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Drug Interactions between Amytal Sodium and Dexacort Phosphate in Respihaler

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

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Interactions between your drugs

Moderate

amobarbital dexAMETHasone

Applies to: Amytal Sodium (amobarbital) and Dexacort Phosphate in Respihaler (dexamethasone)

MONITOR: Barbiturates may decrease the plasma concentrations and systemic effects of both endogenous and exogenous corticosteroids. The mechanism is accelerated corticosteroid metabolism due to induction of the CYP450 3A4 enzymatic pathway by barbiturates.

MANAGEMENT: Patients treated concomitantly with a barbiturate may require higher dosages of corticosteroids or adrenocorticotropic agents. Pharmacologic response to these agents should be monitored more closely whenever a barbiturate is added to or withdrawn from therapy in patients stabilized on their existing corticosteroid or adrenocorticotropic regimen, and the dosage(s) adjusted as necessary.

References

  1. Bartoszek M, Brenner AM, Szefler SJ "Prednisolone and methylprednisolone kinetics in children receiving anticonvulsant therapy." Clin Pharmacol Ther 42 (1987): 424-32
  2. Gambertoglio JG, Holford NH, Kapusnik JE, et al. "Disposition of total and unbound prednisolone in renal transplant patients receiving anticonvulsants." Kidney Int 25 (1984): 119-23
  3. Sehgal VN, Srivastava G "Corticosteroid-unresponsive pemphigus vulgaris following antiepileptic therapy." Int J Dermatol 27 (1988): 258
  4. Brooks PM, Buchanan WW, Grove M, Downie WW "Effects of enzyme induction on metabolism of prednisolone." Ann Rheum Dis 35 (1976): 339-43
  5. Hancock KW, Levell MJ "Primidone/dexamethasone interaction." Lancet 2 (1978): 97-8
  6. Young MC, Hughes IA "Loss of therapeutic control in congenital adrenal hyperplasia due to interaction between dexamethasone and primidone." Acta Paediatr Scand 80 (1991): 120-4
  7. Stjernholm MR, Katz FH "Effects of diphenylhydantoin, phenobarbital, and diazepam on the metabolism of methylprednisolone and its sodium succinate." J Clin Endocrinol Metab 41 (1975): 887-93
  8. "Product Information. Phenobarbital (phenobarbital)." Lilly, Eli and Company PROD (2001):
  9. Brooks SM, Werk EE, Ackerman SJ, Sullivan I, Thrasher K "Adverse effects of phenobarbital on corticosteroid metabolism in patients with bronchial asthma." N Engl J Med 286 (1972): 1125-8
  10. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
View all 10 references

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Drug and food interactions

Major

amobarbital food

Applies to: Amytal Sodium (amobarbital)

GENERALLY AVOID: Concurrent acute use of barbiturates and ethanol may result in additive CNS effects, including impaired coordination, sedation, and death. Tolerance of these agents may occur with chronic use. The mechanism is related to inhibition of microsomal enzymes acutely and induction of hepatic microsomal enzymes chronically.

MANAGEMENT: The combination of ethanol and barbiturates should be avoided.

References

  1. Gupta RC, Kofoed J "Toxological statistics for barbiturates, other sedatives, and tranquilizers in Ontario: a 10-year survey." Can Med Assoc J 94 (1966): 863-5
  2. Misra PS, Lefevre A, Ishii H, Rubin E, Lieber CS "Increase of ethanol, meprobamate and pentobarbital metabolism after chronic ethanol administration in man and in rats." Am J Med 51 (1971): 346-51
  3. Saario I, Linnoila M "Effect of subacute treatment with hypnotics, alone or in combination with alcohol, on psychomotor skills related to driving." Acta Pharmacol Toxicol (Copenh) 38 (1976): 382-92
  4. Stead AH, Moffat AC "Quantification of the interaction between barbiturates and alcohol and interpretation of fatal blood concentrations." Hum Toxicol 2 (1983): 5-14
  5. Seixas FA "Drug/alcohol interactions: avert potential dangers." Geriatrics 34 (1979): 89-102
View all 5 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

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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