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Drug Interactions between Advil Children's Cold and Panglobulin NF

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

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Interactions between your drugs

Major

ibuprofen immune globulin intravenous

Applies to: Advil Children's Cold (ibuprofen / pseudoephedrine) and Panglobulin NF (immune globulin intravenous)

MONITOR CLOSELY: Coadministration of intravenous immune globulin preparations with nephrotoxic agents may potentiate the risk of renal impairment. Many commercially available intravenous formulations of immune globulin contain sucrose as a stabilizer. Immune globulin products, particularly those that contain sucrose as a stabilizer and administered at daily doses of 350 to 400 mg/kg or greater, have been associated with renal dysfunction, acute renal failure, osmotic nephrosis, and death. Factors predisposing to acute renal failure include any degree of preexisting renal insufficiency, age greater than 65 years, diabetes mellitus, volume depletion, sepsis, paraproteinemia, and concomitant use of known nephrotoxic drugs.

MANAGEMENT: Intravenous immune globulin preparations should be administered cautiously in patients treated with other potentially nephrotoxic agents (e.g., e.g., aminoglycosides; polypeptide, glycopeptide, and polymyxin antibiotics; amphotericin B; adefovir; cidofovir; tenofovir; foscarnet; cisplatin; deferasirox; gallium nitrate; lithium; mesalamine; certain immunosuppressants; intravenous bisphosphonates; intravenous pentamidine; high intravenous dosages of methotrexate; high dosages and/or chronic use of nonsteroidal anti-inflammatory agents). The manufacturers recommend administering immune globulin infusions at the minimum concentration available and at the minimum rate of infusion feasible in such patients. Clinicians should ensure that patients are not volume depleted prior to the initiation of immune globulin therapy. Monitoring of urine output and renal function tests, including the measurement of blood urea nitrogen (BUN) and serum creatinine, is recommended prior to the initial infusion and at appropriate intervals thereafter. If renal function deteriorates, discontinuation of the product should be considered. Patients should be advised to seek medical attention if they experience symptoms that may indicate nephrotoxicity such as decreased urine output, sudden weight gain, fluid retention, edema, or shortness of breath.

References

  1. "Product Information. Cytogam (cytomegalovirus immune globulin)." CSL Behring LLC (2002):
  2. "Product Information. Respigam (respiratory syncytial virus immune globulin)." Medimmune Inc (2005):
  3. "Product Information. BabyBIG (botulism immune globulin)." FFF Enterprises (2008):
  4. "Product Information. Bivigam (immune globulin intravenous)." Biotest Pharmaceuticals Corporation (2013):
  5. MMWR Morb Mortal Wkly Rep "Renal insufficiency and failure associated with immune globulin intravenous therapy -- United States, 1985-1998. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4824a3.htm" (2013):
  6. Pusey EY, Levy JB "Nephrotoxicity of intravenous immunoglobulin. http://qjmed.oxfordjournals.org/content/93/11/751.full.pdf+html" (2013):
  7. KDIGO. Kidney Disease Improving Global Outcomes "KDIGO clinical practice guideline for acute kidney injury. http://www.kdigo.org/clinical_practice_guidelines/pdf/KDIGO-AKI-Suppl-Appendices-A-F_March2012.pdf" (2013):
  8. Guo X, Nzerue C "How to prevent, recognize, and treat drug-induced nephrotoxicity. http://www.ccjm.org/content/69/4/289.full.pdf" (2013):
  9. Perazella MA "Renal vulnerability to drug toxicity. http://www.ccjm.org/content/69/4/289.full.pdf" (2013):
  10. Naughton CA "Drug-induced nephrotoxicity. http://www.aafp.org/afp/2008/0915/p743.html" (2013):
  11. Moses S "Nephrotoxic drugs, drug-induced nephrotoxicity. http://www.fpnotebook.com/Renal/Pharm/NphrtxcDrgs.htm" (2013):
View all 11 references

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Drug and food interactions

Moderate

ibuprofen food

Applies to: Advil Children's Cold (ibuprofen / pseudoephedrine)

GENERALLY AVOID: The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.

MANAGEMENT: Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.

References

  1. "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn PROD (2002):

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Moderate

pseudoephedrine food

Applies to: Advil Children's Cold (ibuprofen / pseudoephedrine)

MONITOR: Coadministration of two or more sympathomimetic agents may increase the risk of adverse effects such as nervousness, irritability, and increased heart rate. Central nervous system (CNS) stimulants, particularly amphetamines, can potentiate the adrenergic response to vasopressors and other sympathomimetic agents. Additive increases in blood pressure and heart rate may occur due to enhanced peripheral sympathetic activity.

MANAGEMENT: Caution is advised if two or more sympathomimetic agents are coadministered. Pulse and blood pressure should be closely monitored.

References

  1. Rosenblatt JE, Lake CR, van Kammen DP, Ziegler MG, Bunney WE Jr "Interactions of amphetamine, pimozide, and lithium on plasma norepineophrine and dopamine-beta-hydroxylase in schizophrenic patients." Psychiatry Res 1 (1979): 45-52
  2. Cavanaugh JH, Griffith JD, Oates JA "Effect of amphetamine on the pressor response to tyramine: formation of p-hydroxynorephedrine from amphetamine in man." Clin Pharmacol Ther 11 (1970): 656
  3. "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc PROD (2001):
  4. "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals PROD (2001):
  5. "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals PROD (2001):
  6. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):
  7. "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company (2002):
View all 7 references

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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.

See also

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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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