Can you take Benoxinate ophthalmic with Sinulin?
1 drug interaction and 28 additional warnings found for the following 2 drugs:
- benoxinate ophthalmic
- Sinulin (acetaminophen/chlorpheniramine/phenylpropanolamine)
Drug interactions
Moderate drug interactions
Moderate:
acetaminophen benoxinate ophthalmic
Applies to: Sinulin (acetaminophen / chlorpheniramine / phenylpropanolamine) and benoxinate ophthalmic
Some of the medication in benoxinate ophthalmic may be absorbed into the bloodstream following local application. When present in sufficient concentrations in the blood, local anesthetics such as benoxinate ophthalmic may cause methemoglobinemia, a rare condition that can lead to oxygen deprivation in tissues and vital organs due to reduced oxygen-carrying capacity of the blood. The risk is increased when combined with other medications that can also induce methemoglobinemia such as acetaminophen.
Individuals may be more susceptible to developing methemoglobinemia during treatment with these medications if they are very young (especially neonates and infants) or have:
- anemia
- diseases of the heart or lungs
- blood circulation disorders
- liver cirrhosis
- shock
- sepsis
- certain genetic predispositions such as NADH cytochrome-b5 reductase deficiency, glucose-6-phosphate dehydrogenase deficiency, and hemoglobin M
In addition, use of topical anesthetics on inflamed or abraded areas or broken skin, as well as excessive use such as application of large doses or on larger than recommended areas, can increase absorption and result in high blood levels of the medication. Topical anesthetics that are applied to mucous membranes such as inside the mouth, nose, or throat (e.G., for sore throat; for numbing prior to dental procedures or scoping of the lungs or gastrointestinal tract) may also be absorbed to a significant extent.
What to do: Close medical supervision is necessary when medications that can cause methemoglobinemia are used together. Do not exceed the recommended dose or frequency and duration of use when treated with products that contain local anesthetics, including some over-the-counter preparations.
Signs and symptoms of methemoglobinemia may be delayed by several hours after treatment with topical anesthetics. Patients (or their caregivers) should seek immediate medical attention if they develop:
- a gray discoloration of the skin, mouth, or nail bed
- nausea
- headache
- dizziness
- lightheadedness
- fatigue
- shortness of breath
- rapid or shallow breathing
- a rapid heartbeat
- palpitation
- anxiety
- confusion
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Major food/lifestyle interactions
Major:
acetaminophen Food/Lifestyle
Applies to: Sinulin (acetaminophen / chlorpheniramine / phenylpropanolamine)
Acetaminophen may cause liver damage and taking it with alcohol may increase that risk.
You should avoid or limit the use of alcohol while being treated with acetaminophen.
Call your doctor immediately if you have:
- fever
- chills
- joint pain or swelling
- excessive tiredness or weakness
- unusual bleeding or bruising
- skin rash or itching
- loss of appetite
- nausea
- vomiting
- dark colored urine
- yellowing of the skin or the whites of your eyes
These may be symptoms of liver damage.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Moderate food/lifestyle interactions
Moderate:
chlorpheniramine Food/Lifestyle
Applies to: Sinulin (acetaminophen / chlorpheniramine / phenylpropanolamine)
Alcohol can increase the nervous system side effects of chlorpheniramine such as:
- dizziness
- drowsiness
- difficulty concentrating
Some people may also experience impairment in thinking and judgment.
You should avoid or limit the use of alcohol while being treated with chlorpheniramine.
Do not use more than the recommended dose of chlorpheniramine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you.
Talk to your doctor or pharmacist if you have any questions or concerns.
Moderate:
phenylpropanolamine Food/Lifestyle
Applies to: Sinulin (acetaminophen / chlorpheniramine / phenylpropanolamine)
Using phenylpropanolamine with alcohol can increase the risk of cardiovascular side effects such as:
- increased heart rate
- chest pain
- blood pressure changes
In addition, you may also be more likely to experience nervous system side effects such as:
- dizziness
- drowsiness
- depression
- difficulty concentrating
You should avoid or limit the use of alcohol while being treated with phenylpropanolamine. Do not use more than the recommended dose of phenylpropanolamine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medication without first talking to your doctor.
