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Can you take Excedrin Tension Headache with Methimazole?

1 drug interaction and 34 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

acetaminophen methIMAzole

Applies to: Excedrin Tension Headache (acetaminophen / caffeine) and methimazole

Both acetaminophen and methIMAzole can affect the liver, and combining them may increase the risk of liver damage.

Talk to your doctor before using these medications together, particularly if you have other risk factors for liver problems. Do not use more than the recommended dose of acetaminophen or take more than one medication containing acetaminophen at the same time.

Contact your doctor if you experience increased side effects or symptoms that concern 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.

Food/lifestyle interactions

Major food/lifestyle interactions

Major:

acetaminophen Food/Lifestyle

Applies to: Excedrin Tension Headache (acetaminophen / caffeine)

Acetaminophen may cause liver damage and taking it with alcohol may increase that risk.

You should avoid or limit the use of alcohol while being treated with acetaminophen.

Call your doctor immediately if you have:

  • fever
  • chills
  • joint pain or swelling
  • excessive tiredness or weakness
  • unusual bleeding or bruising
  • skin rash or itching
  • loss of appetite
  • nausea
  • vomiting
  • dark colored urine
  • yellowing of the skin or the whites of your eyes

These may be symptoms of liver damage.

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.

Minor food/lifestyle interactions

Minor:

caffeine Food/Lifestyle

Applies to: Excedrin Tension Headache (acetaminophen / caffeine)

The effect of grapefruit juice on the pharmacologic activity of caffeine is controversial. One report suggests that grapefruit juice increases the effect of caffeine. The proposed mechanism is inhibition of cytochrome P-450 metabolism of caffeine. However, a well-conducted pharmacokinetic/pharmacodynamic study did not demonstrate this effect. The clinical significance of this potential interaction is unknown.

The information above is from our professional interaction data. Consumer information is not available for this interaction.

Disease interactions

32 potential interactions Applies to: 26 conditions, including High Blood Pressure, Depression, GERD, Heart Attack, and Angina.

Alcoholism

Major:

Excedrin Tension Headache

The acetaminophen in Excedrin Tension Headache has a major potential interaction with Alcoholism.

Chronic alcohol abusers may be at increased risk of hepatotoxicity during treatment with acetaminophen (APAP). Severe liver injury, including cases of acute liver failure resulting in liver transplant and death, has been reported in patients using acetaminophen. Therapy with acetaminophen should be administered cautiously, if at all, in patients who consume three or more alcoholic drinks a day. In general, patients should avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure. They should also be advised to seek medical attention if they experience signs and symptoms of liver injury such as fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, and jaundice.

Major:

methimazole

methIMAzole has a major potential interaction with Alcoholism.

The use of thioamide antithyroid agents has been associated with hepatotoxic effects, including transient elevations of serum transaminases and, rarely, cholestatic jaundice, fulminant hepatitis, hepatic necrosis, encephalopathy and death. Therapy with thioamide derivatives should be administered cautiously in patients with preexisting liver disease, a history of alcohol abuse, or hepatitis. Treatment should be discontinued if deterioration in liver function or other signs of hepatic injury occur. The jaundice associated with methimazole-induced hepatitis may persist for several weeks after withdrawal of the medication.

Angina

Moderate:

Excedrin Tension Headache

The caffeine in Excedrin Tension Headache has a moderate potential interaction with Angina.

Like other methylxanthines, caffeine at high dosages may be associated with positive inotropic and chronotropic effects on the heart. Caffeine may also produce an increase in systemic vascular resistance, resulting in elevation of blood pressure. Therapy with products containing caffeine should be administered cautiously in patients with severe cardiac disease, hypertension, hyperthyroidism, or acute myocardial injury. Some clinicians recommend avoiding caffeine in patients with symptomatic cardiac arrhythmias and/or palpitations and during the first several days to weeks after an acute myocardial infarction.

Bleeding Disorder

Major:

methimazole

methIMAzole has a major potential interaction with Bleeding Disorder.

Thioamide antithyroid agents may interfere with the action of vitamin K and have been reported in isolated cases to induce hypoprothombinemia and bleeding. Myelosuppression rarely resulting in thrombocytopenia has also been reported. Therapy with thioamide derivatives should be administered cautiously in patients with significant active bleeding or a hemorrhagic diathesis, including hemostatic and/or coagulation defects associated with hemophilia, vitamin K deficiency, hypoprothombinemia, thrombocytopenia, thrombocytopathy, or severe hepatic impairment. Clinical monitoring of prothrombin time or INR is recommended.

