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Drug Interactions between carvedilol and Motrin Childrens Cold

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

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Interactions between your drugs

Moderate

ibuprofen carvedilol

Applies to: Motrin Childrens Cold (ibuprofen / pseudoephedrine) and carvedilol

MONITOR: Nonsteroidal anti-inflammatory drugs (NSAIDs) may attenuate the antihypertensive effect of beta-blockers. The proposed mechanism is NSAID-induced inhibition of renal prostaglandin synthesis, which results in unopposed pressor activity producing hypertension. In addition, NSAIDs can cause fluid retention, which also affects blood pressure. Indomethacin and piroxicam have been reported to have greater attenuating effects than other NSAIDs, and indomethacin effects may be significant in patients with eclampsia.

MANAGEMENT: Patients receiving a beta-blocker who require prolonged (greater than 1 week) concomitant therapy with an NSAID should have blood pressure monitored more closely following initiation, discontinuation, or change of dosage of the NSAID. The interaction is not expected to occur with low doses (e.g., low-dose aspirin) or intermittent short-term administration of NSAIDs.

References

  1. Salvetti A, Pedrinelli R, Alberici P, Magagna A, Abdel-Haq B "The influence of indomethacin and sulindac on some pharmacological actions of atenolol in hypertensive patients." Br J Clin Pharmacol 17 Suppl 1 (1984): s108-11
  2. Ylitalo P, Pitkajarvi T, Pyykonen ML, Nurmi AK, Seppala E, Vapaatalo H "Inhibition of prostaglandin synthesis by indomethacin interacts with the antihypertensive effect of atenolol." Clin Pharmacol Ther 38 (1985): 443-9
  3. Radack KL, Deck CC, Bloomfield SS "Ibuprofen interferes with the efficacy of antihypertensive drugs." Ann Intern Med 107 (1987): 628-35
  4. Wong DG, Spence JD, Lamki L, Freeman D, McDonald JW "Effect of non-steroidal anti-inflammatory drugs on control of hypertension by beta-blockers and diuretics." Lancet 1 (1986): 997-1001
  5. Durao V, Prata MM, Goncalves LM "Modification of antihypertensive effect of beta-adrenoceptor-blocking agents by inhibition of endogenous prostaglandin synthesis." Lancet 2 (1977): 1005-7
  6. Abate MA, Neely JL, Layne RD, D'Allessandri R "Interaction of indomethacin and sulindac with labetalol." Br J Clin Pharmacol 31 (1991): 363-6
  7. Salvetti A, Arzilli F, Pedrinelli R, Beggi P, Motolese M "Interaction between oxprenolol and indomethacin on blood pressure in essential hypertensive patients." Eur J Clin Pharmacol 22 (1982): 197-201
  8. Durao V, Prata MM, Concalves LM "Modification of antihypertensive effect of B-adrenoceptor-blocking agents by inhibition of endogenous prostaglandin synthesis." Lancet 2 (1977): 1005-7
  9. Hartmann D, Stief G, Lingenfelder M, Guzelhan C, Horsch AK "Study on the possible interaction between tenoxicam and atenolol in hypertensive patients." Arzneimittelforschung 45-1 (1995): 494-8
View all 9 references

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Moderate

pseudoephedrine carvedilol

Applies to: Motrin Childrens Cold (ibuprofen / pseudoephedrine) and carvedilol

MONITOR: Sympathomimetic agents, such as pseudoephedrine, may antagonize the effects of antihypertensives that interfere with sympathetic activity, such as alpha- and beta-adrenergic blocking agents. In contrast, alpha- and beta-blockers may diminish the vasoconstrictive effects of sympathomimetics. The mechanism of this interaction has not been reported, but may involve competitive inhibition at the adrenergic receptor. Severe hypertension may occur in patients receiving beta-blockers.

MANAGEMENT: Caution and close monitoring of blood pressure is recommended if pseudoephedrine is administered with these antihypertensives. Discontinuation of the sympathomimetic may be necessary if hypertension develops.

References

  1. "Product Information. Allegra-D (fexofenadine-pseudoephedrine)." Chattem Consumer Products PROD (2001):
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  3. Cerner Multum, Inc. "Australian Product Information." O 0

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Drug and food interactions

Moderate

ibuprofen food

Applies to: Motrin Childrens Cold (ibuprofen / pseudoephedrine)

GENERALLY AVOID: The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.

MANAGEMENT: Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.

References

  1. "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn PROD (2002):

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Moderate

pseudoephedrine food

Applies to: Motrin Childrens Cold (ibuprofen / pseudoephedrine)

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.

References

  1. Rosenblatt JE, Lake CR, van Kammen DP, Ziegler MG, Bunney WE Jr "Interactions of amphetamine, pimozide, and lithium on plasma norepineophrine and dopamine-beta-hydroxylase in schizophrenic patients." Psychiatry Res 1 (1979): 45-52
  2. Cavanaugh JH, Griffith JD, Oates JA "Effect of amphetamine on the pressor response to tyramine: formation of p-hydroxynorephedrine from amphetamine in man." Clin Pharmacol Ther 11 (1970): 656
  3. "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc PROD (2001):
  4. "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals PROD (2001):
  5. "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals PROD (2001):
  6. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):
  7. "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company (2002):
View all 7 references

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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.

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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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