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Drug Interactions between Indiomin MB and Pyridium Plus

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

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Interactions between your drugs

Moderate

butabarbital methylene blue

Applies to: Pyridium Plus (butabarbital / hyoscyamine / phenazopyridine) and Indiomin MB (hyoscyamine / methenamine / methylene blue / sodium biphosphate)

MONITOR: Limited clinical data suggest that nonselective monoamine oxidase inhibitors (MAOIs) may enhance or prolong the central nervous system effects of barbiturates. The mechanism of interaction is unknown, but may involve inhibition of barbiturate metabolism by MAOIs. Somnolence, dizziness, ataxia, and semi-consciousness have been reported.

MANAGEMENT: Until more information is available, patients should be monitored for increased barbiturate effects during coadministration with an MAOI or other agents that possess MAOI activity such as furazolidone, linezolid, methylene blue, and procarbazine.

References

  1. Sjoqvist F (1965) "Psychotropic drugs (2) interaction between monoamine oxidase (MAO) inhibitors and other substances." Proc R Soc Med, 58, p. 967-78
  2. Domino EF, Sullivan TS, Luby ED (1962) "Barbiturate intoxication in a patient treated with a MAO inhibitor." Am J Psychiatry, 118, p. 941-3
  3. Darcy PF, Griffin JP (1995) "Interactions with drugs used in the treatment of depressive illness." Adverse Drug React Toxicol Rev, 14, p. 211-31

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Drug and food interactions

Major

butabarbital food

Applies to: Pyridium Plus (butabarbital / hyoscyamine / phenazopyridine)

GENERALLY AVOID: Concurrent acute use of barbiturates and ethanol may result in additive CNS effects, including impaired coordination, sedation, and death. Tolerance of these agents may occur with chronic use. The mechanism is related to inhibition of microsomal enzymes acutely and induction of hepatic microsomal enzymes chronically.

MANAGEMENT: The combination of ethanol and barbiturates should be avoided.

References

  1. Gupta RC, Kofoed J (1966) "Toxological statistics for barbiturates, other sedatives, and tranquilizers in Ontario: a 10-year survey." Can Med Assoc J, 94, p. 863-5
  2. Misra PS, Lefevre A, Ishii H, Rubin E, Lieber CS (1971) "Increase of ethanol, meprobamate and pentobarbital metabolism after chronic ethanol administration in man and in rats." Am J Med, 51, p. 346-51
  3. Saario I, Linnoila M (1976) "Effect of subacute treatment with hypnotics, alone or in combination with alcohol, on psychomotor skills related to driving." Acta Pharmacol Toxicol (Copenh), 38, p. 382-92
  4. Stead AH, Moffat AC (1983) "Quantification of the interaction between barbiturates and alcohol and interpretation of fatal blood concentrations." Hum Toxicol, 2, p. 5-14
  5. Seixas FA (1979) "Drug/alcohol interactions: avert potential dangers." Geriatrics, 34, p. 89-102
View all 5 references

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Moderate

sodium biphosphate food

Applies to: Indiomin MB (hyoscyamine / methenamine / methylene blue / sodium biphosphate)

ADJUST DOSING INTERVAL: Bowel cleansing products can increase the gastrointestinal transit rate. Oral medications administered within one hour of the start of administration of the bowel cleansing solution may be flushed from the gastrointestinal tract and not properly absorbed.

MANAGEMENT: Patients should be advised that absorption of oral medications may be impaired during bowel cleansing treatment. Oral medications (e.g., anticonvulsants, oral contraceptives, antidiabetic agents, antibiotics) should not be administered during and within one hour of starting bowel cleansing treatment whenever possible. However, if concomitant use cannot be avoided, monitoring for reduced therapeutic effects may be advisable.

References

  1. "Product Information. Golytely (polyethylene glycol 3350 with electrolytes)." Braintree
  2. (2022) "Product Information. Prepopik (citric acid/Mg oxide/Na picosulfate)." Ferring Pharmaceuticals Inc

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Moderate

hyoscyamine food

Applies to: Indiomin MB (hyoscyamine / methenamine / methylene blue / sodium biphosphate) and Pyridium Plus (butabarbital / hyoscyamine / phenazopyridine)

GENERALLY AVOID: Use of anticholinergic agents with alcohol may result in sufficient impairment of attention so as to render driving and operating machinery more hazardous. In addition, the potential for abuse may be increased with the combination. The mechanism of interaction is not established but may involve additive depressant effects on the central nervous system. No effect of oral propantheline or atropine on blood alcohol levels was observed in healthy volunteers when administered before ingestion of a standard ethanol load. However, one study found impairment of attention in subjects given atropine 0.5 mg or glycopyrrolate 1 mg in combination with alcohol.

MANAGEMENT: Alcohol should generally be avoided during therapy with anticholinergic agents. Patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them.

References

  1. Linnoila M (1973) "Drug effects on psychomotor skills related to driving: interaction of atropine, glycopyrrhonium and alcohol." Eur J Clin Pharmacol, 6, p. 107-12

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Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Anticholinergics/antispasmodics

Therapeutic duplication

The recommended maximum number of medicines in the 'anticholinergics/antispasmodics' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'anticholinergics/antispasmodics' category:

  • Indiomin MB (hyoscyamine/methenamine/methylene blue/sodium biphosphate)
  • Pyridium Plus (butabarbital/hyoscyamine/phenazopyridine)

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

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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