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Can you take De-Congestine with Paramethadione?

1 drug interaction and 33 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

chlorpheniramine paramethadione

Applies to: De-Congestine (chlorpheniramine / pseudoephedrine) and paramethadione

Using chlorpheniramine together with paramethadione may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. 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. 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.

Food/lifestyle interactions

Moderate food/lifestyle interactions

Moderate:

chlorpheniramine Food/Lifestyle

Applies to: De-Congestine (chlorpheniramine / pseudoephedrine)

Alcohol can increase the nervous system side effects of chlorpheniramine 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 chlorpheniramine. Do not use more than the recommended dose of chlorpheniramine, 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.

Moderate:

paramethadione Food/Lifestyle

Applies to: paramethadione

Alcohol can increase the nervous system side effects of paramethadione 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 paramethadione. Do not use more than the recommended dose of paramethadione, 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.

Moderate:

pseudoephedrine Caffeine

Applies to: De-Congestine (chlorpheniramine / pseudoephedrine)

Both pseudoephedrine and caffeine can increase blood pressure and heart rate, and combining them may enhance these effects. Talk to your doctor before using these medications, especially if you have a history of high blood pressure or heart disease. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects. 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.

Disease interactions

30 potential interactions Applies to: 24 conditions, including Depression, Asthma, Benign Prostatic Hyperplasia, COPD, and Hypotension.

Asthma

Moderate:

De-Congestine

The chlorpheniramine in De-Congestine has a moderate potential interaction with Asthma.

It has been suggested that the anticholinergic effect of antihistamines may reduce the volume and cause thickening of bronchial secretions, resulting in obstruction of respiratory tract. Some manufacturers and clinicians recommend that therapy with antihistamines be administered cautiously in patients with asthma or chronic obstructive pulmonary disease.

Benign Prostatic Hyperplasia

Moderate:

De-Congestine

The pseudoephedrine in De-Congestine has a moderate potential interaction with Benign Prostatic Hyperplasia.

Sympathomimetic agents may cause or worsen urinary difficulty in patients with prostate enlargement due to smooth muscle contraction in the bladder neck via stimulation of alpha-1 adrenergic receptors. Therapy with sympathomimetic agents should be administered cautiously in patients with hypertrophy or neoplasm of the prostate.

Bone Marrow Depression/Low Blood Counts

Major:

paramethadione

Paramethadione has a major potential interaction with Bone Marrow Depression/Low Blood Counts.

Hematologic toxicities have been associated with the use of oxazolidinedione anticonvulsants. Fatal aplastic anemia, hypoplastic anemia, pancytopenia, agranulocytosis, leukopenia, neutropenia, thrombocytopenia, eosinophilia, retinal and petechial hemorrhages, vaginal bleeding, epistaxis, and bleeding gums have been reported. Therapy with oxazolidinediones should be administered cautiously, if at all, in patients with preexisting blood dyscrasias and/or bone marrow depression. Complete blood counts, including platelets, should be performed in all patients prior to initiating therapy and at monthly intervals, or as often as necessary, thereafter. A moderate degree of neutropenia, with or without a corresponding drop in the leukocyte count, is not uncommon and does not necessitate the discontinuation of therapy. However, more frequent monitoring is recommended if neutrophil count is less than 3000/mm3. Marked depression of blood counts (e.g., neutrophil count < 2500/mm3) is indication for withdrawal of oxazolidinedione therapy. Therapy with oxazolidinediones should ordinarily not be used in patients with severe blood dyscrasias.

Cardiovascular Conditions and Disorders

Major:

De-Congestine

The pseudoephedrine in De-Congestine has a major potential interaction with Cardiovascular Conditions and Disorders.

Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.

Moderate:

De-Congestine

The chlorpheniramine in De-Congestine has a moderate potential interaction with Cardiovascular Conditions and Disorders.

Antihistamines may infrequently cause cardiovascular adverse effects related to their anticholinergic and local anesthetic (quinidine-like) activities. Tachycardia, palpitation, ECG changes, arrhythmias, hypotension, and hypertension have been reported. Although these effects are uncommon and usually limited to overdosage situations, the manufacturers and some clinicians recommend that therapy with antihistamines be administered cautiously in patients with cardiovascular disease, hypertension, and/or hyperthyroidism.

