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Drug Interactions between Comtrex Non Drowsy Liquigel and MSP-Blu

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

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Interactions between your drugs

Major

dextromethorphan methylene blue

Applies to: Comtrex Non Drowsy Liquigel (acetaminophen / dextromethorphan / phenylpropanolamine) and MSP-Blu (hyoscyamine / methenamine / methylene blue / phenyl salicylate)

Using methylene blue together with dextromethorphan is not recommended. Combining these medications can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. In general, you should wait at least 14 days after stopping methylene blue before you start treatment with dextromethorphan. Conversely, if you have recently been on dextromethorphan and are now starting treatment with methylene blue, you should check with your doctor or pharmacist to see how long you should wait before it is safe for you to use methylene blue, as some medications can take a while to clear from your body. 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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Major

phenylpropanolamine methylene blue

Applies to: Comtrex Non Drowsy Liquigel (acetaminophen / dextromethorphan / phenylpropanolamine) and MSP-Blu (hyoscyamine / methenamine / methylene blue / phenyl salicylate)

Using methylene blue together with phenylpropanolamine is not recommended. Combining these medications can cause dangerously high blood pressure and even death. You may use phenylpropanolamine only after you have been off methylene blue for at least 14 days. You should seek immediate medical attention if you experience sudden and severe headache, blurred vision, confusion, seizures, chest pain, nausea or vomiting, sudden numbness or weakness (especially on one side of the body), speech difficulties, fever, sweating, lightheadedness, and/or fainting during treatment with methylene blue, as these may be signs and symptoms of excessively high blood pressure. 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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Minor

acetaminophen hyoscyamine

Applies to: Comtrex Non Drowsy Liquigel (acetaminophen / dextromethorphan / phenylpropanolamine) and MSP-Blu (hyoscyamine / methenamine / methylene blue / phenyl salicylate)

Information for this minor interaction is available on the professional version.

Drug and food interactions

Major

acetaminophen food

Applies to: Comtrex Non Drowsy Liquigel (acetaminophen / dextromethorphan / phenylpropanolamine)

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: Comtrex Non Drowsy Liquigel (acetaminophen / dextromethorphan / phenylpropanolamine)

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

phenylpropanolamine food

Applies to: Comtrex Non Drowsy Liquigel (acetaminophen / dextromethorphan / phenylpropanolamine)

Using phenylpropanolamine with alcohol can increase the risk of cardiovascular side effects such as increased heart rate, chest pain, or blood pressure changes. In addition, you may also be more likely to experience nervous system side effects such as dizziness, drowsiness, depression, and difficulty concentrating. You should avoid or limit the use of alcohol while being treated with phenylpropanolamine. Do not use more than the recommended dose of phenylpropanolamine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medication without first talking to your doctor.

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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

phenylpropanolamine food

Applies to: Comtrex Non Drowsy Liquigel (acetaminophen / dextromethorphan / phenylpropanolamine)

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.

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