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Drug Interactions between fosphenytoin and Meperitab

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

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Interactions between your drugs

Moderate

meperidine fosphenytoin

Applies to: Meperitab (meperidine) and fosphenytoin

GENERALLY AVOID: Phenytoin may induce the metabolism of meperidine to normeperidine, the latter of which has been associated with adverse effects such as lethargy, agitation, and seizures. The interaction may decrease the therapeutic effects of meperidine while increasing its adverse effects. In four healthy volunteers, phenytoin (300 mg daily for 10 days) increased the systemic clearance of meperidine by 26%, decreased its elimination half-life by 33%, and decreased its oral bioavailability by 30%. Systemic exposure (AUC) of normeperidine from intravenous and oral meperidine increased by 53% and 25%, respectively, during coadministration with phenytoin.

MANAGEMENT: Meperidine product labeling recommends that the combination of meperidine and phenytoin be avoided. The same precaution may be applicable to other hydantoins, although clinical data are lacking.

References (2)
  1. Pond SM, Kretschzmar KM (1981) "Effect of phenytoin on meperidine clearance and normeperidine formation." Clin Pharmacol Ther, 30, p. 680-6
  2. (2002) "Product Information. Demerol (meperidine)." Sanofi Winthrop Pharmaceuticals

Drug and food interactions

Moderate

meperidine food

Applies to: Meperitab (meperidine)

GENERALLY AVOID: Ethanol 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.

MANAGEMENT: Concomitant use of opioid analgesics with ethanol should be avoided.

References (9)
  1. Linnoila M, Hakkinen S (1974) "Effects of diazepam and codeine, alone and in combination with alcohol, on simulated driving." Clin Pharmacol Ther, 15, p. 368-73
  2. Sturner WQ, Garriott JC (1973) "Deaths involving propoxyphene: a study of 41 cases over a two-year period." JAMA, 223, p. 1125-30
  3. Girre C, Hirschhorn M, Bertaux L, et al. (1991) "Enhancement of propoxyphene bioavailability by ethanol: relation to psychomotor and cognitive function in healthy volunteers." Eur J Clin Pharmacol, 41, p. 147-52
  4. Levine B, Saady J, Fierro M, Valentour J (1984) "A hydromorphone and ethanol fatality." J Forensic Sci, 29, p. 655-9
  5. Sellers EM, Hamilton CA, Kaplan HL, Degani NC, Foltz RL (1985) "Pharmacokinetic interaction of propoxyphene with ethanol." Br J Clin Pharmacol, 19, p. 398-401
  6. Carson DJ (1977) "Fatal dextropropoxyphene poisoning in Northern Ireland. Review of 30 cases." Lancet, 1, p. 894-7
  7. Rosser WW (1980) "The interaction of propoxyphene with other drugs." Can Med Assoc J, 122, p. 149-50
  8. Edwards C, Gard PR, Handley SL, Hunter M, Whittington RM (1982) "Distalgesic and ethanol-impaired function." Lancet, 2, p. 384
  9. Kiplinger GF, Sokol G, Rodda BE (1974) "Effect of combined alcohol and propoxyphene on human performance." Arch Int Pharmacodyn Ther, 212, p. 175-80

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

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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