy M "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. Lee KY, Beilin LJ, Vandongen R "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. Lee KY, Beilin LJ, Vandongen R "Severe hypertension after administration of phenylpropanolamine" Med J Aust 1 (1979): 525-6
  40. Horowitz JD, McNeil JJ, Sweet B, Mendelsohn FA, Louis WJ "Hypertension and postural hypotension induced by phenylpropanolamine (Trimolets)." Med J Aust 1 (1979): 175-6
  41. Frewin DB, Leonello PP, Frewin ME "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. McDowell JR, LeBlanc HJ "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. Pentel PR, Aaron C, Paya C "Therapeutic doses of phenylpropanolamine increase supine systolic blood pressure." Int J Obes 9 (1985): 115-9
  51. Finton CK, Barton M, Chernow B "Possible adverse effects of phenylpropanolamine (diet pills) on sympathetic nervous system function--caveat emptor!" Mil Med 147 (1982): 1072
  52. "Product Information. Adrenalin (EPINEPHrine)." Apothecon Inc (2022):
  53. Leo PJ, Hollander JE, Shih RD, Marcus SM "Phenylpropanolamine and associated myocardial injury." Ann Emerg Med 28 (1996): 359-62
  54. Gill ND, Shield A, Blazevich AJ, Zhou S, Weatherby RP "Muscular and cardiorespiratory effects of pseudoephedrine in human athletes." Br J Clin Pharmacol 50 (2000): 205-13
  55. Haller CA, Benowitz NL "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. Samenuk D, Link MS, Homoud MK, 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

Anticholinergics (applies to Extendryl PSE) 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. Schuller DE, Turkewitz D "Adverse effects of antihistamines." Postgrad Med 79 (1986): 75-86
  2. 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
  3. "Product Information. Benadryl (diphenhydramine)." Parke-Davis PROD (2002):
  4. "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation PROD (2001):
  5. "Product Information. Antivert (meclizine)." Roerig Division PROD (2001):
  6. Lunde P "Ventricular fibrillation after intravenous atropine for treatment of sinus bradycardia." Acta Med Scand 199 (1976): 369-71
  7. Cooper MJ, Abinader EG "Atropine-induced ventricular fibrillation: case report and review of the literature." Am Heart J 97 (1979): 225-8
  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. 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
  10. Bradshaw EG "Dysrhythmias associated with oral surgery." Anaesthesia 31 (1976): 13-7
  11. Horgan J "Atropine and ventricular tachyarrhythmia." JAMA 223 (1973): 693
  12. Zsigmond EK, Matsuki A, Sharafabadi C "Atropine and cardiac arrhythmia." N Engl J Med 288 (1973): 635
  13. 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
  14. 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
  15. 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
  16. "Product Information. Atropine Sulfate (atropine)." ESI Lederle Generics (2022):
View all 16 references
Moderate

Anticholinergics (applies to Extendryl PSE) 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 PROD (2001):
Moderate

Antimuscarinics (applies to Extendryl PSE) 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. Lunde P "Ventricular fibrillation after intravenous atropine for treatment of sinus bradycardia." Acta Med Scand 199 (1976): 369-71
  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. Richman S "Adverse effect of atropine during myocardial infarction. Enchancement of ischemia following intravenously administered atropine." JAMA 228 (1974): 1414-6
  4. "Product Information. Atropine Sulfate (atropine)." ESI Lederle Generics (2022):
  5. "Product Information. Bentyl (dicyclomine)." Aventis Pharmaceuticals (2002):
View all 5 references
Moderate

Antimuscarinics (applies to Extendryl PSE) 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. Mevorach D "Adverse effects of atropine sulfate autoinjection." Ann Pharmacother 26 (1992): 564
  3. Cotton BR, Smith G "Single and combined effects of atropine and metoclopramide on the lower oesophageal sphincter pressure." Br J Anaesth 53 (1981): 869-74
  4. "Product Information. Atropine Sulfate (atropine)." ESI Lederle Generics (2022):
View all 4 references
Moderate

Antimuscarinics (applies to Extendryl PSE) 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. 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. 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
  3. Howells TH "The administration of metoclopramide with atropine." Anaesthesia 32 (1977): 677
  4. 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
  5. 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
  6. "Product Information. Atropine Sulfate (atropine)." ESI Lederle Generics (2022):
View all 6 references
Moderate

Antimuscarinics (applies to Extendryl PSE) 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. Famewo CE "A re-evaluation of anticholergic premedication." Can Anaesth Soc J 24 (1977): 39-41
  2. "Product Information. Atropine Sulfate (atropine)." ESI Lederle Generics (2022):
  3. Braunwald E, Hauser SL, Kasper DL, Fauci AS, Isselbacher KJ, Longo DL, Martin JB, eds., Wilson JD "Harrison's Principles of Internal Medicine." New York, NY: McGraw-Hill Health Professionals Division (1998):
  4. "Product Information. Bentyl (dicyclomine)." Aventis Pharmaceuticals (2002):
View all 4 references
Moderate

