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Drug Interactions between Actidose Plus Sorbitol and chlorpromazine

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

chlorproMAZINE charcoal

Applies to: chlorpromazine and Actidose Plus Sorbitol (charcoal / sorbitol)

GENERALLY AVOID: Charcoal may reduce the absorption of many drugs and can absorb enterohepatically circulated drugs. Clinical utility may be the reduction either of the effects or of the toxicity of many drugs. Activated charcoal may adsorb any therapeutic agents administered while it is in the gastrointestinal tract.

MANAGEMENT: The regular ingestion of charcoal should be avoided by patients requiring maintenance medications. If concomitant use is necessary, the dosage or route of administration may need to be altered.

References (25)
  1. Decker WJ, Shpall RA, Corby DG (1969) "Inhibition of aspirin absorption by activated charcoal and apomorphine." Clin Pharmacol Ther, 10, p. 710-3
  2. Knadler MP, Bergstrom RF, Callaghan JT, Obermeyer BD, Rubin A (1987) "Absorption studies of the H2-blocker nizatidine." Clin Pharmacol Ther, 42, p. 514-20
  3. Wing LM, Miners JO, Birkett DJ, et al. (1984) "Lidocaine disposition: sex differences and effects of cimetidine." Clin Pharmacol Ther, 35, p. 695-701
  4. Scheufler E, Bos I (1983) "Influence of peroral charcoal on pharmacokinetics and intestinal toxicity of intravenously given methotrexate." Arch Int Pharmacodyn Ther, 261, p. 180-5
  5. Gadgil SD, Damle SR, Advani SH, Vaidya AB (1982) "Effect of activated charcoal on the pharmacokinetics of high-dose methotrexate." Cancer Treat Rep, 66, p. 1169-71
  6. Park GD, Spector R, Goldberg MJ, Johnson GF (1986) "Expanded role of charcoal therapy in the poisoned and overdosed patient." Arch Intern Med, 146, p. 969-73
  7. Watson WA (1987) "Factors influencing the clinical efficacy of activated charcoal." Drug Intell Clin Pharm, 21, p. 160-6
  8. Kivisto KT, Neuvonen PJ (1990) "The effect of cholestyramine and activated charcoal on glipizide absorption." Br J Clin Pharmacol, 30, p. 733-6
  9. Dolgin JG, Nix DE, Sanchez J, Watson WA (1991) "Pharmacokinetic simulation of the effect of multiple-dose activated charcoal in phenytoin poisoning: report of two pediatric cases." DICP, 25, p. 646-9
  10. Rowden AM, Spoor JE, Bertino JS, Jr (1990) "The effect of activated charcoal on phenytoin pharmacokinetics." Ann Emerg Med, 19, p. 1144-7
  11. Farrar HC, Herold DA, Reed MD (1993) "Acute valproic acid intoxication: enhanced drug clearance with oral-activated charcoal." Crit Care Med, 21, p. 299-301
  12. Howard CE, Roberts RS, Ely DS, Moye RA (1994) "Use of multiple-dose activated charcoal in phenytoin toxicity." Ann Pharmacother, 28, p. 201-3
  13. Chernish SM, Wolen RL, Rodda BE (1972) "Adsorption of propoxyphene hydrochloride by activated charcoal." Clin Toxicol, 5, p. 317-29
  14. Glab WN, Corby DG, Decker WJ, Coldiron VR (1982) "Decreased absorption of propoxyphene by activated charcoal." J Toxicol Clin Toxicol, 19, p. 129-38
  15. Karkkainen S, Neuvonen PJ (1985) "Effect of oral charcoal and urine pH on dextropropoxyphene pharmacokinetics." Int J Clin Pharmacol Ther Toxicol, 23, p. 219-25
  16. Wakabayashi Y, Maruyama S, Hachimura K, Ohwada T (1994) "Activated charcoal interrupts enteroenteric circulation of phenobarbital." J Toxicol Clin Toxicol, 32, p. 419-24
  17. Reed MD (1988) "Oral activated charcoal therapy." Am J Emerg Med, 6, p. 318
  18. Neuvonen PJ (1982) "Clinical pharmacokinetics of oral activated charcoal in acute intoxications." Clin Pharmacokinet, 7, p. 465-89
  19. Naveau S, Bonhomme L, Preaux N, Chaput JC (1991) "A pure charcoal suspension for colonoscopic tattoo." Gastrointest Endosc, 37, p. 624-5
  20. Ilkhanipour K, Yealy DM, Krenzelok EP (1993) "Activated charcoal surface area and its role in multiple-dose charcoal therapy." Am J Emerg Med, 11, p. 583-5
  21. Saetta JP (1993) "Gastric decontaminating procedures: is it time to call a stop?" J R Soc Med, 86, p. 396-9
  22. Orisakwe OE (1994) "Activated charcoal: is failure to use it negligence or ignorance?" South Med J, 87, p. 165-8
  23. Herrington AM, Clifton GD (1995) "Toxicology and management of acute drug ingestions in adults." Pharmacotherapy, 15, p. 182-200
  24. Bonuccelli U, Piccini P, Del Dotto P, Pavese N, D'Antonio P, Muratorio A (1992) "Apomorphine test in de novo Parkinson's disease." Funct Neurol, 7, p. 295-8
  25. (2001) "Product Information. Trileptal (oxcarbazepine)." Novartis Pharmaceuticals

