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Drug Interactions between Hydro-Tussin EXP and Sensipar

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

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Interactions between your drugs

Moderate

dihydrocodeine cinacalcet

Applies to: Hydro-Tussin EXP (dihydrocodeine / guaifenesin / pseudoephedrine) and Sensipar (cinacalcet)

MONITOR: Coadministration with cinacalcet may increase the plasma concentrations of drugs that are substrates of the CYP450 2D6 isoenzyme. The mechanism is decreased clearance due to inhibition of CYP450 2D6 activity by cinacalcet, which is expected to occur in patients who are CYP450 2D6 extensive metabolizers (approximately 93% of Caucasians and more than 98% of Asians and individuals of African descent). Concurrent administration of cinacalcet (25 or 100 mg) increased the systemic exposure of amitriptyline (50 mg) and its active metabolite, nortriptyline, by approximately 20% in CYP450 2D6 extensive metabolizers. However, because amitriptyline is metabolized by multiple CYP450 isoenzymes in addition to 2D6, the degree of interaction with cinacalcet may be less than that expected for other drugs that are primarily metabolized by 2D6.

MANAGEMENT: Caution is advised if cinacalcet must be used concurrently with medications that undergo metabolism by CYP450 2D6, particularly those with a narrow therapeutic range (e.g., class IC antiarrhythmic agents, phenothiazines, certain beta blockers, and most tricyclic antidepressants). Dosage adjustments as well as clinical and laboratory monitoring may be appropriate for some drugs whenever cinacalcet is added to or withdrawn from therapy.

References

  1. (2004) "Product Information. Sensipar (cinacalcet)." Amgen USA
  2. Pharmaceutical Society of Australia (2006) APPGuide online. Australian prescription products guide online. http://www.appco.com.au/appguide/default.asp
  3. Cerner Multum, Inc. "Australian Product Information."

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Drug and food interactions

Moderate

cinacalcet food

Applies to: Sensipar (cinacalcet)

ADJUST DOSING INTERVAL: Food enhances the oral absorption and bioavailability of cinacalcet. According to the product labeling for cinacalcet, administration with a high-fat meal increased the peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of cinacalcet by 82% and 68%, respectively, compared to administration in the fasting state. The Cmax and AUC were increased 65% and 50%, respectively, when cinacalcet was administered with a low-fat meal compared to fasting.

MANAGEMENT: To ensure maximal oral absorption, cinacalcet should be administered with or immediately after a meal. The tablets should be taken whole and not divided or crushed.

References

  1. (2004) "Product Information. Sensipar (cinacalcet)." Amgen USA

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Moderate

pseudoephedrine food

Applies to: Hydro-Tussin EXP (dihydrocodeine / guaifenesin / pseudoephedrine)

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

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

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