Coagulation Defects and Disorders

Major:

methimazole

methIMAzole has a major potential interaction with Coagulation Defects and Disorders.

Thioamide antithyroid agents may interfere with the action of vitamin K and have been reported in isolated cases to induce hypoprothombinemia and bleeding. Myelosuppression rarely resulting in thrombocytopenia has also been reported. Therapy with thioamide derivatives should be administered cautiously in patients with significant active bleeding or a hemorrhagic diathesis, including hemostatic and/or coagulation defects associated with hemophilia, vitamin K deficiency, hypoprothombinemia, thrombocytopenia, thrombocytopathy, or severe hepatic impairment. Clinical monitoring of prothrombin time or INR is recommended.

Dehydration

Major:

Excedrin Tension Headache

The acetaminophen in Excedrin Tension Headache has a major potential interaction with Dehydration.

Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease. Patients with hepatic impairment may be at increased risk of toxicity. Severe liver injury, including cases of acute liver failure and death, have been reported in patients using this drug. Clinical monitoring of hepatic function is recommended. Caution is advised if using acetaminophen in patients with chronic malnutrition or severe hypovolemia. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.

Depression

Major:

Excedrin Tension Headache

The caffeine in Excedrin Tension Headache has a major potential interaction with Depression.

The use of CNS stimulants can cause psychotic symptoms, suicidal ideation, and aggression, and can exacerbate symptoms of behavior disturbance and thought disorder; CNS stimulants may induce a manic or mixed episode in patients with bipolar disorder. Psychiatric symptoms have been reported in patients with and without history of psychiatric disorders. All patients (particularly those with psychotic or bipolar disorders) should be monitored closely, especially during treatment initiation and at times of dose changes. Extreme caution should be exercised when CNS stimulants are given to patients with a history of psychosis, depression, mania, or bipolar disorder. Prior to initiating therapy, all patients should be screened for risk factors for developing a manic episode (e.g., comorbid or history of depressive symptoms or family history of suicide, bipolar disease, or depression). If any psychiatric symptoms emerge or are exacerbated, treatment suspension should be considered. Some CNS stimulants are contraindicated in patients with marked agitation or anxiety.

GERD

Moderate:

Excedrin Tension Headache

The caffeine in Excedrin Tension Headache has a moderate potential interaction with GERD.

Methylxanthines increase gastric acidity and may also relax lower esophageal sphincter, which can lead to gastric reflux into the esophagus. Therapy with products containing methylxanthines should be administered cautiously in patients with significant gastroesophageal reflux.

Heart Attack

Moderate:

Excedrin Tension Headache

The caffeine in Excedrin Tension Headache has a moderate potential interaction with Heart Attack.

Like other methylxanthines, caffeine at high dosages may be associated with positive inotropic and chronotropic effects on the heart. Caffeine may also produce an increase in systemic vascular resistance, resulting in elevation of blood pressure. Therapy with products containing caffeine should be administered cautiously in patients with severe cardiac disease, hypertension, hyperthyroidism, or acute myocardial injury. Some clinicians recommend avoiding caffeine in patients with symptomatic cardiac arrhythmias and/or palpitations and during the first several days to weeks after an acute myocardial infarction.

Heart Disease

Major:

Excedrin Tension Headache

The caffeine in Excedrin Tension Headache has a major potential interaction with Heart Disease.

Many CNS stimulants are contraindicated in patients with significant cardiovascular impairment such as uncompensated heart failure, severe coronary disease, severe hypertension (including that associated with hyperthyroidism or pheochromocytoma), cardiac structural abnormalities, serious arrhythmias, etc. Sudden death has been reported in patients with structural cardiac abnormalities or other serious cardiac disease who are treated with CNS stimulants at the recommended dosages for attention deficit hyperactivity disorder; use of these agents should be avoided in patients with known structural cardiac abnormalities, cardiomyopathy, serious cardiac arrhythmia, coronary artery disease, or other serious cardiac disease. Additionally, stroke, myocardial infarction, chest pain, syncope, arrhythmias, and other symptoms have been reported in adults under treatment. A careful assessment of the cardiovascular status should be done in patients being considered for treatment. This includes family history, physical exam, and further cardiac evaluation (EKG and echocardiogram). Patients who develop symptoms should have a detailed cardiac evaluation and if needed, treatment should be suspended.

