Can you take Acetaminophen / dextromethorphan / phenylephrine with Rilonacept?
1 drug interaction and 22 additional warnings found for the following 2 drugs:
- acetaminophen/dextromethorphan/phenylephrine
- rilonacept
Drug interactions
Moderate drug interactions
Moderate:
dextromethorphan rilonacept
Applies to: acetaminophen / dextromethorphan / phenylephrine and rilonacept
Rilonacept may alter the blood levels and effects of dextromethorphan.
Your doctor may need to monitor you more closely and/or adjust the dosing of your medication(s).
For example, a dose adjustment may be needed if you have been receiving dextromethorphan and are starting treatment with rilonacept. Likewise, if you have been receiving both medications, the dose of dextromethorphan may need to be adjusted when rilonacept is discontinued.
Contact your doctor if your condition changes or you experience increased side effects.
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.
Food/lifestyle interactions
Major food/lifestyle interactions
Major:
acetaminophen Food/Lifestyle
Applies to: acetaminophen / dextromethorphan / phenylephrine
Acetaminophen may cause liver damage and taking it with alcohol may increase that risk.
You should avoid or limit the use of alcohol while being treated with acetaminophen.
Call your doctor immediately if you have:
- fever
- chills
- joint pain or swelling
- excessive tiredness or weakness
- unusual bleeding or bruising
- skin rash or itching
- loss of appetite
- nausea
- vomiting
- dark colored urine
- yellowing of the skin or the whites of your eyes
These may be symptoms of liver damage.
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.
Moderate food/lifestyle interactions
Moderate:
dextromethorphan Food/Lifestyle
Applies to: acetaminophen / dextromethorphan / phenylephrine
Alcohol can increase the nervous system side effects of dextromethorphan such as:
- dizziness
- drowsiness
- difficulty concentrating
Some people may also experience impairment in thinking and judgment.
You should avoid or limit the use of alcohol while being treated with dextromethorphan.
Do not use more than the recommended dose of dextromethorphan, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you.
Talk to your doctor or pharmacist if you have any questions or concerns.
Moderate:
phenylephrine Caffeine
Applies to: acetaminophen / dextromethorphan / phenylephrine
Both phenylephrine and caffeine can increase blood pressure and heart rate, and combining them may enhance these effects.
Talk to your doctor before using these medications, especially if you have a history of high blood pressure or heart disease. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications.
Contact your doctor if your condition changes or you experience increased side effects.
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.
Disease interactions
19 potential interactions Applies to: 18 conditions, including High Cholesterol, Benign Prostatic Hyperplasia, Hyperthyroidism, Diabetes Mellitus, and Liver Disease.
Alcoholism
Major:
acetaminophen / dextromethorphan / phenylephrine
The acetaminophen in acetaminophen / dextromethorphan / phenylephrine has a major potential interaction with Alcoholism.
Chronic alcohol abusers may be at increased risk of hepatotoxicity during treatment with acetaminophen (APAP). Severe liver injury, including cases of acute liver failure resulting in liver transplant and death, has been reported in patients using acetaminophen. Therapy with acetaminophen should be administered cautiously, if at all, in patients who consume three or more alcoholic drinks a day. In general, patients should avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure. They should also be advised to seek medical attention if they experience signs and symptoms of liver injury such as fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, and jaundice.
Benign Prostatic Hyperplasia
Moderate:
acetaminophen / dextromethorphan / phenylephrine
The phenylephrine in acetaminophen / dextromethorphan / phenylephrine has a moderate potential interaction with Benign Prostatic Hyperplasia.
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.
Cardiovascular Conditions and Disorders
Major:
acetaminophen / dextromethorphan / phenylephrine
The phenylephrine in acetaminophen / dextromethorphan / phenylephrine has a major potential interaction with Cardiovascular Conditions and Disorders.
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.
Cerebrovascular Insufficiency
Major:
acetaminophen / dextromethorphan / phenylephrine
The phenylephrine in acetaminophen / dextromethorphan / phenylephrine has a major potential interaction with Cerebrovascular Insufficiency.
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.
Dehydration
Major:
acetaminophen / dextromethorphan / phenylephrine
The acetaminophen in acetaminophen / dextromethorphan / phenylephrine has a major potential interaction with Dehydration.
Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease. Patients with hepatic impairment may be at increased risk of toxicity. Severe liver injury, including cases of acute liver failure and death, have been reported in patients using this drug. Clinical monitoring of hepatic function is recommended. Caution is advised if using acetaminophen in patients with chronic malnutrition or severe hypovolemia. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.
Diabetes Mellitus
Moderate:
acetaminophen / dextromethorphan / phenylephrine
The phenylephrine in acetaminophen / dextromethorphan / phenylephrine has a moderate potential interaction with 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.
Glaucoma/Intraocular Hypertension
Moderate:
acetaminophen / dextromethorphan / phenylephrine
The phenylephrine in acetaminophen / dextromethorphan / phenylephrine has a moderate potential interaction with 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.
High Cholesterol
Moderate:
rilonacept
Rilonacept has a moderate potential interaction with High Cholesterol.
Patients treated with rilonacept experienced increases in their mean total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides. The mean increases from baseline for total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides were 19 mg/dL, 2 mg/dL, 10 mg/dL, and 57 mg/dL respectively after 6 weeks of open-label therapy. Physicians should monitor the lipid profiles of their patients especially those with hyperlipidemias, and consider lipid-lowering therapies as needed based upon cardiovascular risk factors and current guidelines.
