Can you take Acetaminophen / guaifenesin / phenylephrine with Nitrofurantoin?
1 drug interaction and 26 additional warnings found for the following 2 drugs:
- acetaminophen/guaifenesin/phenylephrine
- nitrofurantoin
Drug interactions
Moderate drug interactions
Moderate:
acetaminophen nitrofurantoin
Applies to: acetaminophen / guaifenesin / phenylephrine and nitrofurantoin
Both acetaminophen and nitrofurantoin can affect the liver, and combining them may increase the risk of liver damage. Talk to your doctor before using these medications together, particularly if you have other risk factors for liver problems. Do not use more than the recommended dose of acetaminophen or take more than one medication containing acetaminophen at the same time. Contact your doctor if you experience increased side effects or symptoms that concern you. 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 / guaifenesin / 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, or yellowing of the skin or the whites of your eyes, as 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:
phenylephrine Caffeine
Applies to: acetaminophen / guaifenesin / 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
24 potential interactions Applies to: 22 conditions, including Benign Prostatic Hyperplasia, Peripheral Neuropathy, Hyperthyroidism, Hypocalcemia, and Diabetes Mellitus.
Alcoholism
Major:
acetaminophen / guaifenesin / phenylephrine
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.
Anemia Associated with Vitamin B12 Deficiency
Moderate:
nitrofurantoin
Nitrofurantoin has a moderate potential interaction with Anemia Associated with Vitamin B12 Deficiency.
The use of nitrofurantoin has occasionally been associated with the development of peripheral neuropathy, which may be severe and irreversible. Patients at risk include the elderly and those with renal impairment, anemia, diabetes mellitus, electrolyte imbalance, vitamin B12 deficiency, diabetes, and/or debilitating diseases. Therapy with nitrofurantoin should be administered cautiously in patients with one or more risk factors and/or preexisting peripheral neuropathy. Periodic monitoring of renal function is recommended during prolonged therapy.
Benign Prostatic Hyperplasia
Moderate:
acetaminophen / guaifenesin / phenylephrine
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.
Cardiovascular Conditions and Disorders
Major:
acetaminophen / guaifenesin / phenylephrine
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.
Cerebrovascular Insufficiency
Major:
acetaminophen / guaifenesin / phenylephrine
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.
Dehydration
Major:
acetaminophen / guaifenesin / phenylephrine
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.
Diabetes Mellitus
Moderate:
acetaminophen / guaifenesin / phenylephrine
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.
Moderate:
nitrofurantoin
Nitrofurantoin has a moderate potential interaction with Diabetes Mellitus.
The use of nitrofurantoin has occasionally been associated with the development of peripheral neuropathy, which may be severe and irreversible. Patients at risk include the elderly and those with renal impairment, anemia, diabetes mellitus, electrolyte imbalance, vitamin B12 deficiency, diabetes, and/or debilitating diseases. Therapy with nitrofurantoin should be administered cautiously in patients with one or more risk factors and/or preexisting peripheral neuropathy. Periodic monitoring of renal function is recommended during prolonged therapy.
Electrolyte Abnormalities
Moderate:
nitrofurantoin
Nitrofurantoin has a moderate potential interaction with Electrolyte Abnormalities.
The use of nitrofurantoin has occasionally been associated with the development of peripheral neuropathy, which may be severe and irreversible. Patients at risk include the elderly and those with renal impairment, anemia, diabetes mellitus, electrolyte imbalance, vitamin B12 deficiency, diabetes, and/or debilitating diseases. Therapy with nitrofurantoin should be administered cautiously in patients with one or more risk factors and/or preexisting peripheral neuropathy. Periodic monitoring of renal function is recommended during prolonged therapy.
Folic Acid/Cyanocobalamin Deficiency
Moderate:
nitrofurantoin
Nitrofurantoin has a moderate potential interaction with Folic Acid/Cyanocobalamin Deficiency.
The use of nitrofurantoin has occasionally been associated with the development of peripheral neuropathy, which may be severe and irreversible. Patients at risk include the elderly and those with renal impairment, anemia, diabetes mellitus, electrolyte imbalance, vitamin B12 deficiency, diabetes, and/or debilitating diseases. Therapy with nitrofurantoin should be administered cautiously in patients with one or more risk factors and/or preexisting peripheral neuropathy. Periodic monitoring of renal function is recommended during prolonged therapy.
G-6-PD Deficiency
Major:
nitrofurantoin
Nitrofurantoin has a major potential interaction with G-6-PD Deficiency.
Hemolytic anemia has been reported in patients treated with nitrofurantoin, primarily in patients with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency. Therapy with nitrofurantoin should be avoided or administered cautiously in patients with G-6-PD deficiency. The development of hemolysis is an indication for withdrawal of nitrofurantoin therapy. Hemolysis ceases when the drug is withdrawn.
Glaucoma/Intraocular Hypertension
Moderate:
acetaminophen / guaifenesin / phenylephrine
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.
Hyperthyroidism
Major:
acetaminophen / guaifenesin / phenylephrine
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.
Hypocalcemia
Moderate:
nitrofurantoin
Nitrofurantoin has a moderate potential interaction with Hypocalcemia.
