Can you take Buspirone with Promethazine DM?
3 drug interactions and 41 additional warnings found for the following 2 drugs:
- buspirone
- Promethazine DM (dextromethorphan/promethazine)
Drug interactions
Major drug interactions
Major:
busPIRone dextromethorphan
Applies to: buspirone and Promethazine DM (dextromethorphan / promethazine)
Using busPIRone together with dextromethorphan can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as:
- confusion
- hallucination
- seizure
- extreme changes in blood pressure
- increased heart rate
- fever
- excessive sweating
- shivering or shaking
- blurred vision
- muscle spasm or stiffness
- tremor
- incoordination
- stomach cramp
- nausea
- vomiting
- diarrhea
Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications.
Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications.
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 drug interactions
Moderate:
busPIRone promethazine
Applies to: buspirone and Promethazine DM (dextromethorphan / promethazine)
Using busPIRone together with promethazine may increase side effects such as:
- dizziness
- drowsiness
- confusion
- difficulty concentrating
Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination.
What to do: You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you.
Talk to your doctor if you have any questions or concerns. 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:
dextromethorphan promethazine
Applies to: Promethazine DM (dextromethorphan / promethazine) and Promethazine DM (dextromethorphan / promethazine)
Using dextromethorphan together with promethazine may increase side effects such as:
- dizziness
- drowsiness
- confusion
- difficulty concentrating
Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination.
What to do: You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you.
Talk to your doctor if you have any questions or concerns. 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
Moderate food/lifestyle interactions
Moderate:
busPIRone Food/Lifestyle
Applies to: buspirone
You should avoid the use of alcohol while being treated with busPIRone.
Alcohol can increase the nervous system side effects of busPIRone such as:
- dizziness
- drowsiness
- difficulty concentrating
Some people may also experience impairment in thinking and judgment.
Patients receiving busPIRone should preferably avoid the consumption of large amounts of grapefruits and grapefruit juice. If this is not possible, the busPIRone dose should be taken at least 2 hours before or 8 hours after grapefruit or grapefruit juice.
Large amounts of grapefruit and grapefruit juice may cause increased levels of busPIRone in your body. This can lead to increased adverse effects such as drowsiness.
Talk to your doctor or pharmacist if you have any questions or concerns.
Moderate:
dextromethorphan Food/Lifestyle
Applies to: Promethazine DM (dextromethorphan / promethazine)
Alcohol can increase the nervous system side effects of dextromethorphan 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 dextromethorphan.
Do not use more than the recommended dose of dextromethorphan, 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:
promethazine Alcohol (Ethanol)
Applies to: Promethazine DM (dextromethorphan / promethazine)
Ask your doctor before using promethazine together with ethanol (alcohol).
This can cause:
- uncontrollable movements
- agitation
- seizures
- severe dizziness or fainting
- coma
- very deep sleep
- irregular heartbeats
- high or low body temperature
Use caution when driving, operating machinery, or performing other hazardous activities, these medicaions may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.
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
38 potential interactions Applies to: 32 conditions, including High Blood Pressure, Depression, Asthma, COPD, and Seizures.
Acute Alcohol Intoxication
Major:
Promethazine DM
The promethazine in Promethazine DM has a major potential interaction with Acute Alcohol Intoxication.
Phenothiazines are contraindicated in the presence of large amounts of central nervous system depressants such as alcohol. The risk of suicide and the danger of overdose may be increased in patients who use alcohol excessively. Phenothiazines should be used with caution in patients experiencing alcohol withdrawal.
Alcoholism
Major:
Promethazine DM
The promethazine in Promethazine DM has a major potential interaction with Alcoholism.
Phenothiazines are contraindicated in the presence of large amounts of central nervous system depressants such as alcohol. The risk of suicide and the danger of overdose may be increased in patients who use alcohol excessively. Phenothiazines should be used with caution in patients experiencing alcohol withdrawal.
Moderate:
buspirone
busPIRone has a moderate potential interaction with Alcoholism.