Moderate:
phenylpropanolamine Caffeine
Applies to: Sinulin (acetaminophen / chlorpheniramine / phenylpropanolamine)
Both phenylpropanolamine and caffeine can increase blood pressure and heart rate, and combining them may enhance these effects.
Talk to your doctor before using these medications, especially if you have a history of high blood pressure or heart disease. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications.
Contact your doctor if your condition changes or you experience increased side effects.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Disease interactions
24 potential interactions Applies to: 20 conditions, including Asthma, Benign Prostatic Hyperplasia, COPD, Hypotension, and Hyperthyroidism.
Alcoholism
Major:
Sinulin
The acetaminophen in Sinulin has a major potential interaction with Alcoholism.
Chronic alcohol abusers may be at increased risk of hepatotoxicity during treatment with acetaminophen (APAP). Severe liver injury, including cases of acute liver failure resulting in liver transplant and death, has been reported in patients using acetaminophen. Therapy with acetaminophen should be administered cautiously, if at all, in patients who consume three or more alcoholic drinks a day. In general, patients should avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure. They should also be advised to seek medical attention if they experience signs and symptoms of liver injury such as fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, and jaundice.
Asthma
Moderate:
Sinulin
The chlorpheniramine in Sinulin has a moderate potential interaction with Asthma.
It has been suggested that the anticholinergic effect of antihistamines may reduce the volume and cause thickening of bronchial secretions, resulting in obstruction of respiratory tract. Some manufacturers and clinicians recommend that therapy with antihistamines be administered cautiously in patients with asthma or chronic obstructive pulmonary disease.
Benign Prostatic Hyperplasia
Moderate:
Sinulin
The phenylpropanolamine in Sinulin has a moderate potential interaction with Benign Prostatic Hyperplasia.
Sympathomimetic agents may cause or worsen urinary difficulty in patients with prostate enlargement due to smooth muscle contraction in the bladder neck via stimulation of alpha-1 adrenergic receptors. Therapy with sympathomimetic agents should be administered cautiously in patients with hypertrophy or neoplasm of the prostate.
Cardiovascular Conditions and Disorders
Major:
Sinulin
The phenylpropanolamine in Sinulin has a major potential interaction with Cardiovascular Conditions and Disorders.
Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.
Moderate:
Sinulin
The chlorpheniramine in Sinulin has a moderate potential interaction with Cardiovascular Conditions and Disorders.
Antihistamines may infrequently cause cardiovascular adverse effects related to their anticholinergic and local anesthetic (quinidine-like) activities. Tachycardia, palpitation, ECG changes, arrhythmias, hypotension, and hypertension have been reported. Although these effects are uncommon and usually limited to overdosage situations, the manufacturers and some clinicians recommend that therapy with antihistamines be administered cautiously in patients with cardiovascular disease, hypertension, and/or hyperthyroidism.
Cerebrovascular Insufficiency
Major:
Sinulin
The phenylpropanolamine in Sinulin has a major potential interaction with Cerebrovascular Insufficiency.
Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.
COPD
Moderate:
Sinulin
The chlorpheniramine in Sinulin has a moderate potential interaction with COPD.
It has been suggested that the anticholinergic effect of antihistamines may reduce the volume and cause thickening of bronchial secretions, resulting in obstruction of respiratory tract. Some manufacturers and clinicians recommend that therapy with antihistamines be administered cautiously in patients with asthma or chronic obstructive pulmonary disease.
Dehydration
Major:
Sinulin
The acetaminophen in Sinulin has a major potential interaction with Dehydration.
Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease. Patients with hepatic impairment may be at increased risk of toxicity. Severe liver injury, including cases of acute liver failure and death, have been reported in patients using this drug. Clinical monitoring of hepatic function is recommended. Caution is advised if using acetaminophen in patients with chronic malnutrition or severe hypovolemia. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.
Diabetes Mellitus
Moderate:
Sinulin
The phenylpropanolamine in Sinulin has a moderate potential interaction with Diabetes Mellitus.
