Can you take Iopamidol with Primatene?
1 drug interaction and 26 additional warnings found for the following 2 drugs:
- iopamidol
- Primatene (ephedrine/guaifenesin)
Drug interactions
Major drug interactions
Major:
ePHEDrine iopamidol
Applies to: Primatene (ephedrine / guaifenesin) and iopamidol
Before you undergo any imaging procedure where iopamidol may be injected directly into the spine, let your doctor know if you are currently being treated with ePHEDrine.
Injection of iopamidol into the spine can sometimes cause seizures, and the risk may be increased if you are also using other medications that can cause seizures such as ePHEDrine. You may be more susceptible if you are elderly, undergoing alcohol or drug withdrawal, have a history of seizures, or have a condition affecting the central nervous system such as a brain tumor or head trauma.
Your doctor may want to withhold ePHEDrine for a certain length of time before and after the procedure, or you may need to be monitored more closely during the procedure.
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
Moderate food/lifestyle interactions
Moderate:
ePHEDrine Caffeine
Applies to: Primatene (ephedrine / guaifenesin)
Both ePHEDrine and caffeine can increase blood pressure and heart rate, and combining them may enhance these effects.
Talk to your doctor before using these medications, especially if you have a history of high blood pressure or heart disease. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications.
Contact your doctor if your condition changes or you experience increased side effects.
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.
Disease interactions
25 potential interactions Applies to: 19 conditions, including High Blood Pressure, Allergies, Heart Failure, Asthma, and Benign Prostatic Hyperplasia.
Allergies
Moderate:
iopamidol
Iopamidol has a moderate potential interaction with Allergies.
Iodinated contrast media such as ioversol, can cause life-threatening or fatal hypersensitivity reactions including anaphylaxis and anaphylactic shock. Manifestations include respiratory arrest, laryngospasm, bronchospasm, angioedema, and shock. Most severe reactions develop shortly after the start of the injection (e.g. within 1 to 3 minutes), but delayed reactions may occur. There is an increased risk in patients with a history of a previous reaction to contrast agent, and known allergies (i.e., bronchial asthma, drug, or food allergies), and other hypersensitivities. Caution is advised on these patients. Premedication with antihistamines or corticosteroids to avoid or minimize possible allergic reactions may reduce both their incidence and severity.
Moderate:
iopamidol
Iopamidol has a moderate potential interaction with Allergies.
The possibility of a reaction, including serious, life-threatening, fatal, anaphylactoid or cardiovascular reactions, should always be considered when using iopamidol. Patients at increased risk include those with a history of a previous reaction to a contrast medium, patients with a known sensitivity to iodine per se, and patients with a known clinical hypersensitivity (bronchial asthma, hay fever, and food allergies). Caution and monitoring is advised. Competent personnel and emergency facilities should be available for at least 30 to 60 minutes since severe delayed reactions may occur.
Asthma
Moderate:
iopamidol
Iopamidol has a moderate potential interaction with Asthma.
Iodinated contrast media such as ioversol, can cause life-threatening or fatal hypersensitivity reactions including anaphylaxis and anaphylactic shock. Manifestations include respiratory arrest, laryngospasm, bronchospasm, angioedema, and shock. Most severe reactions develop shortly after the start of the injection (e.g. within 1 to 3 minutes), but delayed reactions may occur. There is an increased risk in patients with a history of a previous reaction to contrast agent, and known allergies (i.e., bronchial asthma, drug, or food allergies), and other hypersensitivities. Caution is advised on these patients. Premedication with antihistamines or corticosteroids to avoid or minimize possible allergic reactions may reduce both their incidence and severity.
Moderate:
iopamidol
Iopamidol has a moderate potential interaction with Asthma.
The possibility of a reaction, including serious, life-threatening, fatal, anaphylactoid or cardiovascular reactions, should always be considered when using iopamidol. Patients at increased risk include those with a history of a previous reaction to a contrast medium, patients with a known sensitivity to iodine per se, and patients with a known clinical hypersensitivity (bronchial asthma, hay fever, and food allergies). Caution and monitoring is advised. Competent personnel and emergency facilities should be available for at least 30 to 60 minutes since severe delayed reactions may occur.
Benign Prostatic Hyperplasia
Moderate:
Primatene
The ePHEDrine in Primatene has a moderate potential interaction with Benign Prostatic Hyperplasia.
Sympathomimetic agents may cause or worsen urinary difficulty in patients with prostate enlargement due to smooth muscle contraction in the bladder neck via stimulation of alpha-1 adrenergic receptors. Therapy with sympathomimetic agents should be administered cautiously in patients with hypertrophy or neoplasm of the prostate.
