Drug Interactions between caffeine / pheniramine / phenylephrine / sodium citrate / sodium salicylate and peppermint oil

Both phenylephrine 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.

Using sodium citrate together with sodium salicylate may decrease the effects of sodium salicylate. Contact your doctor if your condition changes. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. 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.

The following interaction applies to enteric-coated, gastro-resistant formulations of peppermint oil (usually delayed or sustained release capsules):

Acid-lowering agents like sodium citrate may disrupt the release mechanism of delayed or extended release formulations of peppermint oil by causing premature dissolution of the enteric coating in the stomach, resulting in early release of the peppermint oil. This can lead to gastrointestinal irritation such as heartburn, indigestion, nausea and vomiting, as well as reduced effectiveness of the medication. If you are taking an enteric-coated, gastro-resistant formulation of peppermint oil and require the use of antacids (medications that neutralize stomach acid such as Alka-Seltzer, Gaviscon, Gelusil, Maalox, Milk of Magnesia, Mylanta, Rolaids, and Tums), you should separate their times of administration by at least 2 hours. Acid suppressants such as cimetidine (Tagamet), famotidine (Pepcid), ranitidine (Zantac), esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), and pantoprazole (Protonix) should generally be avoided if possible. Talk to your doctor or pharmacist if you have questions on how to take peppermint oil or any of your other medications. 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.