High Blood Pressure

Major:

Excedrin Tension Headache

The caffeine in Excedrin Tension Headache has a major potential interaction with High Blood Pressure.

CNS stimulants increase blood pressure and heart rate; the use of some agents may be contraindicated in patients with severe/uncontrolled hypertension. Caution should be used when administering to patients with preexisting high blood pressure (even mild hypertension) and other cardiovascular conditions. All patients under treatment should be regularly monitored for potential tachycardia and hypertension.

Major:

Excedrin Tension Headache

The caffeine in Excedrin Tension Headache has a major potential interaction with High Blood Pressure.

Many CNS stimulants are contraindicated in patients with significant cardiovascular impairment such as uncompensated heart failure, severe coronary disease, severe hypertension (including that associated with hyperthyroidism or pheochromocytoma), cardiac structural abnormalities, serious arrhythmias, etc. Sudden death has been reported in patients with structural cardiac abnormalities or other serious cardiac disease who are treated with CNS stimulants at the recommended dosages for attention deficit hyperactivity disorder; use of these agents should be avoided in patients with known structural cardiac abnormalities, cardiomyopathy, serious cardiac arrhythmia, coronary artery disease, or other serious cardiac disease. Additionally, stroke, myocardial infarction, chest pain, syncope, arrhythmias, and other symptoms have been reported in adults under treatment. A careful assessment of the cardiovascular status should be done in patients being considered for treatment. This includes family history, physical exam, and further cardiac evaluation (EKG and echocardiogram). Patients who develop symptoms should have a detailed cardiac evaluation and if needed, treatment should be suspended.

Moderate:

Excedrin Tension Headache

The caffeine in Excedrin Tension Headache has a moderate potential interaction with High Blood Pressure.

Like other methylxanthines, caffeine at high dosages may be associated with positive inotropic and chronotropic effects on the heart. Caffeine may also produce an increase in systemic vascular resistance, resulting in elevation of blood pressure. Therapy with products containing caffeine should be administered cautiously in patients with severe cardiac disease, hypertension, hyperthyroidism, or acute myocardial injury. Some clinicians recommend avoiding caffeine in patients with symptomatic cardiac arrhythmias and/or palpitations and during the first several days to weeks after an acute myocardial infarction.

Hyperthyroidism

Major:

Excedrin Tension Headache

The caffeine in Excedrin Tension Headache has a major potential interaction with Hyperthyroidism.

Many CNS stimulants are contraindicated in patients with significant cardiovascular impairment such as uncompensated heart failure, severe coronary disease, severe hypertension (including that associated with hyperthyroidism or pheochromocytoma), cardiac structural abnormalities, serious arrhythmias, etc. Sudden death has been reported in patients with structural cardiac abnormalities or other serious cardiac disease who are treated with CNS stimulants at the recommended dosages for attention deficit hyperactivity disorder; use of these agents should be avoided in patients with known structural cardiac abnormalities, cardiomyopathy, serious cardiac arrhythmia, coronary artery disease, or other serious cardiac disease. Additionally, stroke, myocardial infarction, chest pain, syncope, arrhythmias, and other symptoms have been reported in adults under treatment. A careful assessment of the cardiovascular status should be done in patients being considered for treatment. This includes family history, physical exam, and further cardiac evaluation (EKG and echocardiogram). Patients who develop symptoms should have a detailed cardiac evaluation and if needed, treatment should be suspended.

Moderate:

Excedrin Tension Headache

The caffeine in Excedrin Tension Headache has a moderate potential interaction with Hyperthyroidism.

Like other methylxanthines, caffeine at high dosages may be associated with positive inotropic and chronotropic effects on the heart. Caffeine may also produce an increase in systemic vascular resistance, resulting in elevation of blood pressure. Therapy with products containing caffeine should be administered cautiously in patients with severe cardiac disease, hypertension, hyperthyroidism, or acute myocardial injury. Some clinicians recommend avoiding caffeine in patients with symptomatic cardiac arrhythmias and/or palpitations and during the first several days to weeks after an acute myocardial infarction.