Sympathomimetic agents may cause increases in blood glucose concentrations. These effects are usually transient and slight but may be significant with dosages higher than those normally recommended. Therapy with sympathomimetic agents should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate.
Gastrointestinal Obstruction
Moderate:
Sinulin
The chlorpheniramine in Sinulin has a moderate potential interaction with Gastrointestinal Obstruction.
Antihistamines often have anticholinergic activity, to which elderly patients are particularly sensitive. Therapy with antihistamines should be administered cautiously, if at all, in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders. Conventional, first-generation antihistamines such as the ethanolamines (bromodiphenhydramine, carbinoxamine, clemastine, dimenhydrinate, diphenhydramine, doxylamine, phenyltoloxamine) tend to exhibit substantial anticholinergic effects. In contrast, the newer, relatively nonsedating antihistamines (e.g., cetirizine, fexofenadine, loratadine) reportedly have low to minimal anticholinergic activity at normally recommended dosages and may be appropriate alternatives.
Glaucoma/Intraocular Hypertension
Moderate:
Sinulin
The chlorpheniramine in Sinulin has a moderate potential interaction with Glaucoma/Intraocular Hypertension.
Antihistamines often have anticholinergic activity, to which elderly patients are particularly sensitive. Therapy with antihistamines should be administered cautiously, if at all, in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders. Conventional, first-generation antihistamines such as the ethanolamines (bromodiphenhydramine, carbinoxamine, clemastine, dimenhydrinate, diphenhydramine, doxylamine, phenyltoloxamine) tend to exhibit substantial anticholinergic effects. In contrast, the newer, relatively nonsedating antihistamines (e.g., cetirizine, fexofenadine, loratadine) reportedly have low to minimal anticholinergic activity at normally recommended dosages and may be appropriate alternatives.
Moderate:
Sinulin
The phenylpropanolamine in Sinulin has a moderate potential interaction with Glaucoma/Intraocular Hypertension.
Sympathomimetic agents can induce transient mydriasis via stimulation of alpha-1 adrenergic receptors. In patients with anatomically narrow angles or narrow-angle glaucoma, pupillary dilation can provoke an acute attack. In patients with other forms of glaucoma, mydriasis may occasionally increase intraocular pressure. Therapy with sympathomimetic agents should be administered cautiously in patients with or predisposed to glaucoma, particularly narrow-angle glaucoma.
Hyperthyroidism
Major:
Sinulin
The phenylpropanolamine in Sinulin has a major potential interaction with Hyperthyroidism.
Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.
Moderate:
Sinulin
The chlorpheniramine in Sinulin has a moderate potential interaction with Hyperthyroidism.
Antihistamines may infrequently cause cardiovascular adverse effects related to their anticholinergic and local anesthetic (quinidine-like) activities. Tachycardia, palpitation, ECG changes, arrhythmias, hypotension, and hypertension have been reported. Although these effects are uncommon and usually limited to overdosage situations, the manufacturers and some clinicians recommend that therapy with antihistamines be administered cautiously in patients with cardiovascular disease, hypertension, and/or hyperthyroidism.
Hypotension
Moderate:
Sinulin
The chlorpheniramine in Sinulin has a moderate potential interaction with Hypotension.
Antihistamines may infrequently cause cardiovascular adverse effects related to their anticholinergic and local anesthetic (quinidine-like) activities. Tachycardia, palpitation, ECG changes, arrhythmias, hypotension, and hypertension have been reported. Although these effects are uncommon and usually limited to overdosage situations, the manufacturers and some clinicians recommend that therapy with antihistamines be administered cautiously in patients with cardiovascular disease, hypertension, and/or hyperthyroidism.
Liver Disease
Major:
Sinulin
The acetaminophen in Sinulin has a major potential interaction with Liver Disease.
Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease. Patients with hepatic impairment may be at increased risk of toxicity. Severe liver injury, including cases of acute liver failure and death, have been reported in patients using this drug. Clinical monitoring of hepatic function is recommended. Caution is advised if using acetaminophen in patients with chronic malnutrition or severe hypovolemia. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.
Moderate:
Sinulin
The chlorpheniramine in Sinulin has a moderate potential interaction with Liver Disease.