Hyperthyroidism
Major:
acetaminophen / dextromethorphan / phenylephrine
The phenylephrine in acetaminophen / dextromethorphan / phenylephrine has a major potential interaction with Hyperthyroidism.
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.
Infection
Moderate:
rilonacept
Rilonacept has a moderate potential interaction with Infection.
Interleukin-1 (IL-1) blockade may interfere with the immune response to infections. Treatment with other medication as rilonacept, that work through inhibition of IL-1 has been associated with an increased risk of serious infections, and serious infections have been reported in patients taking rilonacept compared with placebo. Rilonacept should be discontinued if a patient develops a serious infection. Treatment with rilonacept should not be initiated in patients with an active or chronic infection. Additionally, latent tuberculosis can be reactivated and should be treated before initiating therapy with rilonacept.
Liver Disease
Major:
acetaminophen / dextromethorphan / phenylephrine
The acetaminophen in acetaminophen / dextromethorphan / phenylephrine has a major potential interaction with Liver Disease.
Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease. Patients with hepatic impairment may be at increased risk of toxicity. Severe liver injury, including cases of acute liver failure and death, have been reported in patients using this drug. Clinical monitoring of hepatic function is recommended. Caution is advised if using acetaminophen in patients with chronic malnutrition or severe hypovolemia. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.
Moderate:
rilonacept
Rilonacept has a moderate potential interaction with Liver Disease.
No formal studies have been conducted to examine the pharmacokinetics of rilonacept administered subcutaneously in patients with hepatic impairment. Caution is advised if used on these patients.
Malnourishment
Major:
acetaminophen / dextromethorphan / phenylephrine
The acetaminophen in acetaminophen / dextromethorphan / phenylephrine has a major potential interaction with Malnourishment.
Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease. Patients with hepatic impairment may be at increased risk of toxicity. Severe liver injury, including cases of acute liver failure and death, have been reported in patients using this drug. Clinical monitoring of hepatic function is recommended. Caution is advised if using acetaminophen in patients with chronic malnutrition or severe hypovolemia. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.
Phenylketonuria
Moderate:
acetaminophen / dextromethorphan / phenylephrine
The acetaminophen in acetaminophen / dextromethorphan / phenylephrine has a moderate potential interaction with Phenylketonuria.
Several oral acetaminophen and acetaminophen-combination products, particularly flavored chewable tablets, contain the artificial sweetener, aspartame (NutraSweet). Aspartame is converted to phenylalanine in the gastrointestinal tract following ingestion. Chewable and effervescent formulations of acetaminophen products may also contain phenylalanine. The aspartame/phenylalanine content should be considered when these products are used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics).
Pheochromocytoma
Major:
acetaminophen / dextromethorphan / phenylephrine
The phenylephrine in acetaminophen / dextromethorphan / phenylephrine has a major potential interaction with 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.
Prostate Tumor, Benign
Moderate:
acetaminophen / dextromethorphan / phenylephrine
The phenylephrine in acetaminophen / dextromethorphan / phenylephrine has a moderate potential interaction with Prostate Tumor, Benign.
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.
Renal Dysfunction
Moderate:
rilonacept
Rilonacept has a moderate potential interaction with Renal Dysfunction.
No formal studies have been conducted to examine the pharmacokinetics of rilonacept administered subcutaneously in patients with renal impairment. Caution is advised if used on these patients.
Tuberculosis, Latent
Moderate:
rilonacept
Rilonacept has a moderate potential interaction with Tuberculosis, Latent.
Interleukin-1 (IL-1) blockade may interfere with the immune response to infections. Treatment with other medication as rilonacept, that work through inhibition of IL-1 has been associated with an increased risk of serious infections, and serious infections have been reported in patients taking rilonacept compared with placebo. Rilonacept should be discontinued if a patient develops a serious infection. Treatment with rilonacept should not be initiated in patients with an active or chronic infection. Additionally, latent tuberculosis can be reactivated and should be treated before initiating therapy with rilonacept.
Vaccination
Major:
rilonacept
Rilonacept has a major potential interaction with Vaccination.
Live vaccines should not be given concurrently with rilonacept. Rilonacept may interfere with normal immune response to new antigens; therefore, vaccinations may not be effective in patients receiving rilonacept. No data are available on the effectiveness of vaccination with inactivated (killed) antigens in patients receiving rilonacept. Because IL-1 blockade may interfere with immune response to infections, it is recommended that prior to initiation of therapy with rilonacept adult and pediatric patients receive all recommended vaccinations, as appropriate, including pneumococcal vaccine and inactivated influenza vaccine.
More resources
acetaminophen / dextromethorphan / phenylephrine
A total of 952 drugs are known to interact with acetaminophen / dextromethorphan / phenylephrine.
- Acetaminophen / dextromethorphan / phenylephrine is in the drug class upper respiratory combinations.
- Acetaminophen / dextromethorphan / phenylephrine is used to treat the following conditions:
rilonacept
A total of 535 drugs are known to interact with rilonacept.
- Rilonacept is in the drug class interleukin inhibitors.
- Rilonacept is used to treat the following conditions:
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.