Liver Disease

Major:

Excedrin Tension Headache

The acetaminophen in Excedrin Tension Headache has a major potential interaction with Liver Disease.

Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease. Patients with hepatic impairment may be at increased risk of toxicity. Severe liver injury, including cases of acute liver failure and death, have been reported in patients using this drug. Clinical monitoring of hepatic function is recommended. Caution is advised if using acetaminophen in patients with chronic malnutrition or severe hypovolemia. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.

Major:

methimazole

methIMAzole has a major potential interaction with Liver Disease.

The use of thioamide antithyroid agents has been associated with hepatotoxic effects, including transient elevations of serum transaminases and, rarely, cholestatic jaundice, fulminant hepatitis, hepatic necrosis, encephalopathy and death. Therapy with thioamide derivatives should be administered cautiously in patients with preexisting liver disease, a history of alcohol abuse, or hepatitis. Treatment should be discontinued if deterioration in liver function or other signs of hepatic injury occur. The jaundice associated with methimazole-induced hepatitis may persist for several weeks after withdrawal of the medication.

Moderate:

Excedrin Tension Headache

The caffeine in Excedrin Tension Headache has a moderate potential interaction with Liver Disease.

In general, CNS stimulants are extensively metabolized by the liver. Their plasma clearance may be decreased and their half-life prolonged in patients with impaired hepatic function. Therapy with CNS stimulants should be administered cautiously in patients with moderate to severe liver disease, and the dosage should be adjusted accordingly in certain agents. Additionally, postmarketing reports have shown that atomoxetine can cause severe liver injury; laboratory testing should be done at the first sign/symptom of liver dysfunction (jaundice, dark urine, upper quadrant tenderness) and treatment should be discontinued in patients with evidence of liver injury.

Malnourishment

Major:

Excedrin Tension Headache

The acetaminophen in Excedrin Tension Headache has a major potential interaction with Malnourishment.

Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease. Patients with hepatic impairment may be at increased risk of toxicity. Severe liver injury, including cases of acute liver failure and death, have been reported in patients using this drug. Clinical monitoring of hepatic function is recommended. Caution is advised if using acetaminophen in patients with chronic malnutrition or severe hypovolemia. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.

Neutropenia

Major:

methimazole

methIMAzole has a major potential interaction with Neutropenia.

The use of thioamide antithyroid agents may infrequently be associated with the development of blood dyscrasias, primarily agranulocytosis but also leukopenia, thrombocytopenia, and aplastic anemia. Most cases of agranulocytosis occur within the first two months of therapy, with incidence declining gradually thereafter. Patients older than 40 years of age and those receiving more than 40 mg/day of methimazole appear to be at substantially increased risk (a dosage association has not been reported for propylthiouracil). Therapy with thioamide derivatives should be administered cautiously in patients with or predisposed to blood dyscrasias and/or bone marrow depression. Clinical monitoring of hematopoietic function is recommended, with particular focus on leukocyte and differential counts. Because leukopenia (i.e. leukocyte count < 4000/mm3) may also occur in 10% of patients with untreated hyperthyroidism and is often associated with relative granulocytopenia, baseline count should be determined prior to initiating antithyroid medication. Patients should be instructed to immediately report during therapy any signs or symptoms suggestive of myelosuppression such as fever, sore throat, local infection, easy bruising, or bleeding. Cessation of antithyroid drug and institution of appropriate supportive measures are necessary if agranulocytosis or aplastic anemia develops.

Peptic Ulcer

Major:

Excedrin Tension Headache

The caffeine in Excedrin Tension Headache has a major potential interaction with Peptic Ulcer.

Methylxanthines are known to stimulate peptic acid secretion. Therapy with products containing methylxanthines should be administered with extreme caution in patients with active peptic ulcer disease. Some manufacturers consider their use to be contraindicated under such circumstance.

Peripheral Arterial Disease

Major:

Excedrin Tension Headache

The caffeine in Excedrin Tension Headache has a major potential interaction with Peripheral Arterial Disease.