In human and animal studies, buspirone has not shown potential for abuse or diversion, and there is no evidence that it causes tolerance or physical and psychological dependence. However, since it is a CNS-active drug, the manufacturers recommend that therapy with buspirone be administered cautiously in addiction-prone individuals, such as those with a history of alcohol or substance abuse. It may be prudent to refrain from dispensing large quantities of medication to these patients.
Altered Consciousness
Major:
Promethazine DM
The promethazine in Promethazine DM has a major potential interaction with Altered Consciousness.
The use of phenothiazines is contraindicated in comatose patients and patients with severe central nervous system depression. Phenothiazines may potentiate the CNS and respiratory depression in these patients.
Arrhythmia
Major:
Promethazine DM
The promethazine in Promethazine DM has a major potential interaction with Arrhythmia.
Phenothiazines may cause hypotension. Patients with pheochromocytoma, cerebral vascular or renal insufficiency, cardiovascular disease, or a severe cardiac reserve deficiency (e.g., mitral insufficiency) may be more prone to hypotensive reactions. Close monitoring is recommended during treatment if used in at-risk patients; some products may be contraindicated (e.g., thioridazine). Large doses and parenteral administration should be used cautiously, or avoided, in patients with impaired cardiovascular systems.
Asthma
Moderate:
Promethazine DM
The promethazine in Promethazine DM 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.
Bone Marrow Depression/Low Blood Counts
Major:
Promethazine DM
The promethazine in Promethazine DM has a major potential interaction with Bone Marrow Depression/Low Blood Counts.
Phenothiazines may cause hematologic toxicity. In patients with preexisting blood dyscrasias, bone marrow suppression, or a history of drug-induced leukopenia or neutropenia, phenothiazines should not be used or are contraindicated. Complete blood counts should be regularly monitored in patients with risk factors for blood dyscrasias. If white blood cell counts indicate cellular depression, discontinue treatment and institute appropriate therapy.
Breast Cancer
Moderate:
Promethazine DM
The promethazine in Promethazine DM has a moderate potential interaction with Breast Cancer.
The chronic use of phenothiazines is associated with persistent elevations in prolactin levels. The clinical significance in patients with a history of breast cancer is unknown and should be considered prior to therapy; approximately one-third of human breast cancers are thought to be prolactin-dependent. Chronic administration of neuroleptic drugs has been associated with mammary tumorigenesis in animal studies; however, evidence is inconclusive in humans.
Cardiovascular Conditions and Disorders
Major:
Promethazine DM
The promethazine in Promethazine DM has a major potential interaction with Cardiovascular Conditions and Disorders.
Phenothiazines may cause hypotension. Patients with pheochromocytoma, cerebral vascular or renal insufficiency, cardiovascular disease, or a severe cardiac reserve deficiency (e.g., mitral insufficiency) may be more prone to hypotensive reactions. Close monitoring is recommended during treatment if used in at-risk patients; some products may be contraindicated (e.g., thioridazine). Large doses and parenteral administration should be used cautiously, or avoided, in patients with impaired cardiovascular systems.
Central Nervous System Disorders
Moderate:
Promethazine DM
The promethazine in Promethazine DM has a moderate potential interaction with Central Nervous System Disorders.
Phenothiazines can lower the seizure threshold. Caution is recommended during administration in patients with a history of convulsive disorders or EEG abnormalities. Anticonvulsant therapy should be maintained or adequately adjusted during phenothiazine treatment.
Cerebrovascular Insufficiency
Major:
Promethazine DM
The promethazine in Promethazine DM has a major potential interaction with Cerebrovascular Insufficiency.
Phenothiazines may cause hypotension. Patients with pheochromocytoma, cerebral vascular or renal insufficiency, cardiovascular disease, or a severe cardiac reserve deficiency (e.g., mitral insufficiency) may be more prone to hypotensive reactions. Close monitoring is recommended during treatment if used in at-risk patients; some products may be contraindicated (e.g., thioridazine). Large doses and parenteral administration should be used cautiously, or avoided, in patients with impaired cardiovascular systems.
