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Drug Interactions between chlorpheniramine / ibuprofen / pseudoephedrine and probenecid

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

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Interactions between your drugs

Minor

ibuprofen probenecid

Applies to: chlorpheniramine / ibuprofen / pseudoephedrine and probenecid

Probenecid may interfere with the plasma protein binding, metabolism, and/or renal elimination of nonsteroidal anti-inflammatory drugs (NSAIDs), resulting in increased NSAID plasma levels. The risk of NSAID toxicity may be increased. Although adverse effects from this interaction have not been reported, patients receiving this combination should be monitored for increased NSAID side effects. Patients should be advised to report possible signs of NSAID toxicity such as dizziness, drowsiness, headache, tinnitus, nausea, vomiting, dyspepsia, abdominal pain, diarrhea, or black tarry stools.

References (8)
  1. Sinclair H, Gibson T (1986) "Interaction between probenecid and indomethacin." Br J Rheumatol, 25, p. 316-7
  2. Upton RA, Williams RL, Buskin JN, Jones RM (1982) "Effects of probenecid in ketoprofen kinetics." Clin Pharmacol Ther, 31, p. 705-12
  3. Foster RT, Jamali F, Russell AS (1989) "Pharmacokinetics of ketoprofen anentiomers in cholecystectomy patients: influence of probenecid." Eur J Clin Pharmacol, 37, p. 589-94
  4. Brogden RN, Heel RC, Speight TM, Avery GS (1979) "Naproxen up to date: a review of its pharmacological properties and therapeutic efficacy and use in rheumatic diseases and pain states." Drugs, 18, p. 241-77
  5. Runkel R, Mroszczak E, Chaplin M, et al. (1978) "Naproxen-probenecid interaction." Clin Pharmacol Ther, 24, p. 706-13
  6. Diamond JS, Paolino JS (1973) "Evidence for a postsecretory reabsorptive site for uric acid in man." J Clin Invest, 52, p. 1491-9
  7. Mroszczak EJ, Combs DL, Goldblum R, et al. (1992) "The effect of probenecid on ketorolac pharmacokinetics after oral dosing of ketorolac tromethamine." Clin Pharmacol Ther, 51, p. 154
  8. Macdonald JI, Wallace SM, Herman RJ, Verbeeck RK (1995) "Effect of propenecid on the formation and elimination kinetics of the sulphate and glucuronide conjugates of diflunisal." Eur J Clin Pharmacol, 47, p. 519-23

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.


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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.