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Drug Interactions between Doloral Sirop and lindane topical

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

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Interactions between your drugs

Moderate

morphine lindane topical

Applies to: Doloral Sirop (morphine) and lindane topical

MONITOR: Lindane penetrates human skin and has the potential to cause central nervous system toxicity. Seizures have been reported after excessive use or oral ingestion of lindane. There may be a theoretical risk of increased seizure potential when lindane is used with selective serotonin reuptake inhibitors (SSRI antidepressants or anorectics), monoamine oxidase inhibitors, neuroleptic agents, central nervous system stimulants, opioids, tricyclic antidepressants, other tricyclic compounds (e.g., cyclobenzaprine, phenothiazines), and/or any substance that can reduce the seizure threshold (e.g., carbapenems, cholinergic agents, fluoroquinolones, interferons, chloroquine, mefloquine, theophylline). These agents are often individually epileptogenic and may have additive effects when combined.

MANAGEMENT: Caution is advised if lindane is used with any substance that can reduce the seizure threshold, particularly in the very young or the elderly and in patients with epilepsy, a history of seizures, or other risk factors for seizures (e.g., head trauma, brain tumor, metabolic disorders, alcohol and drug withdrawal, CNS infections). Lindane should be used according to recommended dosage and directions for application.

References

  1. Telch J, Jarvis DA (1982) "Acute intoxication with lindane (gamma benzene hexachloride)." Can Med Assoc J, 126, p. 662-3
  2. Munk ZM, Nantel A (1977) "Acute lindane poisoning with development of muscle necrosis." Can Med Assoc J, 117, p. 1050-4
  3. Tenenbein M (1991) "Seizures after lindane therapy." J Am Geriatr Soc, 39, p. 394-5
  4. Pramanik AK, Hansen RC (1979) "Transcutaneous gamma benzene hexachloride absorption and toxicity in infants and children." Arch Dermatol, 115, p. 1224-5
  5. Matsuoka LY (1981) "Convulsions following application of gamma benzene hexachloride." J Am Acad Dermatol, 5, p. 98-9
  6. Solomon BA, Haut SR, Carr EM, Shalita AR (1995) "Neurotoxic reaction to lindane in an HIV-seropositive patient: an old medication's new problem." J Fam Pract, 40, p. 291-6
  7. "Product Information. Kwell (lindane)." Reed and Carnrick, Jersey City, NJ.
  8. Ramchander V, Cameron ES, Reid HF (1991) "Lindane toxicity in an infant." West Indian Med J, 40, p. 41-3
  9. Cox R, Krupnick J, Bush N, Houpt A (2000) "Seizures caused by concomitant use of lindane and dextroamphetamine in a child with attention deficit hyperactivity disorder." J Miss State Med Assoc, 41, p. 690-2
View all 9 references

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Drug and food interactions

Major

morphine food

Applies to: Doloral Sirop (morphine)

GENERALLY AVOID: Alcohol may potentiate the central nervous system (CNS) depressant effects of opioid analgesics including morphine and diamorphine. 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.

GENERALLY AVOID: Consumption of alcohol while taking some sustained-release formulations of morphine may cause rapid release of the drug, resulting in high systemic levels of morphine that may be potentially lethal. Alcohol apparently can disrupt the release mechanism of some sustained-release formulations. The interaction was observed in in vitro studies using a 24-hour morphine formulation (Avinza 30 mg capsule, available in the U.S. from Ligand Pharmaceuticals). When the capsule was mixed with 900 mL of buffer solutions containing ethanol 20% and 40%, the dose of morphine that was released was alcohol concentration-dependent, leading to a more rapid release of morphine. Although the clinical relevance of this finding is unknown, 'dose-dumping' into the bloodstream is conceivable.

MANAGEMENT: Until more information is available, patients taking sustained-release formulations of morphine should not consume alcohol or use medications that contain alcohol. In general, potent narcotics such as morphine or diamorphine should not be combined with alcohol.

References

  1. (2005) "Product Information. Avinza (morphine)." Ligand Pharmaceuticals
  2. Ghalie R (2005) Dear Health Care Professional. http://www.fda.gov/medwatch/safety/2005/AVINZA_DHCP_Letter_Oct2005.pdf
  3. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  4. Cerner Multum, Inc. (2015) "Canadian Product Information."
View all 4 references

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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

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