Interactions between Acetaminophen / guaifenesin / phenylephrine and Flexeril

The acetaminophen in acetaminophen / guaifenesin / 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.

The phenylephrine in acetaminophen / guaifenesin / 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.

The phenylephrine in acetaminophen / guaifenesin / 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.

The cyclobenzaprine in Flexeril has a major potential interaction with Cardiovascular Conditions and Disorders.

The manufacturers consider the use of cyclobenzaprine to be contraindicated in the acute recovery phase following myocardial infarction and in patients with hyperthyroidism, congestive heart failure, arrhythmias, heart block, and/or conduction disturbances. Cyclobenzaprine is structurally related to the tricyclic antidepressants, which have been reported to cause tachycardia, arrhythmias, heart block, hypertension, hypotension (particularly orthostatic hypotension), thrombosis, thrombophlebitis, myocardial infarction, strokes, congestive heart failure, and ECG abnormalities such as PR and QT interval prolongation. Therapy with cyclobenzaprine should be administered cautiously in patients with a history of cardiovascular or cerebrovascular disease or a predisposition to hypotension, particularly if the intended dosage exceeds those normally used for musculoskeletal conditions. Tachycardia, arrhythmia, palpitation, and hypotension have been reported with the use of cyclobenzaprine in less than 1% of patients.

The phenylephrine in acetaminophen / guaifenesin / 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.

The cyclobenzaprine in Flexeril has a major potential interaction with Cerebrovascular Insufficiency.

The manufacturers consider the use of cyclobenzaprine to be contraindicated in the acute recovery phase following myocardial infarction and in patients with hyperthyroidism, congestive heart failure, arrhythmias, heart block, and/or conduction disturbances. Cyclobenzaprine is structurally related to the tricyclic antidepressants, which have been reported to cause tachycardia, arrhythmias, heart block, hypertension, hypotension (particularly orthostatic hypotension), thrombosis, thrombophlebitis, myocardial infarction, strokes, congestive heart failure, and ECG abnormalities such as PR and QT interval prolongation. Therapy with cyclobenzaprine should be administered cautiously in patients with a history of cardiovascular or cerebrovascular disease or a predisposition to hypotension, particularly if the intended dosage exceeds those normally used for musculoskeletal conditions. Tachycardia, arrhythmia, palpitation, and hypotension have been reported with the use of cyclobenzaprine in less than 1% of patients.

The acetaminophen in acetaminophen / guaifenesin / 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.

The cyclobenzaprine in Flexeril has a major potential interaction with Dehydration.

The manufacturers consider the use of cyclobenzaprine to be contraindicated in the acute recovery phase following myocardial infarction and in patients with hyperthyroidism, congestive heart failure, arrhythmias, heart block, and/or conduction disturbances. Cyclobenzaprine is structurally related to the tricyclic antidepressants, which have been reported to cause tachycardia, arrhythmias, heart block, hypertension, hypotension (particularly orthostatic hypotension), thrombosis, thrombophlebitis, myocardial infarction, strokes, congestive heart failure, and ECG abnormalities such as PR and QT interval prolongation. Therapy with cyclobenzaprine should be administered cautiously in patients with a history of cardiovascular or cerebrovascular disease or a predisposition to hypotension, particularly if the intended dosage exceeds those normally used for musculoskeletal conditions. Tachycardia, arrhythmia, palpitation, and hypotension have been reported with the use of cyclobenzaprine in less than 1% of patients.

The phenylephrine in acetaminophen / guaifenesin / 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.

The cyclobenzaprine in Flexeril has a moderate potential interaction with Gastrointestinal Obstruction.

Cyclobenzaprine has anticholinergic activity, to which elderly patients are particularly sensitive. Therapy with cyclobenzaprine should be administered cautiously in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders. Glaucoma should be treated and under control prior to initiation of cyclobenzaprine therapy, and intraocular pressure monitored during therapy.

The phenylephrine in acetaminophen / guaifenesin / 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.

The cyclobenzaprine in Flexeril has a moderate potential interaction with Glaucoma/Intraocular Hypertension.

Cyclobenzaprine has anticholinergic activity, to which elderly patients are particularly sensitive. Therapy with cyclobenzaprine should be administered cautiously in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders. Glaucoma should be treated and under control prior to initiation of cyclobenzaprine therapy, and intraocular pressure monitored during therapy.

The cyclobenzaprine in Flexeril has a major potential interaction with Heart Failure.

The manufacturers consider the use of cyclobenzaprine to be contraindicated in the acute recovery phase following myocardial infarction and in patients with hyperthyroidism, congestive heart failure, arrhythmias, heart block, and/or conduction disturbances. Cyclobenzaprine is structurally related to the tricyclic antidepressants, which have been reported to cause tachycardia, arrhythmias, heart block, hypertension, hypotension (particularly orthostatic hypotension), thrombosis, thrombophlebitis, myocardial infarction, strokes, congestive heart failure, and ECG abnormalities such as PR and QT interval prolongation. Therapy with cyclobenzaprine should be administered cautiously in patients with a history of cardiovascular or cerebrovascular disease or a predisposition to hypotension, particularly if the intended dosage exceeds those normally used for musculoskeletal conditions. Tachycardia, arrhythmia, palpitation, and hypotension have been reported with the use of cyclobenzaprine in less than 1% of patients.

