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Drug Interactions between Citrucel and pyridostigmine

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

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Interactions between your drugs

Moderate

pyRIDostigmine methylcellulose

Applies to: pyridostigmine and Citrucel (methylcellulose)

MONITOR: Limited data suggest that methylcellulose may interfere with the gastrointestinal absorption of pyridostigmine. The mechanism of interaction has not been established. In a study evaluating plasma pyridostigmine levels in 16 patients receiving pyridostigmine for myasthenia gravis, one subject who was also taking oral methylcellulose during the study was found to have undetectable pyridostigmine levels on two separate occasions. After stopping methylcellulose, the subject demonstrated a pattern of pyridostigmine in plasma similar to that of the other subjects. No other detail is available regarding the potential interaction.

MANAGEMENT: Caution may be advisable during concomitant use of pyridostigmine and methylcellulose. Consideration may be given to separating the times of administration by as much as possible or avoiding the use of methylcellulose if an interaction is suspected. It is not known if cellulose can also cause this interaction.

References (3)
  1. White MC, De Silva P, Havard CW (1981) "Plasma pyridostigmine levels in myasthenia gravis." Neurology, 31, p. 145-50
  2. Aquilonius S-M, Hartvig P (1986) "Clinical pharmacokinetics of cholinesterase inhibitors." Clin Pharmacokinet, 11, p. 236-49
  3. Cerner Multum, Inc. "UK Summary of Product Characteristics."

Drug and food interactions

Moderate

methylcellulose food

Applies to: Citrucel (methylcellulose)

ADJUST DOSING INTERVAL: Bulk-forming laxatives such as guar gum, psyllium, polycarbophil, or methylcellulose may affect the bioavailability of concomitantly administered substances due to their effect on the rate of gastrointestinal transit and gastric emptying.

MANAGEMENT: In general, oral medications should be administered at least 2 hours before or 2 hours after dosing of the bulk-forming laxative.

References (1)
  1. (2001) "Product Information. Metamucil (psyllium)." Procter and Gamble Pharmaceuticals

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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