Drug Interactions between Dihistine and procarbazine

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Alcohol may potentiate the central nervous system (CNS) depressant effects of opioid analgesics. Concomitant use may result in additive CNS depression and impairment of judgment, thinking, and psychomotor skills. In more severe cases, hypotension, respiratory depression, profound sedation, coma, or even death may occur. In addition, alcohol may affect opioid release from sustained-release formulations.

GENERALLY AVOID: Grapefruit or grapefruit juice may increase the plasma concentrations of opioid analgesics by inhibiting CYP450 3A4-mediated metabolism of these agents, although the interaction has not been studied. In general, the effect of grapefruit juice is concentration-, dose- and preparation-dependent, and can vary widely among brands. Certain preparations of grapefruit juice (e.g., high dose, double strength) have sometimes demonstrated potent inhibition of CYP450 3A4, while other preparations (e.g., low dose, single strength) have typically demonstrated moderate inhibition. Pharmacokinetic interactions involving grapefruit juice are also subject to a high degree of interpatient variability, thus the extent to which a given patient may be affected is difficult to predict.

MANAGEMENT: Patients should not consume alcoholic beverages or use drug products that contain alcohol during treatment with opioid analgesics. Any history of alcohol or illicit drug use should be considered when prescribing an opioid analgesic, and therapy initiated at a lower dosage if necessary. Patients should be closely monitored for signs and symptoms of sedation, respiratory depression, and hypotension. Due to a high degree of interpatient variability with respect to grapefruit juice interactions, patients treated with opioid analgesics should preferably avoid the consumption of grapefruit and grapefruit juice.

During and within two weeks after treatment with procarbazine, you must not consume any foods or beverages that are high in tyramine content. Doing so can raise your blood pressure to dangerous levels, a condition known as hypertensive crisis. The condition is potentially fatal and may cause symptoms such as severe headache, confusion, blurred vision, problems with speech or balance, nausea, vomiting, chest pain, convulsions, and sudden numbness or weakness (especially on one side of the body). You should seek immediate medical attention if you have any of these symptoms. Foods that are high in tyramine include, but are not limited to, air dried meats; aged or fermented meats; sausage or salami; pickled herring; anchovies; liver; red wine; beer; aged cheeses, including blue, brick, brie, cheddar, parmesan, romano, and swiss; sour cream; sauerkraut; canned figs; raisins; bananas or avocados (particularly if overripe); soy beans; soy sauce; tofu; miso soup; bean curd; fava beans; or yeast extracts (such as Marmite). You should avoid the use of alcohol while being treated with procarbazine, as alcohol may increase some of the nervous system side effects such as dizziness, drowsiness, and difficulty concentrating. Also 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.

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.