Cerebrovascular Insufficiency

Major:

De-Congestine

The pseudoephedrine in De-Congestine has a major potential interaction with Cerebrovascular Insufficiency.

Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.

COPD

Moderate:

De-Congestine

The chlorpheniramine in De-Congestine has a moderate potential interaction with COPD.

It has been suggested that the anticholinergic effect of antihistamines may reduce the volume and cause thickening of bronchial secretions, resulting in obstruction of respiratory tract. Some manufacturers and clinicians recommend that therapy with antihistamines be administered cautiously in patients with asthma or chronic obstructive pulmonary disease.

Depression

Moderate:

paramethadione

Paramethadione has a moderate potential interaction with Depression.

Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. AEDs should be administered cautiously in patients with depression or other psychiatric disorders; phentermine-topiramate should be avoided in patients with history of suicidal attempts or active suicidal ideation. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. If patients have symptoms of suicidal ideation or behavior, a dosage reduction or treatment discontinuation should be considered.

Dermatitis, Drug-Induced

Major:

paramethadione

Paramethadione has a major potential interaction with Dermatitis, Drug-Induced.

Potentially serious reactions to oxazolidinedione anticonvulsants such as exfoliative dermatitis and severe forms of erythema multiforme have been reported. Therapy with oxazolidinediones should be administered cautiously in patients with preexisting drug-induced dermatitis, since it may delay the recognition of a potential reaction to oxazolidinediones. Oxazolidinedione therapy should be withdrawn promptly at the first sign of a dermatologic adverse effect. Even a minor acneiform or morbilliform rash should be allowed to clear completely before treatment with these agents is resumed.

Diabetes Mellitus

Moderate:

De-Congestine

The pseudoephedrine in De-Congestine has a moderate potential interaction with Diabetes Mellitus.

Sympathomimetic agents may cause increases in blood glucose concentrations. These effects are usually transient and slight but may be significant with dosages higher than those normally recommended. Therapy with sympathomimetic agents should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate.

Gastrointestinal Obstruction

Moderate:

De-Congestine

The pseudoephedrine in De-Congestine has a moderate potential interaction with Gastrointestinal Obstruction.

The extended-release formulation of pseudoephedrine (Sudafed 24 Hour) contains a non-deformable material. There have been rare reports of obstructive symptoms in patients with known strictures following the ingestion of similar sustained-release products. Therapy with the extended-release formulation of pseudoephedrine should be administered cautiously in patients with preexisting severe gastrointestinal narrowing or obstruction, whether pathologic or iatrogenic.

Moderate:

De-Congestine

The chlorpheniramine in De-Congestine has a moderate potential interaction with Gastrointestinal Obstruction.

Antihistamines often have anticholinergic activity, to which elderly patients are particularly sensitive. Therapy with antihistamines should be administered cautiously, if at all, in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders. Conventional, first-generation antihistamines such as the ethanolamines (bromodiphenhydramine, carbinoxamine, clemastine, dimenhydrinate, diphenhydramine, doxylamine, phenyltoloxamine) tend to exhibit substantial anticholinergic effects. In contrast, the newer, relatively nonsedating antihistamines (e.g., cetirizine, fexofenadine, loratadine) reportedly have low to minimal anticholinergic activity at normally recommended dosages and may be appropriate alternatives.

Glaucoma/Intraocular Hypertension

Moderate:

De-Congestine

The pseudoephedrine in De-Congestine has a moderate potential interaction with Glaucoma/Intraocular Hypertension.

Sympathomimetic agents can induce transient mydriasis via stimulation of alpha-1 adrenergic receptors. In patients with anatomically narrow angles or narrow-angle glaucoma, pupillary dilation can provoke an acute attack. In patients with other forms of glaucoma, mydriasis may occasionally increase intraocular pressure. Therapy with sympathomimetic agents should be administered cautiously in patients with or predisposed to glaucoma, particularly narrow-angle glaucoma.

Moderate:

De-Congestine

The chlorpheniramine in De-Congestine has a moderate potential interaction with Glaucoma/Intraocular Hypertension.