COPD
Moderate:
Promethazine DM
The promethazine in Promethazine DM 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:
Promethazine DM
The promethazine in Promethazine DM has a major potential interaction with Dehydration.
Promethazine has weak central antidopaminergic activity. While its use is rarely associated with adverse effects secondary to dopaminergic blockade, large doses have produced extrapyramidal reactions. During chronic administration and/or high-dose therapy, the usual contraindications, warnings and precautions applicable to phenothiazines should be observed with promethazine.
Depression
Major:
buspirone
busPIRone has a major potential interaction with Depression.
A variety of abnormal thinking and behavior changes have been reported to occur in association with the use of most anxiolytics, sedatives and hypnotics. Some of these changes include decreased inhibition, aggressiveness, agitation, and hallucinations. These drugs can cause or exacerbate mental depression and cause suicidal behavior and ideation. Therapy with these drugs should be administered cautiously in patients with a history of depression or other psychiatric disorders. Patients should be monitored for any changes in mood or behavior. It may be prudent to refrain from dispensing large quantities of medication to these patients.
Drug Dependence
Moderate:
buspirone
busPIRone has a moderate potential interaction with Drug Dependence.
In human and animal studies, buspirone has not shown potential for abuse or diversion, and there is no evidence that it causes tolerance or physical and psychological dependence. However, since it is a CNS-active drug, the manufacturers recommend that therapy with buspirone be administered cautiously in addiction-prone individuals, such as those with a history of alcohol or substance abuse. It may be prudent to refrain from dispensing large quantities of medication to these patients.
Gastrointestinal Obstruction
Moderate:
Promethazine DM
The promethazine in Promethazine DM 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:
buspirone
busPIRone has a moderate potential interaction with Glaucoma/Intraocular Hypertension.
Some hypnotic drugs can have an anticholinergic effect and should be used with caution in patients with glaucoma, and trouble urinating due to retention or enlarged prostate.
Moderate:
Promethazine DM
The promethazine in Promethazine DM 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.
High Blood Pressure
Major:
Promethazine DM
The promethazine in Promethazine DM has a major potential interaction with High Blood Pressure.
Phenothiazines may cause hypotension. Patients with pheochromocytoma, cerebral vascular or renal insufficiency, cardiovascular disease, or a severe cardiac reserve deficiency (e.g., mitral insufficiency) may be more prone to hypotensive reactions. Close monitoring is recommended during treatment if used in at-risk patients; some products may be contraindicated (e.g., thioridazine). Large doses and parenteral administration should be used cautiously, or avoided, in patients with impaired cardiovascular systems.
History - Cerebrovascular Disease
Major:
Promethazine DM
The promethazine in Promethazine DM has a major potential interaction with History - Cerebrovascular Disease.
Phenothiazines may cause hypotension. Patients with pheochromocytoma, cerebral vascular or renal insufficiency, cardiovascular disease, or a severe cardiac reserve deficiency (e.g., mitral insufficiency) may be more prone to hypotensive reactions. Close monitoring is recommended during treatment if used in at-risk patients; some products may be contraindicated (e.g., thioridazine). Large doses and parenteral administration should be used cautiously, or avoided, in patients with impaired cardiovascular systems.
History - Myocardial Infarction
Major:
Promethazine DM
The promethazine in Promethazine DM has a major potential interaction with History - Myocardial Infarction.
Phenothiazines may cause hypotension. Patients with pheochromocytoma, cerebral vascular or renal insufficiency, cardiovascular disease, or a severe cardiac reserve deficiency (e.g., mitral insufficiency) may be more prone to hypotensive reactions. Close monitoring is recommended during treatment if used in at-risk patients; some products may be contraindicated (e.g., thioridazine). Large doses and parenteral administration should be used cautiously, or avoided, in patients with impaired cardiovascular systems.