Many CNS stimulants are contraindicated in patients with significant cardiovascular impairment such as uncompensated heart failure, severe coronary disease, severe hypertension (including that associated with hyperthyroidism or pheochromocytoma), cardiac structural abnormalities, serious arrhythmias, etc. Sudden death has been reported in patients with structural cardiac abnormalities or other serious cardiac disease who are treated with CNS stimulants at the recommended dosages for attention deficit hyperactivity disorder; use of these agents should be avoided in patients with known structural cardiac abnormalities, cardiomyopathy, serious cardiac arrhythmia, coronary artery disease, or other serious cardiac disease. Additionally, stroke, myocardial infarction, chest pain, syncope, arrhythmias, and other symptoms have been reported in adults under treatment. A careful assessment of the cardiovascular status should be done in patients being considered for treatment. This includes family history, physical exam, and further cardiac evaluation (EKG and echocardiogram). Patients who develop symptoms should have a detailed cardiac evaluation and if needed, treatment should be suspended.

Phenylketonuria

Moderate:

Excedrin Tension Headache

The acetaminophen in Excedrin Tension Headache has a moderate potential interaction with Phenylketonuria.

Several oral acetaminophen and acetaminophen-combination products, particularly flavored chewable tablets, contain the artificial sweetener, aspartame (NutraSweet). Aspartame is converted to phenylalanine in the gastrointestinal tract following ingestion. Chewable and effervescent formulations of acetaminophen products may also contain phenylalanine. The aspartame/phenylalanine content should be considered when these products are used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics).

Pheochromocytoma

Major:

Excedrin Tension Headache

The caffeine in Excedrin Tension Headache has a major potential interaction with Pheochromocytoma.

Many CNS stimulants are contraindicated in patients with significant cardiovascular impairment such as uncompensated heart failure, severe coronary disease, severe hypertension (including that associated with hyperthyroidism or pheochromocytoma), cardiac structural abnormalities, serious arrhythmias, etc. Sudden death has been reported in patients with structural cardiac abnormalities or other serious cardiac disease who are treated with CNS stimulants at the recommended dosages for attention deficit hyperactivity disorder; use of these agents should be avoided in patients with known structural cardiac abnormalities, cardiomyopathy, serious cardiac arrhythmia, coronary artery disease, or other serious cardiac disease. Additionally, stroke, myocardial infarction, chest pain, syncope, arrhythmias, and other symptoms have been reported in adults under treatment. A careful assessment of the cardiovascular status should be done in patients being considered for treatment. This includes family history, physical exam, and further cardiac evaluation (EKG and echocardiogram). Patients who develop symptoms should have a detailed cardiac evaluation and if needed, treatment should be suspended.

Post MI Syndrome

Moderate:

Excedrin Tension Headache

The caffeine in Excedrin Tension Headache has a moderate potential interaction with Post MI Syndrome.

Like other methylxanthines, caffeine at high dosages may be associated with positive inotropic and chronotropic effects on the heart. Caffeine may also produce an increase in systemic vascular resistance, resulting in elevation of blood pressure. Therapy with products containing caffeine should be administered cautiously in patients with severe cardiac disease, hypertension, hyperthyroidism, or acute myocardial injury. Some clinicians recommend avoiding caffeine in patients with symptomatic cardiac arrhythmias and/or palpitations and during the first several days to weeks after an acute myocardial infarction.

Psychosis

Major:

Excedrin Tension Headache

The caffeine in Excedrin Tension Headache has a major potential interaction with Psychosis.

The use of CNS stimulants can cause psychotic symptoms, suicidal ideation, and aggression, and can exacerbate symptoms of behavior disturbance and thought disorder; CNS stimulants may induce a manic or mixed episode in patients with bipolar disorder. Psychiatric symptoms have been reported in patients with and without history of psychiatric disorders. All patients (particularly those with psychotic or bipolar disorders) should be monitored closely, especially during treatment initiation and at times of dose changes. Extreme caution should be exercised when CNS stimulants are given to patients with a history of psychosis, depression, mania, or bipolar disorder. Prior to initiating therapy, all patients should be screened for risk factors for developing a manic episode (e.g., comorbid or history of depressive symptoms or family history of suicide, bipolar disease, or depression). If any psychiatric symptoms emerge or are exacerbated, treatment suspension should be considered. Some CNS stimulants are contraindicated in patients with marked agitation or anxiety.

Renal Dysfunction

Moderate:

Excedrin Tension Headache

The caffeine in Excedrin Tension Headache has a moderate potential interaction with Renal Dysfunction.

