Can you take DM-PE-Chlor with Metoclopramide?

The chlorpheniramine in DM-PE-Chlor 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.

The phenylephrine in DM-PE-Chlor 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.

The phenylephrine in DM-PE-Chlor 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.

The chlorpheniramine in DM-PE-Chlor 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.

The phenylephrine in DM-PE-Chlor 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.

Metoclopramide has a moderate potential interaction with Cirrhosis.

Metoclopramide produces a transient increase in plasma aldosterone and may cause fluid retention and volume overload in susceptible patients. Therapy with metoclopramide should be administered cautiously in patients with or at risk for fluid overload (e.g., cirrhosis, congestive heart failure). If these side effects occur at any time during metoclopramide therapy, the drug should be discontinued.

The chlorpheniramine in DM-PE-Chlor 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.

Metoclopramide has a major potential interaction with Depression.

Metoclopramide has been reported to cause mental depression in patients with and without a prior history of depression. Symptoms have ranged from mild to severe and have included suicidal ideation and suicide. Therapy with metoclopramide in patients with a history of mental depression, especially suicidal tendencies, should be administered cautiously, and only if benefits are anticipated to outweigh the potential risks. Some patients who experience depression with metoclopramide have improved following temporary discontinuation of the drug and reinstitution at a lower dosage with gradual titration.

The phenylephrine in DM-PE-Chlor 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.

Metoclopramide has a moderate potential interaction with Fluid Retention.

Metoclopramide produces a transient increase in plasma aldosterone and may cause fluid retention and volume overload in susceptible patients. Therapy with metoclopramide should be administered cautiously in patients with or at risk for fluid overload (e.g., cirrhosis, congestive heart failure). If these side effects occur at any time during metoclopramide therapy, the drug should be discontinued.

Metoclopramide has a major potential interaction with Gastrointestinal Hemorrhage.

The use of metoclopramide is contraindicated in patients with conditions where stimulation of gastrointestinal motility might be harmful, such as mechanical bowel obstruction, bowel perforation, or gastrointestinal hemorrhage.

The chlorpheniramine in DM-PE-Chlor 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.

Metoclopramide has a major potential interaction with Gastrointestinal Perforation.

The use of metoclopramide is contraindicated in patients with conditions where stimulation of gastrointestinal motility might be harmful, such as mechanical bowel obstruction, bowel perforation, or gastrointestinal hemorrhage.

The chlorpheniramine in DM-PE-Chlor 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.

The phenylephrine in DM-PE-Chlor 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.

Metoclopramide has a moderate potential interaction with Heart Failure.

Metoclopramide produces a transient increase in plasma aldosterone and may cause fluid retention and volume overload in susceptible patients. Therapy with metoclopramide should be administered cautiously in patients with or at risk for fluid overload (e.g., cirrhosis, congestive heart failure). If these side effects occur at any time during metoclopramide therapy, the drug should be discontinued.

Metoclopramide has a moderate potential interaction with High Blood Pressure.

In a study involving patients with essential hypertension, intravenously administered metoclopramide was shown to induce the release of catecholamines. Therapy with metoclopramide should be administered cautiously in patients with hypertension because of potential increases in blood pressure.

The phenylephrine in DM-PE-Chlor 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.

The chlorpheniramine in DM-PE-Chlor 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.

The chlorpheniramine in DM-PE-Chlor 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.

Metoclopramide has a major potential interaction with Intestinal Obstruction.

The use of metoclopramide is contraindicated in patients with conditions where stimulation of gastrointestinal motility might be harmful, such as mechanical bowel obstruction, bowel perforation, or gastrointestinal hemorrhage.

The chlorpheniramine in DM-PE-Chlor 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.

Metoclopramide has a major potential interaction with Neuroleptic Malignant Syndrome.

Although not a neuroleptic agent, metoclopramide has antidopaminergic effects and may rarely precipitate or aggravate a potentially fatal symptom complex known as Neuroleptic Malignant Syndrome (NMS). Clinical manifestations of NMS include hyperpyrexia, muscle rigidity, involuntary movements, altered mental status and autonomic instability (irregular pulse or blood pressure, tachycardia, diaphoresis and cardiac arrhythmias). Metoclopramide therapy should not be initiated in patients with active NMS and should be immediately discontinued if currently being administered in such patients. In patients with a history of NMS, introduction or reintroduction of metoclopramide or other antidopaminergic therapy should be carefully considered, since NMS may recur.

Metoclopramide has a moderate potential interaction with Parkinsonism.

Metoclopramide has antidopaminergic effects and may cause parkinsonian-like symptoms such as akinesia, bradykinesia, tremors, pill-rolling motion, cogwheel rigidity, and postural abnormalities including stooped posture and shuffling gait. The onset is usually within the first six months following initiation of therapy but occasionally after longer periods. Symptoms generally subside within 2 to 3 months after drug discontinuation. Therapy with metoclopramide should be administered cautiously, if at all, in patients with Parkinson's disease or parkinsonian symptoms.

The phenylephrine in DM-PE-Chlor 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.

Metoclopramide has a major potential interaction with Pheochromocytoma.

The use of metoclopramide is contraindicated in patients with pheochromocytoma. In a study involving patients with essential hypertension, intravenously administered metoclopramide was shown to induce the release of catecholamines. Hypertensive crises may occur in patients with pheochromocytoma due to induction of catecholamine release from the tumor.

The phenylephrine in DM-PE-Chlor 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.

The chlorpheniramine in DM-PE-Chlor 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.

Metoclopramide has a moderate potential interaction with Renal Dysfunction.

Renal function affects the clearance of metoclopramide. In patients with varying degrees of renal impairment, a reduction in creatinine clearance was correlated with a reduction in plasma clearance, renal clearance, and non-renal clearance, and increase in elimination half-life of metoclopramide. Therapy with metoclopramide should be administered cautiously in patients with impaired renal function. A dosage reduction may be appropriate to avoid drug accumulation.

Metoclopramide has a major potential interaction with Seizures.

The use of metoclopramide is contraindicated in patients with seizure disorders. Metoclopramide may increase the frequency and severity of seizures.

Metoclopramide has a major potential interaction with Tardive Dyskinesia.

Metoclopramide may precipitate symptoms of tardive dyskinesia (TD) following chronic administration. Elderly patients, particularly women, are most susceptible. Both the risk of developing TD and the likelihood that it will become irreversible increase with the duration and total cumulative dose of metoclopramide or other antidopaminergic therapy administered. Metoclopramide therapy should be discontinued in patients who develop signs or symptoms of tardive dyskinesia. There is no known treatment for tardive dyskinesia. In some patients, symptoms may lessen or resolve after metoclopramide treatment is stopped. Treatment with metoclopramide for longer than 12 weeks should be avoided in all but rare cases where therapeutic benefit is thought to outweigh the risk of developing tardive dyskinesia. In patients with preexisting drug-induced TD, initiating or increasing the dosage of metoclopramide therapy may temporarily mask the symptoms of TD but may eventually worsen the condition.

The chlorpheniramine in DM-PE-Chlor 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.