Drug Interactions between Acetocot and Enlon-Plus
This report displays the potential drug interactions for the following 2 drugs:
- Acetocot (triamcinolone)
- Enlon-Plus (atropine/edrophonium)
Interactions between your drugs
atropine edrophonium
Applies to: Enlon-Plus (atropine / edrophonium) and Enlon-Plus (atropine / edrophonium)
GENERALLY AVOID: Anticholinergic agents and other agents with significant anticholinergic activity (e.g., clozapine, class IA antiarrhythmics especially disopyramide) may antagonize the effects of cholinergic skeletal muscle stimulants (e.g., ambenonium, edrophonium, guanidine, neostigmine, pyridostigmine). Although this interaction may be desirable in some situations, such as when atropine is used to treat excessive muscarinic side effects and cholinergic crisis induced by anticholinesterase overdose, unintentional or indiscriminate use of anticholinergic agents in the treatment of myasthenia gravis may exacerbate symptoms. In addition, such use may mask the less serious, gastrointestinal signs of cholinergic overdose and lead to inadvertent induction of cholinergic crisis, which can produce respiratory paralysis and death.
MANAGEMENT: Agents with potent anticholinergic activity should preferably be avoided in patients receiving cholinergic skeletal muscle stimulants. If concurrent use is necessary, patients treated for myasthenia gravis should be monitored for potential exacerbation of symptoms. Caution is advised not only because anticholinergic agents may mask the signs of a cholinergic overdose, but also because increasing muscle weakness associated with disease aggravation may be difficult to distinguish from that due to cholinergic crisis.
References
- (2001) "Product Information. Mestinon (pyridostigmine)." ICN Pharmaceuticals Inc
edrophonium triamcinolone
Applies to: Enlon-Plus (atropine / edrophonium) and Acetocot (triamcinolone)
ADJUST DOSE: Corticosteroids and adrenocorticotropic agents may diminish the therapeutic effects of acetylcholinesterase inhibitors in myasthenia gravis. The mechanism of interaction is unknown. Marked deterioration in muscle strength has been reported in patients with myasthenia gravis shortly after the initiation of corticosteroid therapy, particularly when high dosages were used. In most cases, the decline in muscular function was relatively refractory to acetylcholinesterase inhibitors. However, clinical improvement generally occurs during prolonged corticosteroid therapy when administered properly.
MANAGEMENT: Corticosteroid therapy should be instituted at relatively low dosages (15 to 25 mg/day of prednisone or equivalent) and in a controlled setting in patients with myasthenia gravis. Respiratory support should be available, and the dosage should be increased stepwise as tolerated (approximately 5 mg/day of prednisone or equivalent at 2- to 3-day intervals until marked clinical improvement or a dosage of 50 mg/day is reached). Dose reductions of the acetylcholinesterase inhibitor may be required as symptoms improve, which often may be delayed and gradual.
References
- Namba T (1972) "Corticotropin therapy in patients with myasthenia gravis." Arch Neurol, 26, p. 144-50
- Brunner NG, Namba T, Grob D (1972) "Corticosteroids in management of severe, generalized myasthenia gravis." Neurology, 22, p. 603-10
- Millikan CH, Eaton LM (1951) "Clinical evaluation of ACTH and cortisone in myasthenia gravis." Neurology, 1, p. 145-52
- Patten BM, Oliver KL, Engel WK (1974) "Adverse interaction between steroid hormones and anticholinesterase drugs." Neurology, 24, p. 442-9
- Braunwald E, Hauser SL, Kasper DL, Fauci AS, Isselbacher KJ, Longo DL, Martin JB, eds., Wilson JD (1998) "Harrison's Principles of Internal Medicine." New York, NY: McGraw-Hill Health Professionals Division
Drug and food interactions
atropine food
Applies to: Enlon-Plus (atropine / edrophonium)
GENERALLY AVOID: Use of anticholinergic agents with alcohol may result in sufficient impairment of attention so as to render driving and operating machinery more hazardous. In addition, the potential for abuse may be increased with the combination. The mechanism of interaction is not established but may involve additive depressant effects on the central nervous system. No effect of oral propantheline or atropine on blood alcohol levels was observed in healthy volunteers when administered before ingestion of a standard ethanol load. However, one study found impairment of attention in subjects given atropine 0.5 mg or glycopyrrolate 1 mg in combination with alcohol.
MANAGEMENT: Alcohol should generally be avoided during therapy with anticholinergic agents. Patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them.
References
- Linnoila M (1973) "Drug effects on psychomotor skills related to driving: interaction of atropine, glycopyrrhonium and alcohol." Eur J Clin Pharmacol, 6, p. 107-12
Therapeutic duplication warnings
No warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
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
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