Antihistamines often have anticholinergic activity, to which elderly patients are particularly sensitive. Therapy with antihistamines should be administered cautiously, if at all, in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders. Conventional, first-generation antihistamines such as the ethanolamines (bromodiphenhydramine, carbinoxamine, clemastine, dimenhydrinate, diphenhydramine, doxylamine, phenyltoloxamine) tend to exhibit substantial anticholinergic effects. In contrast, the newer, relatively nonsedating antihistamines (e.g., cetirizine, fexofenadine, loratadine) reportedly have low to minimal anticholinergic activity at normally recommended dosages and may be appropriate alternatives.

Hyperthyroidism

Major:

De-Congestine

The pseudoephedrine in De-Congestine has a major potential interaction with Hyperthyroidism.

Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.

Moderate:

De-Congestine

The chlorpheniramine in De-Congestine has a moderate potential interaction with Hyperthyroidism.

Antihistamines may infrequently cause cardiovascular adverse effects related to their anticholinergic and local anesthetic (quinidine-like) activities. Tachycardia, palpitation, ECG changes, arrhythmias, hypotension, and hypertension have been reported. Although these effects are uncommon and usually limited to overdosage situations, the manufacturers and some clinicians recommend that therapy with antihistamines be administered cautiously in patients with cardiovascular disease, hypertension, and/or hyperthyroidism.

Hypotension

Moderate:

De-Congestine

The chlorpheniramine in De-Congestine has a moderate potential interaction with Hypotension.

Antihistamines may infrequently cause cardiovascular adverse effects related to their anticholinergic and local anesthetic (quinidine-like) activities. Tachycardia, palpitation, ECG changes, arrhythmias, hypotension, and hypertension have been reported. Although these effects are uncommon and usually limited to overdosage situations, the manufacturers and some clinicians recommend that therapy with antihistamines be administered cautiously in patients with cardiovascular disease, hypertension, and/or hyperthyroidism.

Liver Disease

Major:

paramethadione

Paramethadione has a major potential interaction with Liver Disease.

Hepatitis has been associated rarely with the use of oxazolidinedione anticonvulsants. In addition, these agents are primarily metabolized by the liver and may accumulate in the presence of liver disease. Therapy with oxazolidinediones should be administered cautiously, if at all, in patients with hepatic impairment. Liver function tests should be performed in all patients prior to initiating therapy and at monthly intervals, or as often as necessary, thereafter. The development of jaundice or other signs of liver dysfunction is indication for withdrawal of oxazolidinedione therapy.

Moderate:

De-Congestine

The chlorpheniramine in De-Congestine has a moderate potential interaction with Liver Disease.

Limited pharmacokinetic data are available for the older, first-generation antihistamines. Many appear to be primarily metabolized by the liver, and both parent drugs and metabolites are excreted in the urine. Patients with renal and/or liver disease may be at greater risk for adverse effects from antihistamines due to drug and metabolite accumulation. Therapy with antihistamines should be administered cautiously in such patients. Lower initial dosages may be appropriate.

Lupus Erythematosus

Moderate:

paramethadione

Paramethadione has a moderate potential interaction with Lupus Erythematosus.

Manifestations of systemic lupus erythematosus (SLE) have been associated with the use of oxazolidinedione anticonvulsants. Therapy with oxazolidinediones should be administered cautiously in patients with preexisting SLE. The development or exacerbation of SLE symptoms is indication for withdrawal of oxazolidinedione therapy.

Myasthenia Gravis

Moderate:

paramethadione

Paramethadione has a moderate potential interaction with Myasthenia Gravis.

A myasthenia gravis-like syndrome has been associated with the chronic use of oxazolidinedione anticonvulsants. Therapy with oxazolidinediones should be administered cautiously in patients with myasthenia gravis. The development or exacerbation of myasthenic symptoms is indication for withdrawal of oxazolidinedione therapy.

Optic Nerve Disorder

Major:

paramethadione

Paramethadione has a major potential interaction with Optic Nerve Disorder.

Hemeralopia has occurred with the use of oxazolidinedione anticonvulsants, probably as a result of the drugs' effects on the neural layers of the retina. The condition may be reversed by a reduction in dosage. Therapy with oxazolidinediones should be administered cautiously in patients with diseases of the retina or optic nerve. The development of scotomata or other significant ocular abnormality is indication for withdrawal of oxazolidinedione therapy.