Overall CNS stimulants should be administered with caution in patients with significantly impaired renal function as the reduction in the rate of elimination may alter the therapeutic response. The dosage should be adjusted accordingly in certain agents.

Seizures

Moderate:

Excedrin Tension Headache

The caffeine in Excedrin Tension Headache has a moderate potential interaction with Seizures.

Due to general central nervous system stimulation, therapy with CNS stimulant drugs may cause seizures. These drugs may lower the convulsive threshold in patients with history of seizures, with prior electroencephalogram (EEG) abnormalities without seizures, and very rarely, without history of seizures and no prior EEG evidence of seizures. Therapy with CNS stimulants should be used with caution in patients with or predisposed to seizures. If seizures occur, therapy should be discontinued.

Tachyarrhythmia

Moderate:

Excedrin Tension Headache

The caffeine in Excedrin Tension Headache has a moderate potential interaction with Tachyarrhythmia.

Like other methylxanthines, caffeine at high dosages may be associated with positive inotropic and chronotropic effects on the heart. Caffeine may also produce an increase in systemic vascular resistance, resulting in elevation of blood pressure. Therapy with products containing caffeine should be administered cautiously in patients with severe cardiac disease, hypertension, hyperthyroidism, or acute myocardial injury. Some clinicians recommend avoiding caffeine in patients with symptomatic cardiac arrhythmias and/or palpitations and during the first several days to weeks after an acute myocardial infarction.

Thrombocytopathy

Major:

methimazole

methIMAzole has a major potential interaction with Thrombocytopathy.

Thioamide antithyroid agents may interfere with the action of vitamin K and have been reported in isolated cases to induce hypoprothombinemia and bleeding. Myelosuppression rarely resulting in thrombocytopenia has also been reported. Therapy with thioamide derivatives should be administered cautiously in patients with significant active bleeding or a hemorrhagic diathesis, including hemostatic and/or coagulation defects associated with hemophilia, vitamin K deficiency, hypoprothombinemia, thrombocytopenia, thrombocytopathy, or severe hepatic impairment. Clinical monitoring of prothrombin time or INR is recommended.

Thrombocytopenia

Major:

methimazole

methIMAzole has a major potential interaction with Thrombocytopenia.

The use of thioamide antithyroid agents may infrequently be associated with the development of blood dyscrasias, primarily agranulocytosis but also leukopenia, thrombocytopenia, and aplastic anemia. Most cases of agranulocytosis occur within the first two months of therapy, with incidence declining gradually thereafter. Patients older than 40 years of age and those receiving more than 40 mg/day of methimazole appear to be at substantially increased risk (a dosage association has not been reported for propylthiouracil). Therapy with thioamide derivatives should be administered cautiously in patients with or predisposed to blood dyscrasias and/or bone marrow depression. Clinical monitoring of hematopoietic function is recommended, with particular focus on leukocyte and differential counts. Because leukopenia (i.e. leukocyte count < 4000/mm3) may also occur in 10% of patients with untreated hyperthyroidism and is often associated with relative granulocytopenia, baseline count should be determined prior to initiating antithyroid medication. Patients should be instructed to immediately report during therapy any signs or symptoms suggestive of myelosuppression such as fever, sore throat, local infection, easy bruising, or bleeding. Cessation of antithyroid drug and institution of appropriate supportive measures are necessary if agranulocytosis or aplastic anemia develops.

Vitamin K Deficiency

Major:

methimazole

methIMAzole has a major potential interaction with Vitamin K Deficiency.

Thioamide antithyroid agents may interfere with the action of vitamin K and have been reported in isolated cases to induce hypoprothombinemia and bleeding. Myelosuppression rarely resulting in thrombocytopenia has also been reported. Therapy with thioamide derivatives should be administered cautiously in patients with significant active bleeding or a hemorrhagic diathesis, including hemostatic and/or coagulation defects associated with hemophilia, vitamin K deficiency, hypoprothombinemia, thrombocytopenia, thrombocytopathy, or severe hepatic impairment. Clinical monitoring of prothrombin time or INR is recommended.

More resources

Excedrin Tension Headache

A total of 635 drugs are known to interact with Excedrin Tension Headache.

methimazole

A total of 66 drugs are known to interact with methimazole.

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.