The cyclobenzaprine in Flexeril has a major potential interaction with History - Cerebrovascular Disease.

The manufacturers consider the use of cyclobenzaprine to be contraindicated in the acute recovery phase following myocardial infarction and in patients with hyperthyroidism, congestive heart failure, arrhythmias, heart block, and/or conduction disturbances. Cyclobenzaprine is structurally related to the tricyclic antidepressants, which have been reported to cause tachycardia, arrhythmias, heart block, hypertension, hypotension (particularly orthostatic hypotension), thrombosis, thrombophlebitis, myocardial infarction, strokes, congestive heart failure, and ECG abnormalities such as PR and QT interval prolongation. Therapy with cyclobenzaprine should be administered cautiously in patients with a history of cardiovascular or cerebrovascular disease or a predisposition to hypotension, particularly if the intended dosage exceeds those normally used for musculoskeletal conditions. Tachycardia, arrhythmia, palpitation, and hypotension have been reported with the use of cyclobenzaprine in less than 1% of patients.

The cyclobenzaprine in Flexeril has a major potential interaction with History - Myocardial Infarction.

The manufacturers consider the use of cyclobenzaprine to be contraindicated in the acute recovery phase following myocardial infarction and in patients with hyperthyroidism, congestive heart failure, arrhythmias, heart block, and/or conduction disturbances. Cyclobenzaprine is structurally related to the tricyclic antidepressants, which have been reported to cause tachycardia, arrhythmias, heart block, hypertension, hypotension (particularly orthostatic hypotension), thrombosis, thrombophlebitis, myocardial infarction, strokes, congestive heart failure, and ECG abnormalities such as PR and QT interval prolongation. Therapy with cyclobenzaprine should be administered cautiously in patients with a history of cardiovascular or cerebrovascular disease or a predisposition to hypotension, particularly if the intended dosage exceeds those normally used for musculoskeletal conditions. Tachycardia, arrhythmia, palpitation, and hypotension have been reported with the use of cyclobenzaprine in less than 1% of patients.

The phenylephrine in acetaminophen / guaifenesin / 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.

The cyclobenzaprine in Flexeril has a major potential interaction with Hyperthyroidism.

The manufacturers consider the use of cyclobenzaprine to be contraindicated in the acute recovery phase following myocardial infarction and in patients with hyperthyroidism, congestive heart failure, arrhythmias, heart block, and/or conduction disturbances. Cyclobenzaprine is structurally related to the tricyclic antidepressants, which have been reported to cause tachycardia, arrhythmias, heart block, hypertension, hypotension (particularly orthostatic hypotension), thrombosis, thrombophlebitis, myocardial infarction, strokes, congestive heart failure, and ECG abnormalities such as PR and QT interval prolongation. Therapy with cyclobenzaprine should be administered cautiously in patients with a history of cardiovascular or cerebrovascular disease or a predisposition to hypotension, particularly if the intended dosage exceeds those normally used for musculoskeletal conditions. Tachycardia, arrhythmia, palpitation, and hypotension have been reported with the use of cyclobenzaprine in less than 1% of patients.

The cyclobenzaprine in Flexeril has a major potential interaction with Hypotension.

The manufacturers consider the use of cyclobenzaprine to be contraindicated in the acute recovery phase following myocardial infarction and in patients with hyperthyroidism, congestive heart failure, arrhythmias, heart block, and/or conduction disturbances. Cyclobenzaprine is structurally related to the tricyclic antidepressants, which have been reported to cause tachycardia, arrhythmias, heart block, hypertension, hypotension (particularly orthostatic hypotension), thrombosis, thrombophlebitis, myocardial infarction, strokes, congestive heart failure, and ECG abnormalities such as PR and QT interval prolongation. Therapy with cyclobenzaprine should be administered cautiously in patients with a history of cardiovascular or cerebrovascular disease or a predisposition to hypotension, particularly if the intended dosage exceeds those normally used for musculoskeletal conditions. Tachycardia, arrhythmia, palpitation, and hypotension have been reported with the use of cyclobenzaprine in less than 1% of patients.

The acetaminophen in acetaminophen / guaifenesin / 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.

The acetaminophen in acetaminophen / guaifenesin / 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.

The acetaminophen in acetaminophen / guaifenesin / 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).

The phenylephrine in acetaminophen / guaifenesin / 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.

The phenylephrine in acetaminophen / guaifenesin / 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.

The cyclobenzaprine in Flexeril has a moderate potential interaction with Urinary Retention.

Cyclobenzaprine has anticholinergic activity, to which elderly patients are particularly sensitive. Therapy with cyclobenzaprine should be administered cautiously in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders. Glaucoma should be treated and under control prior to initiation of cyclobenzaprine therapy, and intraocular pressure monitored during therapy.