Hypocalcemia
Major:
Promethazine DM
The promethazine in Promethazine DM has a major potential interaction with Hypocalcemia.
Promethazine has weak central antidopaminergic activity. While its use is rarely associated with adverse effects secondary to dopaminergic blockade, large doses have produced extrapyramidal reactions. During chronic administration and/or high-dose therapy, the usual contraindications, warnings and precautions applicable to phenothiazines should be observed with promethazine.
Hypotension
Major:
Promethazine DM
The promethazine in Promethazine DM has a major potential interaction with Hypotension.
Phenothiazines may cause hypotension. Patients with pheochromocytoma, cerebral vascular or renal insufficiency, cardiovascular disease, or a severe cardiac reserve deficiency (e.g., mitral insufficiency) may be more prone to hypotensive reactions. Close monitoring is recommended during treatment if used in at-risk patients; some products may be contraindicated (e.g., thioridazine). Large doses and parenteral administration should be used cautiously, or avoided, in patients with impaired cardiovascular systems.
Liver Disease
Major:
buspirone
busPIRone has a major potential interaction with Liver Disease.
Buspirone is primarily metabolized by the liver and subsequently eliminated by the kidney. In one study, steady-state area under the plasma concentration-time curve (AUC) of buspirone increased 13-fold in subjects with hepatic impairment and 4-fold in those with renal impairment compared to healthy subjects. Therapy with buspirone is not recommended in the presence of significantly impaired hepatic or renal function.
Major:
Promethazine DM
The promethazine in Promethazine DM has a major potential interaction with Liver Disease.
Therapy with phenothiazines should be administered cautiously or are contraindicated in patients with preexisting liver disease or with a history of jaundice due to phenothiazine hypersensitivity. Patients with a history of hepatic encephalopathy due to cirrhosis may have increased sensitivity to the central nervous system effects of some phenothiazines (e.g., chlorpromazine). Treatment should be discontinued if jaundice occurs.
Moderate:
buspirone
busPIRone has a moderate potential interaction with Liver Disease.
In general, anxiolytics, sedatives and hypnotics are extensively metabolized by the liver. Their plasma clearance may be decreased and their half-life prolonged in patients with impaired hepatic function. Therapy with these drugs should be administered cautiously in patients with liver disease (some are not recommended in severe liver impairment), and the dosage should be adjusted accordingly. Laboratory testing is recommended prior and during treatment.
Neuroleptic Malignant Syndrome
Major:
Promethazine DM
The promethazine in Promethazine DM has a major potential interaction with Neuroleptic Malignant Syndrome.
Promethazine has weak central antidopaminergic activity. While its use is rarely associated with adverse effects secondary to dopaminergic blockade, large doses have produced extrapyramidal reactions. During chronic administration and/or high-dose therapy, the usual contraindications, warnings and precautions applicable to phenothiazines should be observed with promethazine.
Moderate:
Promethazine DM
The promethazine in Promethazine DM has a moderate potential interaction with Neuroleptic Malignant Syndrome.
Therapy with phenothiazines may precipitate or aggravate a potentially fatal symptom complex known as neuroleptic malignant syndrome (NMS). Treatment should not be initiated in patients with active NMS, and should be immediately discontinued if currently administered in such patients. In patients with a history of NMS, introduction or reintroduction of phenothiazines should be carefully considered, since NMS may recur.
Parkinsonism
Moderate:
Promethazine DM
The promethazine in Promethazine DM has a moderate potential interaction with Parkinsonism.
Promethazine has weak central antidopaminergic activity. While its use is rarely associated with adverse effects secondary to dopaminergic blockade, large doses have produced extrapyramidal reactions. During chronic administration and/or high-dose therapy, the usual contraindications, warnings and precautions applicable to phenothiazines should be observed with promethazine.
Pheochromocytoma
Major:
Promethazine DM
The promethazine in Promethazine DM has a major potential interaction with Pheochromocytoma.
