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Drug Interactions between Breo Ellipta and hyoscyamine / methenamine / methylene blue / sodium biphosphate

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

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Interactions between your drugs

Moderate

methylene blue vilanterol

Applies to: hyoscyamine / methenamine / methylene blue / sodium biphosphate and Breo Ellipta (fluticasone / vilanterol)

MONITOR: Monoamine oxidase inhibitors (MAOIs) can potentiate the cardiovascular adverse effects of beta-2 adrenergic agonists such as hypertension, palpitation, tachycardia, and chest pain.

MANAGEMENT: Cardiovascular status should be closely monitored when beta-2 agonists are coadministered with MAOIs or other agents that possess MAOI activity (e.g., furazolidone, linezolid, methylene blue, procarbazine). Preferably, at least 14 days should elapse between discontinuation of MAOI therapy and initiation of treatment with beta-2 agonists.

References

  1. Finch JS "Cardiovascular toxicity: clinical evaluation of albuterol, isoproterenol and placebo in rising dose tolerance trial." Ann Allergy 47 (1981): 402-4
  2. "Adverse effects and complications of treatment with beta-adrenergic agonist drugs. Committee on drugs, the American Academy of Allergy and Immunology." J Allergy Clin Immunol 75 (1985): 443-9
  3. "Product Information. Proventil (albuterol)." Schering Corporation PROD (2002):
  4. "Product Information. Brethaire (terbutaline)." Novartis Pharmaceuticals PROD (2001):
  5. "Product Information. Isuprel (isoproterenol)." Sanofi Winthrop Pharmaceuticals PROD (2001):
  6. "Product Information. Serevent (salmeterol)." Glaxo Wellcome PROD
  7. "Product Information. Maxair (pirbuterol)." 3M Pharmaceuticals PROD (2001):
  8. Boakes AJ, Laurence DR, Teoh PC, Barar FS, Benedikter LT, Prichard BN "Interactions between sympathomimetic amines and antidepressant agents in man." Br Med J 1 (1973): 311-5
  9. Darcy PF, Griffin JP "Interactions with drugs used in the treatment of depressive illness." Adverse Drug React Toxicol Rev 14 (1995): 211-31
  10. "Product Information. Alupent (metaproterenol)." Boehringer-Ingelheim PROD (2001):
  11. "Product Information. Tornalate (bitolterol)." Apothecon Inc (2022):
  12. "Product Information. Xopenex (levalbuterol)." Sepracor Inc PROD (2001):
  13. "Product Information. Foradil (formoterol)." Novartis Pharmaceuticals PROD (2001):
  14. "Product Information. Brovana (arformoterol)." Sepracor Inc (2006):
  15. "Product Information. S2 Inhalant (racepinephrine)." Nephron Pharmaceuticals (2010):
  16. "Product Information. Arcapta Neohaler (indacaterol)." Novartis Pharmaceuticals (2011):
  17. "Product Information. Breo Ellipta (fluticasone-vilanterol)." GlaxoSmithKline (2013):
  18. "Product Information. Striverdi Respimat (olodaterol)." Boehringer Ingelheim (2014):
View all 18 references

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Minor

fluticasone vilanterol

Applies to: Breo Ellipta (fluticasone / vilanterol) and Breo Ellipta (fluticasone / vilanterol)

Although they are often combined in clinical practice, the concomitant use of beta-2 adrenergic agonists and corticosteroids may result in additive hypokalemic effects. Since beta-2 agonists can sometimes cause QT interval prolongation, the development of hypokalemia may potentiate the risk of ventricular arrhythmias including torsade de pointes. However, clinical data are limited, and the potential significance is unknown. Patients who are receiving systemic or nebulized formulations of beta-2 agonists, high dosages of inhaled beta-2 agonists, or systemic corticosteroid therapy may be at a greater risk of developing hypokalemia.

References

  1. "Product Information. Foradil (formoterol)." Novartis Pharmaceuticals PROD (2001):
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  3. Cerner Multum, Inc. "Australian Product Information." O 0
  4. Agencia Española de Medicamentos y Productos Sanitarios Healthcare "Centro de información online de medicamentos de la AEMPS - CIMA. https://cima.aemps.es/cima/publico/home.html" (2008):
View all 4 references

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Drug and food interactions

Moderate

sodium biphosphate food

Applies to: hyoscyamine / methenamine / methylene blue / sodium biphosphate

ADJUST DOSING INTERVAL: Bowel cleansing products can increase the gastrointestinal transit rate. Oral medications administered within one hour of the start of administration of the bowel cleansing solution may be flushed from the gastrointestinal tract and not properly absorbed.

MANAGEMENT: Patients should be advised that absorption of oral medications may be impaired during bowel cleansing treatment. Oral medications (e.g., anticonvulsants, oral contraceptives, antidiabetic agents, antibiotics) should not be administered during and within one hour of starting bowel cleansing treatment whenever possible. However, if concomitant use cannot be avoided, monitoring for reduced therapeutic effects may be advisable.

References

  1. "Product Information. Golytely (polyethylene glycol 3350 with electrolytes)." Braintree
  2. "Product Information. Prepopik (citric acid/Mg oxide/Na picosulfate)." Ferring Pharmaceuticals Inc (2022):

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Moderate

hyoscyamine food

Applies to: hyoscyamine / methenamine / methylene blue / sodium biphosphate

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.

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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