Interactions between Desgen and Gadopiclenol
1 drug interaction and 18 additional warnings found for the following 2 drugs:
- Desgen (dextromethorphan/guaifenesin/phenylephrine)
- gadopiclenol
Drug interactions
Moderate drug interactions
Moderate:
phenylephrine gadopiclenol
Applies to: Desgen (dextromethorphan / guaifenesin / phenylephrine) and gadopiclenol
Monitor
Use of gadopiclenol or gadoterate meglumine in patients receiving vasoactive agents, angiotensin-converting enzyme inhibitors, or angiotensin II receptor antagonists may reduce compensatory cardiovascular responses to blood pressure changes associated with contrast administration. The mechanism is pharmacodynamic and likely relates to the effects of these medicines on vascular tone, the renin-angiotensin system, or other blood-pressure regulatory pathways, which may limit physiologic compensation if hypotension or other hemodynamic reactions occur during or after contrast administration. Clinical data directly evaluating this interaction are lacking.
Management
Before administering gadopiclenol or gadoterate meglumine, clinicians should be aware of concomitant therapy with these medications. Monitor patients appropriately during and after contrast administration for hemodynamic reactions, with usual contrast-reaction management measures available.
References (6)
- (2026) "Product Information. Elucirem (gadopiclenol)." Guerbet LLC
- "Product Information. ELUCIREM (gadopiclenol)." GUERBET
- (2025) "Product Information. Elucirem (gadopiclenol)." Guerbet Australia Pty Ltd
- (2025) "Product Information. Elucirem (gadopiclenol)." Guerbet Laboratories Ltd
- Bracco Imaging Canada (2026) Product monograph: gadopiclenol injection (Vueway). https://pdf.hres.ca/dpd_pm/00084254.PDF
- (2025) "Product Information. Clariscan (gadoteric acid)." GE Healthcare Ltd
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
dextromethorphan Food/Lifestyle
Applies to: Desgen (dextromethorphan / guaifenesin / phenylephrine)
Generally avoid
Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.
Management
Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
References (4)
- Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
- Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
- (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
- (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka America Pharmaceutical, Inc.
Moderate:
phenylephrine Caffeine
Applies to: Desgen (dextromethorphan / guaifenesin / phenylephrine)
Monitor
Coadministration of two or more sympathomimetic or noradrenergic agents may increase the risk of nervousness, irritability, tachycardia, and/or increased blood pressure. Central nervous system (CNS) stimulants, particularly amphetamines, can potentiate the adrenergic response to vasopressors and other sympathomimetic and/or noradrenergic agents, including norepinephrine transporter inhibitors. 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 or noradrenergic agents are coadministered. Pulse and blood pressure should be closely monitored. Consultation with individual product labeling, as well as relevant institutional protocols, may be advisable for further guidance.
References (20)
- 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
- 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
- (2001) "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc
- (2001) "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals
- (2001) "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals
- (2001) "Product Information. Focalin (dexmethylphenidate)." Mikart Inc
- (2024) "Product Information. Ephedrine (ephedrine)." Hameln Pharma Ltd
- (2023) "Product Information. Ephedrine Hydrochloride (ephedrine)." Wockhardt UK Ltd
- (2026) "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company
- (2025) "Product Information. Atomoxetine (atomoxetine)." Zentiva Pharma UK Ltd
- (2026) "Product Information. Atomoxetine (Apo) (atomoxetine)." Arrotex Pharmaceuticals Pty Ltd
- Angita Pharma, Inc (2026) AG-ATOMOXETINE Product Monograph (Health Canada) https://pdf.hres.ca/dpd_pm/00059014.PDF
- (2026) "Product Information. Boots Decongestant (Pseudoephedrine) (pseudoephedrine)." The Boots Company Plc
- (2023) "Product Information. Sinus and Nasal Decongestant (Trust) (pseudoephedrine)." Noumed Pharmaceuticals Pty Ltd
- (2019) "Product Information. Ephedrine (ephedrine)." Pfizer Australia Pty Ltd
- (2024) "Product Information. EPHEDrine Sulfate (ePHEDrine)." Amneal Pharmaceuticals LLC
- (2024) "Product Information. Lemsip Cough Max for Mucus Cough and Cold (guaifenesin/paracetamol/phenylephrine)." Reckitt Benckiser Healthcare (UK) Ltd
- emc (2026) Product information: sudafed plus blocked nose 1mg/50mg/ml nasal spray. https://www.medicines.org.uk/emc/product/14256/smpc?utm_source=chatgpt.com
- (2023) "Product Information. EPHEDrine Sulfate (ePHEDrine)." Baxter Corporation
- Neo Health (OTC) Pty Ltd (2026) Product information: pseudoephedrine hydrochloride-paracetamol capsules. https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2024-PI-02603-1&d=20260804172310101&d=20260827172310101
Disease interactions
16 potential interactions Applies to: 13 conditions, including High Blood Pressure, Allergies, Asthma, Benign Prostatic Hyperplasia, and Hyperthyroidism.
