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Drug Interactions between Desyrel and propiomazine

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

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Interactions between your drugs

Moderate

traZODone propiomazine

Applies to: Desyrel (trazodone) and propiomazine

MONITOR: The coadministration of phenothiazines with trazodone may produce additive hypotensive effects due to alpha-1 adrenergic blockade. There have been case reports of patients treated with a phenothiazine who developed hypotension following the addition of trazodone therapy. The hypotension resolved with the discontinuation of trazodone. Besides additive effects, it is also possible that competitive inhibition of CYP450 2D6 metabolism may occur, since many phenothiazines as well as antidepressants have been found to be substrates of this isoenzyme. Theoretically, this could produce increased plasma concentrations of phenothiazine and/or trazodone, resulting in increased pharmacologic effects of one or both drugs. In one study, thioridazine (20 mg orally twice a day for one week) increased the plasma concentrations of trazodone and its active metabolite in 11 depressed patients by 36% and 54%, respectively.

MANAGEMENT: Caution is advised if trazodone is administered concomitantly with a phenothiazine. Lower initial dosages and/or more gradual titration are recommended. Patients should be monitored for adverse effects such as hypotension and tachycardia during coadministration, and for altered therapeutic response to the remaining agent following withdrawal of the other agent.

References (2)
  1. Asayesh K (1986) "Combination of trazodone and phenothiazines: a possible additive hypotensive effect." Can J Psychiatry, 31, p. 857-8
  2. Yasui N, Otani K, Kaneko S, Ohkubo T, Osanai T, Ishida M, Mihara K, Kondo T, Sugawara K, Fukushima Y (1995) "Inhibition of trazodone metabolism by thioridazine in humans." Ther Drug Monit, 17, p. 333-5

Drug and food interactions

Moderate

traZODone food

Applies to: Desyrel (trazodone)

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)
  1. Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
  2. 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.
  3. (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
  4. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
Moderate

propiomazine food

Applies to: propiomazine

GENERALLY AVOID: Concurrent use of ethanol and phenothiazines may result in additive CNS depression and psychomotor impairment. Also, ethanol may precipitate dystonic reactions in patients who are taking phenothiazines. The two drugs probably act on different sites in the brain, although the exact mechanism of the interaction is not known.

MANAGEMENT: Patients should be advised to avoid alcohol during phenothiazine therapy.

References (2)
  1. Lutz EG (1976) "Neuroleptic-induced akathisia and dystonia triggered by alcohol." JAMA, 236, p. 2422-3
  2. Freed E (1981) "Alcohol-triggered-neuroleptic-induced tremor, rigidity and dystonia." Med J Aust, 2, p. 44-5

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.

See also

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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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