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Drug Interactions between Eperbel-S and Tusdec-HC

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

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Interactions between your drugs

Major

ergotamine phenylephrine

Applies to: Eperbel-S (belladonna / ergotamine / phenobarbital) and Tusdec-HC (hydrocodone / phenylephrine)

Using ergotamine together with phenylephrine is generally not recommended. Ergotamine may cause significant increases in blood pressure by constricting the blood vessels, and the risk for complications may be increased when used with other drugs that also have this effect such as decongestants, stimulants, and certain medications for headache, glaucoma, or eye redness relief. Combining these medications may also reduce blood flow to vital organs and increase the risk of rare but serious side effects such as heart attack, stroke, intestinal problems, and gangrene (death of tissues, usually in the arm or leg, that may require surgical amputation). Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. You should seek immediate medical attention if you experience severe abdominal pain, nausea, vomiting, numbness or tingling, muscle pain or weakness, blue or purple discoloration of fingers or toes, pale or cold skin, chest pain or tightness, severe or throbbing headache, irregular heartbeat, shortness of breath, blurred vision, confusion, and/or slurred speech during treatment with these medications. 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.

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Major

PHENobarbital HYDROcodone

Applies to: Eperbel-S (belladonna / ergotamine / phenobarbital) and Tusdec-HC (hydrocodone / phenylephrine)

Using HYDROcodone together with other medications that cause central nervous system depression such as PHENobarbital can lead to serious side effects including respiratory distress, coma, and even death. Additionally, PHENobarbital may reduce the blood levels of HYDROcodone in some cases, which may make the medication less effective in treating your condition. If you have been receiving treatment with HYDROcodone, adding PHENobarbital may cause you to experience unpleasant withdrawal symptoms such as watery eyes, runny nose, sneezing, yawning, excessive sweating, goose bumps, fever, chills, flushing, restlessness, irritability, anxiety, depression, pupil dilation, tremor, rapid heart beat, body aches, involuntary twitching and kicking, abdominal cramping, loss of appetite, nausea, vomiting, diarrhea, and weight loss. On the other hand, if you have been receiving both medications, discontinuing PHENobarbital may increase the blood levels of HYDROcodone, which could lead to an overdose. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Do not drink alcohol or self-medicate with these medications without your doctor's approval, and do not exceed the doses or frequency and duration of use prescribed by your doctor. Also, you should avoid driving or operating hazardous machinery until you know how these medications affect you. 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.

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Moderate

ergotamine PHENobarbital

Applies to: Eperbel-S (belladonna / ergotamine / phenobarbital) and Eperbel-S (belladonna / ergotamine / phenobarbital)

PHENobarbital may reduce the blood levels and effects of ergotamine. Contact your doctor if your symptoms worsen or your condition changes during treatment with these medications. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. 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.

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Moderate

phenylephrine belladonna

Applies to: Tusdec-HC (hydrocodone / phenylephrine) and Eperbel-S (belladonna / ergotamine / phenobarbital)

Belladonna may increase the effects of phenylephrine on your blood pressure and heart rate. Before receiving these medications, you should let your doctor know if you have high blood pressure or heart disease. You may not be able to use one or both of these medications, or you may need closer monitoring by your doctor in order to use these medications. 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.

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Moderate

belladonna HYDROcodone

Applies to: Eperbel-S (belladonna / ergotamine / phenobarbital) and Tusdec-HC (hydrocodone / phenylephrine)

Using HYDROcodone together with belladonna may increase the risk and/or severity of some side effects such as dizziness, drowsiness, confusion, difficulty concentrating, difficulty urinating, dry mouth, abdominal cramping, and constipation. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. 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.

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Drug and food interactions

Major

HYDROcodone food

Applies to: Tusdec-HC (hydrocodone / phenylephrine)

Do not use alcohol or medications that contain alcohol while you are receiving treatment with HYDROcodone. This may increase nervous system side effects such as drowsiness, dizziness, lightheadedness, difficulty concentrating, and impairment in thinking and judgment. In severe cases, low blood pressure, respiratory distress, fainting, coma, or even death may occur. If you are taking certain long-acting formulations of hydrocodone, consumption of alcohol may also cause rapid release of the drug, resulting in high blood levels that may be potentially lethal. Likewise, you should avoid consuming grapefruit and grapefruit juice, as this may increase the blood levels and effects of hydrocodone. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. Do not use more than the recommended dose of HYDROcodone, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medication without first talking to your doctor.

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Major

PHENobarbital food

Applies to: Eperbel-S (belladonna / ergotamine / phenobarbital)

Ask your doctor before using PHENobarbital together with ethanol, this can add to dizziness, drowsiness and other side effects of PHENobarbital. Be careful if you drive or do activities that require you to be awake and alert. Talk with your doctor before using any medications together, or drinking alcohol with PHENobarbital. 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.

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Moderate

ergotamine food

Applies to: Eperbel-S (belladonna / ergotamine / phenobarbital)

Grapefruit juice may increase the blood levels of certain medications such as ergotamine. You may want to limit your consumption of grapefruit and grapefruit juice during treatment with ergotamine. However, if you have been regularly consuming grapefruit or grapefruit juice with the medication, then it is advisable for you to talk with your doctor before changing the amounts of these products in your diet, as this may alter the effects of your medication. Contact your doctor if your condition changes or you experience increased side effects. Orange juice is not expected to interact.

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Moderate

belladonna food

Applies to: Eperbel-S (belladonna / ergotamine / phenobarbital)

Ask your doctor before using belladonna together with ethanol. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking belladonna. You should be warned not to exceed recommended dosages and to avoid activities requiring mental alertness. If your doctor prescribes these medications together, you may need a dose adjustment to safely take this combination. 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.

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Moderate

phenylephrine food

Applies to: Tusdec-HC (hydrocodone / phenylephrine)

Consumer information for this interaction is not currently available.

MONITOR: Coadministration of two or more sympathomimetic agents may increase the risk of adverse effects such as nervousness, irritability, and increased heart rate. Central nervous system (CNS) stimulants, particularly amphetamines, can potentiate the adrenergic response to vasopressors and other sympathomimetic agents. 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 agents are coadministered. Pulse and blood pressure should be closely monitored.

References

  1. Rosenblatt JE, Lake CR, van Kammen DP, Ziegler MG, Bunney WE Jr "Interactions of amphetamine, pimozide, and lithium on plasma norepineophrine and dopamine-beta-hydroxylase in schizophrenic patients." Psychiatry Res 1 (1979): 45-52
  2. Cavanaugh JH, Griffith JD, Oates JA "Effect of amphetamine on the pressor response to tyramine: formation of p-hydroxynorephedrine from amphetamine in man." Clin Pharmacol Ther 11 (1970): 656
  3. "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc PROD (2001):
  4. "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals PROD (2001):
  5. "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals PROD (2001):
  6. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):
  7. "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company (2002):
View all 7 references
Moderate

ergotamine food

Applies to: Eperbel-S (belladonna / ergotamine / phenobarbital)

Nicotine may increase the effects of ergotamine in narrowing the blood vessels and decreasing blood flow. A severe decrease in blood flow to the brain and other parts of the body can lead to dangerous side effects. Contact your doctor immediately if you experience coldness, paleness, discoloration, numbness, tingling, or pain in your hands or feet; muscle pain or weakness; severe or worsening headache; blurred vision; severe abdominal pain; chest pain; or shortness of breath while using these medications. 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.

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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.


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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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