Limited pharmacokinetic data are available for the older, first-generation antihistamines. Many appear to be primarily metabolized by the liver, and both parent drugs and metabolites are excreted in the urine. Patients with renal and/or liver disease may be at greater risk for adverse effects from antihistamines due to drug and metabolite accumulation. Therapy with antihistamines should be administered cautiously in such patients. Lower initial dosages may be appropriate.
Malnourishment
Major:
Sinulin
The acetaminophen in Sinulin has a major potential interaction with Malnourishment.
Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease. Patients with hepatic impairment may be at increased risk of toxicity. Severe liver injury, including cases of acute liver failure and death, have been reported in patients using this drug. Clinical monitoring of hepatic function is recommended. Caution is advised if using acetaminophen in patients with chronic malnutrition or severe hypovolemia. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.
Phenylketonuria
Moderate:
Sinulin
The acetaminophen in Sinulin has a moderate potential interaction with Phenylketonuria.
Several oral acetaminophen and acetaminophen-combination products, particularly flavored chewable tablets, contain the artificial sweetener, aspartame (NutraSweet). Aspartame is converted to phenylalanine in the gastrointestinal tract following ingestion. Chewable and effervescent formulations of acetaminophen products may also contain phenylalanine. The aspartame/phenylalanine content should be considered when these products are used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics).
Prostate Tumor, Benign
Moderate:
Sinulin
The phenylpropanolamine in Sinulin has a moderate potential interaction with Prostate Tumor, Benign.
Sympathomimetic agents may cause or worsen urinary difficulty in patients with prostate enlargement due to smooth muscle contraction in the bladder neck via stimulation of alpha-1 adrenergic receptors. Therapy with sympathomimetic agents should be administered cautiously in patients with hypertrophy or neoplasm of the prostate.
Psychiatric Disorders
Moderate:
Sinulin
The phenylpropanolamine in Sinulin has a moderate potential interaction with Psychiatric Disorders.
Phenylpropanolamine may precipitate or exacerbate psychotic symptoms, particularly at high dosages. Therapy with phenylpropanolamine should be administered cautiously in patients with a history of psychiatric disorders.
Psychosis
Moderate:
Sinulin
The phenylpropanolamine in Sinulin has a moderate potential interaction with Psychosis.
Phenylpropanolamine may precipitate or exacerbate psychotic symptoms, particularly at high dosages. Therapy with phenylpropanolamine should be administered cautiously in patients with a history of psychiatric disorders.
Renal Dysfunction
Moderate:
Sinulin
The chlorpheniramine in Sinulin has a moderate potential interaction with Renal Dysfunction.
Limited pharmacokinetic data are available for the older, first-generation antihistamines. Many appear to be primarily metabolized by the liver, and both parent drugs and metabolites are excreted in the urine. Patients with renal and/or liver disease may be at greater risk for adverse effects from antihistamines due to drug and metabolite accumulation. Therapy with antihistamines should be administered cautiously in such patients. Lower initial dosages may be appropriate.
Urinary Retention
Moderate:
Sinulin
The chlorpheniramine in Sinulin has a moderate potential interaction with Urinary Retention.
Antihistamines often have anticholinergic activity, to which elderly patients are particularly sensitive. Therapy with antihistamines should be administered cautiously, if at all, in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders. Conventional, first-generation antihistamines such as the ethanolamines (bromodiphenhydramine, carbinoxamine, clemastine, dimenhydrinate, diphenhydramine, doxylamine, phenyltoloxamine) tend to exhibit substantial anticholinergic effects. In contrast, the newer, relatively nonsedating antihistamines (e.g., cetirizine, fexofenadine, loratadine) reportedly have low to minimal anticholinergic activity at normally recommended dosages and may be appropriate alternatives.
More resources
benoxinate ophthalmic
A total of 53 drugs are known to interact with benoxinate ophthalmic.
- Benoxinate ophthalmic is in the drug class ophthalmic anesthetics.
Sinulin
A total of 927 drugs are known to interact with Sinulin.
- Sinulin is in the drug class upper respiratory combinations.
- Sinulin is used to treat Cold Symptoms.
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.