Phenothiazines may cause hypotension. Patients with pheochromocytoma, cerebral vascular or renal insufficiency, cardiovascular disease, or a severe cardiac reserve deficiency (e.g., mitral insufficiency) may be more prone to hypotensive reactions. Close monitoring is recommended during treatment if used in at-risk patients; some products may be contraindicated (e.g., thioridazine). Large doses and parenteral administration should be used cautiously, or avoided, in patients with impaired cardiovascular systems.
Pulmonary Impairment
Major:
Promethazine DM
The promethazine in Promethazine DM has a major potential interaction with Pulmonary Impairment.
Promethazine is contraindicated for use in the treatment of lower respiratory tract symptoms including asthma. Furthermore, promethazine tablets may lead to potentially fatal respiratory depression, and its use should be avoided in patients with compromised respiratory function such as patients with COPD, and sleep apnea.
Renal Dysfunction
Major:
buspirone
busPIRone has a major potential interaction with Renal Dysfunction.
Buspirone is primarily metabolized by the liver and subsequently eliminated by the kidney. In one study, steady-state area under the plasma concentration-time curve (AUC) of buspirone increased 13-fold in subjects with hepatic impairment and 4-fold in those with renal impairment compared to healthy subjects. Therapy with buspirone is not recommended in the presence of significantly impaired hepatic or renal function.
Respiratory Arrest
Major:
Promethazine DM
The promethazine in Promethazine DM has a major potential interaction with Respiratory Arrest.
The use of phenothiazines is contraindicated in comatose patients and patients with severe central nervous system depression. Phenothiazines may potentiate the CNS and respiratory depression in these patients.
Seizures
Moderate:
Promethazine DM
The promethazine in Promethazine DM has a moderate potential interaction with Seizures.
Phenothiazines can lower the seizure threshold. Caution is recommended during administration in patients with a history of convulsive disorders or EEG abnormalities. Anticonvulsant therapy should be maintained or adequately adjusted during phenothiazine treatment.
Tardive Dyskinesia
Major:
Promethazine DM
The promethazine in Promethazine DM has a major potential interaction with Tardive Dyskinesia.
Promethazine has weak central antidopaminergic activity. While its use is rarely associated with adverse effects secondary to dopaminergic blockade, large doses have produced extrapyramidal reactions. During chronic administration and/or high-dose therapy, the usual contraindications, warnings and precautions applicable to phenothiazines should be observed with promethazine.
Urinary Retention
Moderate:
buspirone
busPIRone has a moderate potential interaction with Urinary Retention.
Some hypnotic drugs can have an anticholinergic effect and should be used with caution in patients with glaucoma, and trouble urinating due to retention or enlarged prostate.
Moderate:
Promethazine DM
The promethazine in Promethazine DM 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.
Valvular Heart Disease
Major:
Promethazine DM
The promethazine in Promethazine DM has a major potential interaction with Valvular Heart Disease.
Phenothiazines may cause hypotension. Patients with pheochromocytoma, cerebral vascular or renal insufficiency, cardiovascular disease, or a severe cardiac reserve deficiency (e.g., mitral insufficiency) may be more prone to hypotensive reactions. Close monitoring is recommended during treatment if used in at-risk patients; some products may be contraindicated (e.g., thioridazine). Large doses and parenteral administration should be used cautiously, or avoided, in patients with impaired cardiovascular systems.
More resources
buspirone
A total of 554 drugs are known to interact with buspirone.
- Buspirone is in the drug class miscellaneous anxiolytics, sedatives and hypnotics.
-
Buspirone is used to treat the following conditions:
- Anxiety
- Borderline Personality Disorder (off-label)
- Panic Disorder
- Sexual Dysfunction, SSRI Induced (off-label)
Promethazine DM
A total of 773 drugs are known to interact with Promethazine DM.
- Promethazine dm is in the drug class upper respiratory combinations.
- Promethazine dm is used to treat the following conditions:
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.