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Drug Interactions between atropine / pralidoxime and Ocusert

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

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Interactions between your drugs

Moderate

atropine pilocarpine ophthalmic

Applies to: atropine / pralidoxime and Ocusert (pilocarpine ophthalmic)

MONITOR: Theoretically, anticholinergic agents and other agents with significant anticholinergic activity (e.g., antihistamines, antispasmodics, neuroleptics, phenothiazines, skeletal muscle relaxants, tricyclic antidepressants, class IA antiarrhythmics especially disopyramide) may antagonize the effects of topically administered cholinergic agents such as acetylcholine, carbachol, demecarium, echothiophate, isoflurophate, physostigmine, and pilocarpine. The proposed mechanism involves opposing pharmacodynamic action on muscarinic receptor sites in ocular tissue. This interaction is sometimes desirable and is the basis for using atropine in the treatment of excessive muscarinic side effects and cholinergic crisis induced by cholinergic overdose.

MANAGEMENT: Patients receiving long-term therapy with anticholinergic agents should be monitored for potentially diminished therapeutic (miotic) response to ophthalmic cholinergic therapy, and dosages adjusted as necessary.

References

  1. "Multum Information Services, Inc. Expert Review Panel"
  2. "Product Information. Pilopine-HS (pilocarpine ophthalmic)." Alcon Laboratories Inc PROD

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Minor

atropine pralidoxime

Applies to: atropine / pralidoxime and atropine / pralidoxime

Pralidoxime and other drugs within the family of compounds called oximes, such as obidoxime, may potentiate the pharmacologic effects of atropine. Signs of atropinization such as flushing, mydriasis, tachycardia, and dry mouth and nose may occur earlier than expected during coadministration with pralidoxime relative to administration of atropine alone, particularly if the total dose of atropine has been large and the administration of pralidoxime was delayed. Clinicians should be aware of the potential interaction and monitor patients as appropriate. Pralidoxime may be used in conjunction with atropine in the treatment of organophosphate insecticide poisoning and nerve agent poisoning in terrorism or chemical warfare.

References

  1. "Product Information. DuoDote (atropine-pralidoxime)." Meridian Medical Technologies Inc (2010):

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Drug and food interactions

Moderate

atropine food

Applies to: atropine / pralidoxime

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

  1. Linnoila M "Drug effects on psychomotor skills related to driving: interaction of atropine, glycopyrrhonium and alcohol." Eur J Clin Pharmacol 6 (1973): 107-12

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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.


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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.