Pseudoephedrine (applies to Extendryl PSE) GI narrowing

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

The extended-release formulation of pseudoephedrine (Sudafed 24 Hour) contains a non-deformable material. There have been rare reports of obstructive symptoms in patients with known strictures following the ingestion of similar sustained-release products. Therapy with the extended-release formulation of pseudoephedrine should be administered cautiously in patients with preexisting severe gastrointestinal narrowing or obstruction, whether pathologic or iatrogenic.

References

  1. "Product Information. Sudafed (pseudoephedrine)." Glaxo Wellcome PROD (2001):
Moderate

Pseudoephedrine (applies to Extendryl PSE) PKU

Moderate Potential Hazard, High plausibility. Applicable conditions: Phenylketonuria

Chewable products frequently may contain aspartame, which is metabolized in the gastrointestinal tract to phenylalanine. Sudafed (brand of pseudoephedrine) chewable 15 mg tablets provide the equivalent of 0.78 mg of phenylalanine per each tablet. The aspartame/phenylalanine content should be considered when this and similar products are used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics).

References

  1. "Product Information. Sudafed (pseudoephedrine)." Glaxo Wellcome PROD (2001):
Moderate

Sympathomimetics (applies to Extendryl PSE) 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 PROD (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 Extendryl PSE) 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 PROD (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 (EPINEPHrine)." Apothecon Inc (2022):
  6. "Product Information. Akovaz (ephedrine)." Eclat Pharmaceuticals (2016):
View all 6 references
Moderate

Sympathomimetics (applies to Extendryl PSE) 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 PROD (2001):
  3. Fraunfelder FT, Fraunfelder FW; Randall JA "Drug-Induced Ocular Side Effects" Boston, MA: Butterworth-Heinemann (2001):
Minor

Anticholinergics (applies to Extendryl PSE) 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. Benadryl (diphenhydramine)." Parke-Davis PROD (2002):
  2. "Product Information. Antivert (meclizine)." Roerig Division PROD (2001):
  3. "Product Information. Marezine (cyclizine)." Glaxo Wellcome PROD (2001):
  4. 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
  5. "Product Information. Atropine Sulfate (atropine)." ESI Lederle Generics (2022):
  6. "Product Information. Artane (trihexyphenidyl)." Lederle Laboratories PROD (2001):
  7. "Product Information. Atropisol (atropine ophthalmic)." Ciba Vision Ophthalmics (2002):
View all 7 references
Minor

Anticholinergics (applies to Extendryl PSE) 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 PROD (2002):
  2. "Product Information. Chlor-Trimeton (chlorpheniramine)." Schering-Plough PROD
  3. "Product Information. Periactin (cyproheptadine)." Merck & Co., Inc PROD (2002):
  4. "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation PROD (2001):
  5. "Product Information. Antivert (meclizine)." Roerig Division PROD (2001):
  6. "Product Information. Optimine (azatadine)." Schering Corporation PROD (2001):
  7. "Product Information. Atropine Sulfate (atropine)." ESI Lederle Generics (2022):
  8. "Product Information. Poly-Histine-D (pyrilamine)." Bock Pharmacal Company PROD (2001):
View all 8 references
Minor

Antimuscarinics (applies to Extendryl PSE) 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 (atropine)." ESI Lederle Generics (2022):
Minor

Atropine-like agents (applies to Extendryl PSE) 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. Stadnyk AN, Glezos JD "Drug-induced heat stroke." Can Med Assoc J 128 (1983): 957-9
  2. Sarnquist F, Larson CP Jr "Drug-induced heat stroke." Anesthesiology 39 (1973): 348-50
  3. Lee BS "Possibility of hyperpyrexia with antipsychotic and anticholinergic drugs." J Clin Psychiatry 47 (1986): 571
  4. Forester D "Fatal drug-induced heat stroke." JACEP 7 (1978): 243-4
  5. "Product Information. Atropine Sulfate (atropine)." ESI Lederle Generics (2022):
  6. "Product Information. Cogentin (benztropine)." Merck & Co., Inc PROD (2001):
View all 6 references

Extendryl PSE drug interactions

There are 347 drug interactions with Extendryl PSE (methscopolamine / pseudoephedrine).

Extendryl PSE alcohol/food interactions

There are 3 alcohol/food interactions with Extendryl PSE (methscopolamine / pseudoephedrine).


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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.