Phenylketonuria

Moderate:

De-Congestine

The pseudoephedrine in De-Congestine has a moderate potential interaction with Phenylketonuria.

Chewable products frequently may contain aspartame, which is metabolized in the gastrointestinal tract to phenylalanine. Sudafed (brand of pseudoephedrine) chewable 15 mg tablets provide the equivalent of 0.78 mg of phenylalanine per each tablet. The aspartame/phenylalanine content should be considered when this and similar products are used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics).

Pheochromocytoma

Major:

De-Congestine

The pseudoephedrine in De-Congestine has a major potential interaction with Pheochromocytoma.

Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.

Prostate Tumor, Benign

Moderate:

De-Congestine

The pseudoephedrine in De-Congestine has a moderate potential interaction with Prostate Tumor, Benign.

Sympathomimetic agents may cause or worsen urinary difficulty in patients with prostate enlargement due to smooth muscle contraction in the bladder neck via stimulation of alpha-1 adrenergic receptors. Therapy with sympathomimetic agents should be administered cautiously in patients with hypertrophy or neoplasm of the prostate.

Psychosis

Moderate:

paramethadione

Paramethadione has a moderate potential interaction with Psychosis.

Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. AEDs should be administered cautiously in patients with depression or other psychiatric disorders; phentermine-topiramate should be avoided in patients with history of suicidal attempts or active suicidal ideation. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. If patients have symptoms of suicidal ideation or behavior, a dosage reduction or treatment discontinuation should be considered.

Renal Dysfunction

Major:

paramethadione

Paramethadione has a major potential interaction with Renal Dysfunction.

Fatal nephrosis has been associated with the use of oxazolidinedione anticonvulsants. In addition, the active metabolites of these agents are excreted slowly by the kidney and may accumulate in the presence of renal disease. Therapy with oxazolidinediones should be administered cautiously, if at all, in patients with impaired renal function. Urinalyses should be performed in all patients prior to initiating therapy and at monthly intervals, or as often as necessary, thereafter. The development of persistent or increasing albuminuria or any other significant renal abnormality is indication for withdrawal of oxazolidinedione therapy.

Moderate:

De-Congestine

The chlorpheniramine in De-Congestine has a moderate potential interaction with Renal Dysfunction.

Limited pharmacokinetic data are available for the older, first-generation antihistamines. Many appear to be primarily metabolized by the liver, and both parent drugs and metabolites are excreted in the urine. Patients with renal and/or liver disease may be at greater risk for adverse effects from antihistamines due to drug and metabolite accumulation. Therapy with antihistamines should be administered cautiously in such patients. Lower initial dosages may be appropriate.

Retinal Disorders

Major:

paramethadione

Paramethadione has a major potential interaction with Retinal Disorders.

Hemeralopia has occurred with the use of oxazolidinedione anticonvulsants, probably as a result of the drugs' effects on the neural layers of the retina. The condition may be reversed by a reduction in dosage. Therapy with oxazolidinediones should be administered cautiously in patients with diseases of the retina or optic nerve. The development of scotomata or other significant ocular abnormality is indication for withdrawal of oxazolidinedione therapy.

Urinary Retention

Moderate:

De-Congestine

The chlorpheniramine in De-Congestine has a moderate potential interaction with Urinary Retention.

Antihistamines often have anticholinergic activity, to which elderly patients are particularly sensitive. Therapy with antihistamines should be administered cautiously, if at all, in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders. Conventional, first-generation antihistamines such as the ethanolamines (bromodiphenhydramine, carbinoxamine, clemastine, dimenhydrinate, diphenhydramine, doxylamine, phenyltoloxamine) tend to exhibit substantial anticholinergic effects. In contrast, the newer, relatively nonsedating antihistamines (e.g., cetirizine, fexofenadine, loratadine) reportedly have low to minimal anticholinergic activity at normally recommended dosages and may be appropriate alternatives.

More resources

De-Congestine

A total of 541 drugs are known to interact with De-Congestine.

paramethadione

A total of 247 drugs are known to interact with paramethadione.

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.