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Drug Interactions between cocaine nasal and Guaifenex PSE 80

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

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Interactions between your drugs

Major

pseudoephedrine cocaine nasal

Applies to: Guaifenex PSE 80 (guaifenesin / pseudoephedrine) and cocaine nasal

GENERALLY AVOID: Concomitant use of cocaine with sympathomimetic agents such as epinephrine and phenylephrine may lead to additive cardiovascular effects. The proposed mechanism involves increased circulating catecholamines and increased activity of the sympathetic nervous system. Locally administered cocaine and epinephrine have been used in combination during septal surgery; however, concerns regarding cardiovascular side effects have been raised. Myocardial ischemia, myocardial infarction, and ventricular arrhythmias have been reported following coadministration of topical intranasal cocaine with epinephrine and phenylephrine during nasal and sinus surgery. Cases documenting the development of arrhythmias after the nasal application of cocaine and epinephrine 25%-0.18% topical paste have also been reported in 2 children and one adult receiving general anesthesia. However, the dosage of cocaine administered in these cases was above the maximum recommended dose in fit adults (1.5 mg/kg).

MANAGEMENT: Concomitant use of cocaine with sympathomimetic agents should be avoided. If coadministration is required, prolonged vital sign and ECG monitoring may be necessary.

References (7)
  1. (2022) "Product Information. Adrenalin (EPINEPHrine)." Apothecon Inc
  2. Nicholson K, Rogers J (1995) "Cocaine and adrenaline paste: a fatal combination?" Br Med J, 311, p. 250-1
  3. (2003) "Product Information. Cocaine Hydrochloride (cocaine topical)." Mallinckrodt Medical Inc
  4. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  5. (2018) "Product Information. Cocaine Hydrochloride Nasal (cocaine nasal)." Genus Lifesciences Inc.
  6. Thevasagyam M, Jindal M, Allsop P, Oates J (2007) "Does epinephrine infiltration in septoplasty make any difference?" Eur Arch Otorhinolaryngol, 264, p. 1175-8
  7. Kara CO, Kaftan A, Atalay H, Pinar HS, Ogmen G (2001) "Cardiovascular safety of cocaine anaesthesia in the presence of adrenaline during septal surger." J Otolaryngol, 30, p. 145-8

Drug and food interactions

Moderate

pseudoephedrine food

Applies to: Guaifenex PSE 80 (guaifenesin / 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.

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