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Drug Interactions between Combigan and Tylenol Plus Children's Cold & Cough

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

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Interactions between your drugs

Moderate

phenylephrine timolol ophthalmic

Applies to: Tylenol Plus Children's Cold & Cough (acetaminophen / dextromethorphan / phenylephrine) and Combigan (brimonidine / timolol ophthalmic)

Using phenylephrine together with a beta-blocker like timolol ophthalmic may lead to an increase in blood pressure. Some beta-blockers may enhance the effects of phenylephrine, which can lead to constriction of your blood vessels and an increase in blood pressure. Contact your doctor if your condition changes. You may need a dose adjustment or your blood pressure checked more often if you use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

dextromethorphan brimonidine ophthalmic

Applies to: Tylenol Plus Children's Cold & Cough (acetaminophen / dextromethorphan / phenylephrine) and Combigan (brimonidine / timolol ophthalmic)

After using brimonidine ophthalmic, some of the medication may be absorbed into the bloodstream and occasionally produce central nervous system side effects such as dizziness, drowsiness, and difficulty concentrating. Combining it with dextromethorphan or other medications that can also have these effects may increase the risk. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

timolol ophthalmic brimonidine ophthalmic

Applies to: Combigan (brimonidine / timolol ophthalmic) and Combigan (brimonidine / timolol ophthalmic)

After using brimonidine ophthalmic, some of the medication may be absorbed into the bloodstream and occasionally produce cardiovascular side effects such as decreases in blood pressure and heart rate. Combining it with timolol ophthalmic or other medications that can also have these effects may increase the risk. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart beat. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Drug and food interactions

Major

acetaminophen food

Applies to: Tylenol Plus Children's Cold & Cough (acetaminophen / dextromethorphan / phenylephrine)

Ask your doctor before using acetaminophen together with ethanol. This can cause serious side effects that affect your liver. Call your doctor immediately if you experience a fever, chills, joint pain or swelling, excessive tiredness or weakness, unusual bleeding or bruising, skin rash or itching, loss of appetite, nausea, vomiting, or yellowing of the skin or the whites of your eyes. If your doctor does prescribe these medications together, you may need a dose adjustment or special tests to safely take both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

dextromethorphan food

Applies to: Tylenol Plus Children's Cold & Cough (acetaminophen / dextromethorphan / phenylephrine)

Alcohol can increase the nervous system side effects of dextromethorphan such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with dextromethorphan. Do not use more than the recommended dose of dextromethorphan, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

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Moderate

phenylephrine food

Applies to: Tylenol Plus Children's Cold & Cough (acetaminophen / dextromethorphan / phenylephrine)

Consumer information for this interaction is not currently available.

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

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.