Drug Interactions between Bell/ans and Sudafed 12 Hour Pressure+Pain
This report displays the potential drug interactions for the following 2 drugs:
- Bell/ans (sodium bicarbonate)
- Sudafed 12 Hour Pressure+Pain (naproxen/pseudoephedrine)
Interactions between your drugs
sodium bicarbonate pseudoephedrine
Applies to: Bell / ans (sodium bicarbonate) and Sudafed 12 Hour Pressure+Pain (naproxen / pseudoephedrine)
MONITOR: Alkalization of the urine decreases the urinary excretion increases the elimination half-life of ephedrine, pseudoephedrine, and related drugs. According to one report, an increase in pH from 5.1 to 7.1 increased the half-life of pseudoephedrine from 5 to 16 hours. Toxicity from long-term use of pseudoephedrine has been demonstrated in patients with persistently alkaline urine.
MANAGEMENT: Patients should be monitored for toxic effects such as tremor, anxiety, insomnia, irritability, or nervousness. Dosage reductions may be required.
References
- Brater DC, Kaojarern S, Benet LZ, et al. "Renal excretion of pseudoephedrine." Clin Pharmacol Ther 28 (1980): 690-4
- Wilkinson GR, Beckett AH "Absorption metabolism and excretion of the ephedrines in man. I. The influence of urinary pH and urine volume output." J Pharmacol Exp Ther 162 (1968): 139-47
- Kuntzman RG, Tsai I, Brand L, Mark LC "The influence of urinary pH on the plasma half-life of pseudoephedrine in man and dog and a sensitive assay for its determination in human plasma." Clin Pharmacol Ther 12 (1971): 62-7
naproxen sodium bicarbonate
Applies to: Sudafed 12 Hour Pressure+Pain (naproxen / pseudoephedrine) and Bell / ans (sodium bicarbonate)
Antacids and some oral aluminum, calcium, or magnesium containing preparations may decrease the gastrointestinal absorption of enteric-coated naproxen, which requires an acidic environment for dissolution. The proposed mechanism is an increase in gastric pH (i.e. decreased gastric acidity) produced by antacids. In patients treated with antacids, the possibility of a reduced or subtherapeutic response to enteric-coated naproxen should be considered. Concomitant use of these drugs is generally not recommended. Aluminum hydroxide and some magnesium-containing antacids have also been reported to reduce the absorption of regular naproxen. The interaction may be minimized by separating the times of administration by at least 2 hours.
References
- Segre EJ, Sevelius H, Varady J "Effects of antacids on naproxen absorption." N Engl J Med 291 (1974): 582-3
- Brogden RN, Heel RC, Speight TM, Avery GS "Naproxen up to date: a review of its pharmacological properties and therapeutic efficacy and use in rheumatic diseases and pain states." Drugs 18 (1979): 241-77
Drug and food interactions
naproxen food
Applies to: Sudafed 12 Hour Pressure+Pain (naproxen / 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
- "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn PROD (2002):
pseudoephedrine food
Applies to: Sudafed 12 Hour Pressure+Pain (naproxen / 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
- 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
- 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
- "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc PROD (2001):
- "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals PROD (2001):
- "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals PROD (2001):
- "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):
- "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company (2002):
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
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
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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