The use of nitrofurantoin has occasionally been associated with the development of peripheral neuropathy, which may be severe and irreversible. Patients at risk include the elderly and those with renal impairment, anemia, diabetes mellitus, electrolyte imbalance, vitamin B12 deficiency, diabetes, and/or debilitating diseases. Therapy with nitrofurantoin should be administered cautiously in patients with one or more risk factors and/or preexisting peripheral neuropathy. Periodic monitoring of renal function is recommended during prolonged therapy.
Liver Disease
Major:
acetaminophen / guaifenesin / phenylephrine
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.
Major:
nitrofurantoin
Nitrofurantoin has a major potential interaction with Liver Disease.
The use of nitrofurantoin has rarely been associated with hepatotoxicity, including hepatitis, cholestatic jaundice, chronic active hepatitis, and hepatic necrosis. Nitrofurantoin macrocrystals capsules are contraindicated in patients with a previous history of cholestatic jaundice/hepatic dysfunction associated with nitrofurantoin. Most acute reactions are self-limiting and resolve spontaneously, although fatalities have been reported. Therapy with nitrofurantoin should be administered cautiously in patients with liver disease. Periodic monitoring of liver function is recommended during prolonged therapy. The drug should be withdrawn immediately if hepatitis or liver damage occurs and is felt to be drug-related. Since nitrofurantoin is partially metabolized by the liver, a reduced dosage may also be necessary to prevent toxicity.
Malnourishment
Major:
acetaminophen / guaifenesin / phenylephrine
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.
Noninfectious Colitis
Major:
nitrofurantoin
Nitrofurantoin has a major potential interaction with Noninfectious Colitis.
Clostridioides difficile-associated diarrhea (CDAD), formerly pseudomembranous colitis, has been reported with almost all antibacterial drugs and may range from mild diarrhea to fatal colitis. The most common culprits include clindamycin and lincomycin. Antibacterial therapy alters the normal flora of the colon, leading to overgrowth of C difficile, whose toxins A and B contribute to CDAD development. Morbidity and mortality are increased with hypertoxin-producing strains of C difficile; these infections can be resistant to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea after antibacterial use. Since CDAD has been reported to occur more than 2 months after antibacterial use, careful medical history is necessary. Therapy with broad-spectrum antibacterials and other agents with significant antibacterial activity should be administered cautiously in patients with history of gastrointestinal disease, particularly colitis; pseudomembranous colitis (generally characterized by severe, persistent diarrhea and severe abdominal cramps, and sometimes associated with the passage of blood and mucus), if it occurs, may be more severe in these patients and may be associated with flares in underlying disease activity. Antibacterial drugs not directed against C difficile may need to be stopped if CDAD is suspected or confirmed. Appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C difficile, and surgical evaluation should be started as clinically indicated.
Peripheral Neuropathy
Moderate:
nitrofurantoin
Nitrofurantoin has a moderate potential interaction with Peripheral Neuropathy.
The use of nitrofurantoin has occasionally been associated with the development of peripheral neuropathy, which may be severe and irreversible. Patients at risk include the elderly and those with renal impairment, anemia, diabetes mellitus, electrolyte imbalance, vitamin B12 deficiency, diabetes, and/or debilitating diseases. Therapy with nitrofurantoin should be administered cautiously in patients with one or more risk factors and/or preexisting peripheral neuropathy. Periodic monitoring of renal function is recommended during prolonged therapy.
Phenylketonuria
Moderate:
acetaminophen / guaifenesin / phenylephrine
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).
Pheochromocytoma
Major:
acetaminophen / guaifenesin / phenylephrine
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.
Prostate Tumor, Benign
Moderate:
acetaminophen / guaifenesin / phenylephrine
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.
Pulmonary Impairment
Moderate:
nitrofurantoin
Nitrofurantoin has a moderate potential interaction with Pulmonary Impairment.
Chronic pulmonary reactions, generally in patients who have received continuous treatment for 6 months or longer have been reported with the use of nitrofurantoin. Caution is recommended when prescribing this agent to patients with pulmonary dysfunction.
Renal Dysfunction
Major:
nitrofurantoin
Nitrofurantoin has a major potential interaction with Renal Dysfunction.
The use of nitrofurantoin is contraindicated in patients with anuria, oliguria, or significant renal impairment (CrCl < 60 mL/min). Urinary concentration of the drug is likely to be inadequate in these patients, increasing the risk of therapeutic failure. Since nitrofurantoin is eliminated by the kidney, risk of toxicity may also be increased.
More resources
acetaminophen / guaifenesin / phenylephrine
A total of 721 drugs are known to interact with acetaminophen / guaifenesin / phenylephrine.
- Acetaminophen / guaifenesin / phenylephrine is in the drug class upper respiratory combinations.
- Acetaminophen / guaifenesin / phenylephrine is used to treat Cough and Nasal Congestion.
nitrofurantoin
A total of 229 drugs are known to interact with nitrofurantoin.
- Nitrofurantoin is in the drug class urinary anti-infectives.
- Nitrofurantoin 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.