Allergies
Moderate:
gadopiclenol
Gadopiclenol has a moderate potential interaction with Allergies.
Patients with history of bronchial asthma might have an increased risk for a hypersensitivity reaction to gadolinium-based contrast agents. Patients should always be assessed for any history of a reaction to contrast media, asthma or other allergic disorders before the administration of these agents.
Asthma
Moderate:
gadopiclenol
Gadopiclenol has a moderate potential interaction with Asthma.
Patients with history of bronchial asthma might have an increased risk for a hypersensitivity reaction to gadolinium-based contrast agents. Patients should always be assessed for any history of a reaction to contrast media, asthma or other allergic disorders before the administration of these agents.
Benign Prostatic Hyperplasia
Moderate:
Desgen
The phenylephrine in Desgen 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.
Cardiovascular Conditions and Disorders
Major:
Desgen
The phenylephrine in Desgen 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.
Cerebrovascular Insufficiency
Major:
Desgen
The phenylephrine in Desgen 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.
Diabetes Mellitus
Major:
gadopiclenol
Gadopiclenol has a major potential interaction with Diabetes Mellitus.
Gadolinium-based contrast agents (GBCAs) increase the risk for nephrogenic systemic fibrosis (NSF) among patients with impaired elimination of the drugs. Gadobenate ion is eliminated predominately via the kidneys. The risk for NSF appears highest among patients with chronic, severe kidney disease (GFR <30 mL/min/1.73m2), or acute kidney injury. It is recommended to avoid the use of GBCAs in these patients unless the diagnostic information is essential and not available with non-contrasted MRI or other processes. NSF may result in fatal or debilitating systemic fibrosis affecting the skin, muscle and internal organs. Consider screening patients for acute kidney injury and other conditions that may reduce renal function and for patients at risk for chronically reduced renal function (e.g., age > 60 years, hypertension or diabetes), estimate the glomerular filtration rate (GFR) through laboratory testing. For patients receiving hemodialysis, physicians may consider the prompt initiation of hemodialysis following the administration of a GBCA to enhance the contrast agent's elimination. The usefulness of hemodialysis in the prevention of NSF is unknown.
Moderate:
Desgen
The phenylephrine in Desgen 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.
Glaucoma/Intraocular Hypertension
Moderate:
Desgen
The phenylephrine in Desgen 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.
High Blood Pressure
Major:
gadopiclenol
Gadopiclenol has a major potential interaction with High Blood Pressure.
