Drug Interactions between Benylin Multi-Symptom and sodium iodide-i-131

MONITOR: Excessive intake of dietary iodine (e.g., iodised salt) may interfere with adequate uptake of radioiodide by the thyroid .

MANAGEMENT: A diet low in iodine is recommended before initiating therapy with sodium iodide I-131 or I-123.

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.

ADJUST DOSING INTERVAL: Certain drugs may affect the pharmacokinetics, pharmacodynamics, and/or diagnostic results of radioiodides.

MANAGEMENT: Antithyroid agents such as carbimazole or propylthiouracil should generally be withheld for 1 week before administration of sodium iodide I-131 or I-123, and for a few days afterward. Salicylates, steroids, anticoagulants, antihistamines, antiparasitics, penicillins, sulfonamides, tolbutamide, thiopental, and nitroprusside should generally be withheld for 1 week. Amiodarone, lithium, and benzodiazepines should be withheld for at least 4 weeks.

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.