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Drug Interactions between C-Topical Solution 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

Major

methylene blue cocaine topical

Applies to: hyoscyamine / methenamine / methylene blue / sodium biphosphate and C-Topical Solution (cocaine topical)

GENERALLY AVOID: Cocaine exerts an indirect sympathomimetic effect and may precipitate hypertensive reactions and hyperpyrexia in patients treated with monoamine oxidase inhibitors (MAOIs), as has been reported with other indirect- or mixed-acting sympathomimetic agents such as amphetamine and ephedrine. The mechanism involves a synergistic effect due to enhanced norepinephrine storage in adrenergic neurons (MAOI activity) and decreased reuptake of catecholamines (indirect sympathomimetic activity). Headache, blood pressure increases, palpitations, and chest tightness were reported in two patients who used cocaine while receiving phenelzine for cocaine addiction. Increased serotonergic activity may also occur. An interaction resulting in unconsciousness, tremors, and muscle rigidity was suspected in a patient on phenelzine therapy who received 1 mL of a 10% cocaine spray to his vocal chords prior to surgery.

MANAGEMENT: In general, indirect-acting sympathomimetic agents such as cocaine should not be used concurrently with MAOIs or other agents that possess MAOI activity (e.g., furazolidone, linezolid, methylene blue, procarbazine). At least 14 days should elapse between discontinuation of MAOI therapy and initiation of treatment with sympathomimetic agents.

References

  1. Smith RB (1973) "Cocaine and catecholamine interaction. A review." Arch Otolaryngol, 98, p. 139-41
  2. Tordoff SG, Stubbing JF, Linter SP (1991) "Delayed excitatory reaction following interaction of cocaine and monoamine oxidase inhibitor (phenelzine)." Br J Anaesth, 66, p. 516-8
  3. Brewer C (1993) "Treatment of cocaine abuse with monoamine oxidase inhibitors." Br J Psychiatry, 163, p. 815-6
  4. (2001) "Product Information. Nardil (phenelzine)." Parke-Davis
  5. (2001) "Product Information. Parnate (tranylcypromine)." SmithKline Beecham
  6. (2001) "Product Information. Marplan (isocarboxazid)." Roche Laboratories
  7. (2018) "Product Information. Cocaine Hydrochloride Nasal (cocaine nasal)." Genus Lifesciences Inc.
View all 7 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. (2022) "Product Information. Prepopik (citric acid/Mg oxide/Na picosulfate)." Ferring Pharmaceuticals Inc

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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 (1973) "Drug effects on psychomotor skills related to driving: interaction of atropine, glycopyrrhonium and alcohol." Eur J Clin Pharmacol, 6, p. 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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