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Drug Interactions between chlorpheniramine / ibuprofen / pseudoephedrine and pitolisant

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

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Interactions between your drugs

Moderate

ibuprofen pitolisant

Applies to: chlorpheniramine / ibuprofen / pseudoephedrine and pitolisant

MONITOR: Concomitant use of pitolisant with NSAIDs and/or corticosteroids may increase the risk of gastrointestinal adverse effects such as dyspepsia, abdominal pain or discomfort, and gastritis due to potential additive irritant effects on the gastrointestinal mucosa. Clinical studies with pitolisant reported gastric disorders caused by hyperacidity in 3.5% of patients. However, the effects were described as mostly mild to moderate in severity. Data are not available on the potential for serious gastrointestinal (GI) toxicity, including inflammation, bleeding, ulceration, and perforation.

MANAGEMENT: Caution is advised if pitolisant is used in combination with NSAIDs and/or corticosteroids, particularly in patients with a prior history of peptic ulcer disease or GI bleeding and in elderly or debilitated patients. If concomitant therapy is required, patients should be advised to report signs and symptoms of adverse GI effects, including abdominal pain or discomfort, dyspepsia, gastroesophageal reflux disease, gastritis, or the appearance of black, tarry stools.

References (1)
  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
Moderate

chlorpheniramine pitolisant

Applies to: chlorpheniramine / ibuprofen / pseudoephedrine and pitolisant

GENERALLY AVOID: Because pitolisant enhances the activity of histaminergic neurons in the brain, centrally acting histamine H1-receptor antagonists or medicines with H1-receptor antagonist properties (e.g., tri- and tetracyclic antidepressants) may impair the efficacy of pitolisant.

MANAGEMENT: According to the manufacturer, coadministration of pitolisant with centrally acting H1-receptor antagonists or tri- and tetracyclic antidepressants should be avoided.

References (2)
  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. (2019) "Product Information. Wakix (pitolisant)." Harmony Biosciences, LLC

Drug and food interactions

Moderate

chlorpheniramine food

Applies to: chlorpheniramine / ibuprofen / pseudoephedrine

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References (4)
  1. Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
  3. (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
  4. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
Moderate

ibuprofen food

Applies to: chlorpheniramine / 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)
  1. (2002) "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn
Moderate

pseudoephedrine food

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

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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