Drug and food interactions

Moderate

chlorproMAZINE food

Applies to: chlorpromazine

GENERALLY AVOID: Concurrent use of ethanol and phenothiazines may result in additive CNS depression and psychomotor impairment. Also, ethanol may precipitate dystonic reactions in patients who are taking phenothiazines. The two drugs probably act on different sites in the brain, although the exact mechanism of the interaction is not known.

MANAGEMENT: Patients should be advised to avoid alcohol during phenothiazine therapy.

References (2)
  1. Lutz EG (1976) "Neuroleptic-induced akathisia and dystonia triggered by alcohol." JAMA, 236, p. 2422-3
  2. Freed E (1981) "Alcohol-triggered-neuroleptic-induced tremor, rigidity and dystonia." Med J Aust, 2, p. 44-5
Moderate

chlorproMAZINE food

Applies to: chlorpromazine

MONITOR: Smoking cessation may lead to elevated plasma concentrations and enhanced pharmacologic effects of drugs that are substrates of CYP450 1A2 (and possibly CYP450 1A1) and/or certain drugs with a narrow therapeutic index (e.g., flecainide, pentazocine). One proposed mechanism is related to the loss of CYP450 1A2 and 1A1 induction by polycyclic aromatic hydrocarbons in tobacco smoke; when smoking cessation agents are initiated and smoking stops, the metabolism of certain drugs may decrease leading to increased plasma concentrations. The mechanism by which smoking cessation affects narrow therapeutic index drugs that are not known substrates of CYP450 1A2 or 1A1 is unknown. The clinical significance of this interaction is unknown as clinical data are lacking.

MANAGEMENT: Until more information is available, caution is advisable if smoking cessation agents are used concomitantly with drugs that are substrates of CYP450 1A2 or 1A1 and/or those with a narrow therapeutic range. Patients receiving smoking cessation agents may require periodic dose adjustments and closer clinical and laboratory monitoring of medications that are substrates of CYP450 1A2 or 1A1.

References (4)
  1. (2024) "Product Information. Cytisine (cytisinicline)." Consilient Health Ltd
  2. jeong sh, Newcombe D, sheridan j, Tingle M (2015) "Pharmacokinetics of cytisine, an a4 b2 nicotinic receptor partial agonist, in healthy smokers following a single dose." Drug Test Anal, 7, p. 475-82
  3. Vaughan DP, Beckett AH, Robbie DS (1976) "The influence of smoking on the intersubject variation in pentazocine elimination." Br J Clin Pharmacol, 3, p. 279-83
  4. Zevin S, Benowitz NL (1999) "Drug interactions with tobacco smoking: an update" Clin Pharmacokinet, 36, p. 425-38

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.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor 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.
Unknown No interaction information available.

Further information

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