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Drug Interactions between Combivent and MSP-Blu

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

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Interactions between your drugs

Moderate

ipratropium hyoscyamine

Applies to: Combivent (albuterol / ipratropium) and MSP-Blu (hyoscyamine / methenamine / methylene blue / phenyl salicylate)

Using ipratropium together with hyoscyamine may increase side effects such as drowsiness, blurred vision, dry mouth, heat intolerance, flushing, decreased sweating, difficulty urinating, abdominal cramping, constipation, rapid heart beat, confusion, memory problems, and glaucoma. Although serious side effects are not very common with inhaled or topically applied preparations because only limited amounts of the medication generally get absorbed into the bloodstream from the lungs or skin, they can sometimes occur, especially in the elderly or when combined with other medications that have similar side effects. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact. You should avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how these medications affect you. When using an inhaled product by nebulizer, keep your eyes closed or use an eye mask to avoid having the medication get into the eyes, which can cause blurry vision and eye pain as well as increase absorption of the medication into the bloodstream. When using a topical preparation such as a cream or solution, avoid applying to broken skin or using occlusive dressings over the application areas, and also avoid touching the eyes until after you wash your hands with soap and water. 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

albuterol methylene blue

Applies to: Combivent (albuterol / ipratropium) and MSP-Blu (hyoscyamine / methenamine / methylene blue / phenyl salicylate)

Using albuterol together with methylene blue may increase cardiovascular side effects such as heart palpitations, chest pain, increased heart and pulse rates, and blood pressure elevations. The risk exists even when albuterol or similar medications are given by oral inhalation directly into the lungs, and more so if these products are overused. Talk to your doctor before using these medications if you have a history of heart disease or high blood pressure. Depending on your condition, it may be preferable to wait at least 14 days after you are off methylene blue before you start using albuterol. Do not exceed the dose and frequency of use of albuterol recommended on the product label or prescribed by your doctor. 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

Moderate

hyoscyamine food

Applies to: MSP-Blu (hyoscyamine / methenamine / methylene blue / phenyl salicylate)

Ask your doctor before using hyoscyamine together with ethanol. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking hyoscyamine. You should be warned not to exceed recommended dosages and to avoid activities requiring mental alertness. If your doctor prescribes these medications together, you may need a dose adjustment to safely take this combination. 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

albuterol food

Applies to: Combivent (albuterol / ipratropium)

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

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Anticholinergics/antispasmodics

Therapeutic duplication

The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category:

  • Combivent (albuterol/ipratropium)
  • MSP-Blu (hyoscyamine/methenamine/methylene blue/phenyl salicylate)

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.


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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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