Gadolinium-based contrast agents (GBCAs) increase the risk for nephrogenic systemic fibrosis (NSF) among patients with impaired elimination of the drugs. Gadobenate ion is eliminated predominately via the kidneys. The risk for NSF appears highest among patients with chronic, severe kidney disease (GFR <30 mL/min/1.73m2), or acute kidney injury. It is recommended to avoid the use of GBCAs in these patients unless the diagnostic information is essential and not available with non-contrasted MRI or other processes. NSF may result in fatal or debilitating systemic fibrosis affecting the skin, muscle and internal organs. Consider screening patients for acute kidney injury and other conditions that may reduce renal function and for patients at risk for chronically reduced renal function (e.g., age > 60 years, hypertension or diabetes), estimate the glomerular filtration rate (GFR) through laboratory testing. For patients receiving hemodialysis, physicians may consider the prompt initiation of hemodialysis following the administration of a GBCA to enhance the contrast agent's elimination. The usefulness of hemodialysis in the prevention of NSF is unknown.
Hyperthyroidism
Major:
Desgen
The phenylephrine in Desgen 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.
Liver Disease
Moderate:
gadopiclenol
Gadopiclenol has a moderate potential interaction with Liver Disease.
The use of certain Gadolinium-based contrast agents (GBCAs) in patients with severe renal or hepatic impairment may impair imaging performance. If GBCAs are used in these patients, complete MRI no later than 60 minutes after GBCAs administration and use a paired non-contrast and contrast MRI set for diagnosis. It is recommended to exercise caution when interpreting contrast MR images in the absence of companion non-contrast MR images
Pheochromocytoma
Major:
Desgen
The phenylephrine in Desgen 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:
Desgen
The phenylephrine in Desgen 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.
Renal Dysfunction
Major:
gadopiclenol
Gadopiclenol has a major potential interaction with Renal Dysfunction.
Gadolinium based contrast agents (GBCAs) increase the risk for nephrogenic systemic fibrosis (NSF) among patients with impaired elimination of the drugs. Use of these agents should be avoided in these patients unless the diagnostic information is essential and unavailable with non- contrasted MRI or other diagnostic modalities. NSF may result in fatal or debilitating fibrosis affecting the skin, muscle and internal organs. The risk of NSF appears to be higher in patients with chronic severe renal disease and patients with acute kidney injury. Patients should be screened for acute renal injury and other conditions that might affect renal function such as age >60 years old, hypertension, and diabetes.
Major:
gadopiclenol
Gadopiclenol has a major potential interaction with Renal Dysfunction.
Gadolinium-based contrast agents (GBCAs) increase the risk for nephrogenic systemic fibrosis (NSF) among patients with impaired elimination of the drugs. Gadobenate ion is eliminated predominately via the kidneys. The risk for NSF appears highest among patients with chronic, severe kidney disease (GFR <30 mL/min/1.73m2), or acute kidney injury. It is recommended to avoid the use of GBCAs in these patients unless the diagnostic information is essential and not available with non-contrasted MRI or other processes. NSF may result in fatal or debilitating systemic fibrosis affecting the skin, muscle and internal organs. Consider screening patients for acute kidney injury and other conditions that may reduce renal function and for patients at risk for chronically reduced renal function (e.g., age > 60 years, hypertension or diabetes), estimate the glomerular filtration rate (GFR) through laboratory testing. For patients receiving hemodialysis, physicians may consider the prompt initiation of hemodialysis following the administration of a GBCA to enhance the contrast agent's elimination. The usefulness of hemodialysis in the prevention of NSF is unknown.
Moderate:
gadopiclenol
Gadopiclenol has a moderate potential interaction with Renal Dysfunction.
The use of certain Gadolinium-based contrast agents (GBCAs) in patients with severe renal or hepatic impairment may impair imaging performance. If GBCAs are used in these patients, complete MRI no later than 60 minutes after GBCAs administration and use a paired non-contrast and contrast MRI set for diagnosis. It is recommended to exercise caution when interpreting contrast MR images in the absence of companion non-contrast MR images
More resources
Desgen
A total of 546 drugs are known to interact with Desgen.
- Desgen is in the drug class upper respiratory combinations.
- Desgen is used to treat Cough and Nasal Congestion.
gadopiclenol
A total of 101 drugs are known to interact with gadopiclenol.
- Gadopiclenol is in the drug class magnetic resonance imaging contrast media.
- Gadopiclenol is used to treat Diagnosis and Investigation.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
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