Can You Take A-Spas S/L with Pilocarpine?

Ask your doctor before using hyoscyamine together with ethanol (alcohol). Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking hyoscyamine. You should be warned not to exceed recommended dosages and to avoid activities requiring mental alertness. If your doctor prescribes these medications together, you may need a dose adjustment to safely take this combination. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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.

The use of cholinergic agonists is contraindicated in patients with uncontrolled reactive airway disease. Cholinergic agonists inhibits the hydrolysis of acetylcholine. The enhanced effect of acetylcholine produces constriction of the bronchi, increased bronchial secretions, and bronchospasm.

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.

The use of cholinergic agonists is contraindicated in patients with peptic ulcers, mechanical GI obstruction, acute GI inflammatory conditions, or urinary obstruction. Cholinergic activity may result in an increase in gastric acid secretion, GI motility, and gastric contractions. In patients with urinary retention, urinary reflux may occur if the sphincter fails to relax when the bladder is contracted by cholinergic stimulation. The reflux of urine from the bladder can cause infection in the kidneys and upper urinary tract if bacteriuria is present.

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.

The use of cholinergic agonists is contraindicated in patients with peptic ulcers, mechanical GI obstruction, acute GI inflammatory conditions, or urinary obstruction. Cholinergic activity may result in an increase in gastric acid secretion, GI motility, and gastric contractions. In patients with urinary retention, urinary reflux may occur if the sphincter fails to relax when the bladder is contracted by cholinergic stimulation. The reflux of urine from the bladder can cause infection in the kidneys and upper urinary tract if bacteriuria is present.

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.

The use of pilocarpine is contraindicated in conditions where miosis is undesirable, such as acute iritis and in narrow-angle (angle closure) glaucoma.

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.

The use of cholinergic agonists, such as bethanechol and pilocarpine, is contraindicated in patients with pronounced bradycardia, hypotension/hypertension, coronary artery disease or conduction disorders.

The use of cholinergic agonists, such as bethanechol and pilocarpine, is contraindicated in patients with pronounced bradycardia, hypotension/hypertension, coronary artery disease or conduction disorders.

The use of cholinergic agents may be contraindicated in patients with hyperthyroidism. Atrial fibrillation has occurred in hyperthyroid patients administered a cholinergic agonist.

The use of cholinergic agonists, such as bethanechol and pilocarpine, is contraindicated in patients with pronounced bradycardia, hypotension/hypertension, coronary artery disease or conduction disorders.

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.

The use of cholinergic agonists, such as bethanechol and pilocarpine, is contraindicated in patients with pronounced bradycardia, hypotension/hypertension, coronary artery disease or conduction disorders.

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.

The use of cholinergic agonists may be contraindicated in patients with parkinsonism. Cholinergic agonists directly stimulates the parasympathetic nervous system inducing acetylcholinergic effects. Symptoms of Parkinson's disease may be exacerbated.

The use of cholinergic agonists is contraindicated in patients with peptic ulcers, mechanical GI obstruction, acute GI inflammatory conditions, or urinary obstruction. Cholinergic activity may result in an increase in gastric acid secretion, GI motility, and gastric contractions. In patients with urinary retention, urinary reflux may occur if the sphincter fails to relax when the bladder is contracted by cholinergic stimulation. The reflux of urine from the bladder can cause infection in the kidneys and upper urinary tract if bacteriuria is present.

The use of cholinergic agonists may be contraindicated in patients with seizure disorders. Cholinomimetics have been associated with convulsions.

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.

The use of cholinergic agonists is contraindicated in patients with peptic ulcers, mechanical GI obstruction, acute GI inflammatory conditions, or urinary obstruction. Cholinergic activity may result in an increase in gastric acid secretion, GI motility, and gastric contractions. In patients with urinary retention, urinary reflux may occur if the sphincter fails to relax when the bladder is contracted by cholinergic stimulation. The reflux of urine from the bladder can cause infection in the kidneys and upper urinary tract if bacteriuria is present.

The use of pilocarpine is contraindicated in conditions where miosis is undesirable, such as acute iritis and in narrow-angle (angle closure) glaucoma.

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.

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.

Pilocarpine should be administered with caution to patients with known or suspected cholelithiasis or biliary tract disease. Contractions of the gallbladder or biliary smooth muscle could precipitate complications including cholecystitis, cholangitis, and biliary obstruction.

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.

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.

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.

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.

Atropine-like agents undergo significant hepatic metabolism. Therapy with atropine-like agents should be administered cautiously to patients with liver disease.

Pilocarpine may increase ureteral smooth muscle tone and could theoretically precipitate renal colic (or ureteral reflux), particularly in patients with nephrolithiasis. Caution is advised when used on these patients.

Atropine-like agents are primarily eliminated by the kidney. Therapy with atropine-like agents should be administered cautiously to patients with renal disease.

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.

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.

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.

Cardiovascular effects of anticholinergics may exacerbate hypertension. Therapy with anticholinergic agents should be administered cautiously in patients with hypertension.

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.