Cardiovascular Conditions and Disorders
Major:
Primatene
The ePHEDrine in Primatene has a major potential interaction with Cardiovascular Conditions and Disorders.
Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.
Cerebrovascular Insufficiency
Major:
Primatene
The ePHEDrine in Primatene has a major potential interaction with Cerebrovascular Insufficiency.
Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.
Dehydration
Moderate:
iopamidol
Iopamidol has a moderate potential interaction with Dehydration.
When using iopamidol, preparatory dehydration is dangerous and may contribute to acute renal failure in patients with advanced vascular disease, diabetic patients, and in susceptible nondiabetic patients (often elderly with preexisting renal disease). Patients should be well hydrated prior to and following iopamidol administration.
Diabetes Mellitus
Moderate:
Primatene
The ePHEDrine in Primatene has a moderate potential interaction with Diabetes Mellitus.
Sympathomimetic agents may cause increases in blood glucose concentrations. These effects are usually transient and slight but may be significant with dosages higher than those normally recommended. Therapy with sympathomimetic agents should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate.
Moderate:
Primatene
The ePHEDrine in Primatene has a moderate potential interaction with Diabetes Mellitus.
Ephedrine may produce slight increases in blood glucose concentrations. Therapy with ephedrine should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate. It is important that the recommended dosages of ephedrine are not exceeded.
Heart Failure
Moderate:
iopamidol
Iopamidol has a moderate potential interaction with Heart Failure.
After parenteral administration of a radiopaque agent such as iopamidol, competent personnel and emergency facilities should be available for at least 30 to 60 minutes since severe delayed reactions may occur. Caution should be exercised in hydrating patients with underlying conditions that may be worsened by fluid overload, such as congestive heart failure.
Moderate:
iopamidol
Iopamidol has a moderate potential interaction with Heart Failure.
In patients with advanced renal disease, iodinated contrast media should be used with caution, and only when the need for the examination dictates, since the excretion of the medium may be impaired. Patients with combined renal and hepatic disease, severe hypertension or congestive heart failure, and those with recent renal transplant may present an additional risk.
High Blood Pressure
Moderate:
iopamidol
Iopamidol has a moderate potential interaction with High Blood Pressure.
In patients with advanced renal disease, iodinated contrast media should be used with caution, and only when the need for the examination dictates, since the excretion of the medium may be impaired. Patients with combined renal and hepatic disease, severe hypertension or congestive heart failure, and those with recent renal transplant may present an additional risk.
Hyperthyroidism
Major:
iopamidol
Iopamidol has a major potential interaction with Hyperthyroidism.
Reports of thyroid storm following the use of iodinated diagnostic agents in patients with hyperthyroidism or with an autonomously functioning thyroid nodule suggest that this additional risk be evaluated in such patients before the use of any contrast medium. Some agents such as ioversol are contraindicated in symptomatic hyperthyroidism.
Major:
Primatene
The ePHEDrine in Primatene has a major potential interaction with Hyperthyroidism.
Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.
Kidney Transplant
Moderate:
iopamidol
Iopamidol has a moderate potential interaction with Kidney Transplant.
In patients with advanced renal disease, iodinated contrast media should be used with caution, and only when the need for the examination dictates, since the excretion of the medium may be impaired. Patients with combined renal and hepatic disease, severe hypertension or congestive heart failure, and those with recent renal transplant may present an additional risk.
Liver Disease
Moderate:
iopamidol
Iopamidol has a moderate potential interaction with Liver Disease.
In patients with advanced renal disease, iodinated contrast media should be used with caution, and only when the need for the examination dictates, since the excretion of the medium may be impaired. Patients with combined renal and hepatic disease, severe hypertension or congestive heart failure, and those with recent renal transplant may present an additional risk.
Multiple Myeloma
Moderate:
iopamidol
Iopamidol has a moderate potential interaction with Multiple Myeloma.
A definite risk exists in the use of intravascular contrast agents in patients who are known to have multiple myeloma. In such cases, anuria has developed resulting in progressive uremia, renal failure and eventually death. Although neither the contrast agent nor dehydration has separately proved to be the cause of anuria in myeloma, it has been speculated that the combination of both may be causative factors. The risk in patients with myeloma is not a contraindication to the procedure; however, partial dehydration in the preparation of these patients for the examination is not recommended since this may predispose to precipitation of myeloma protein in the renal tubules. Myeloma, which occurs most commonly in persons over 40, should be considered before instituting intravascular administration of contrast agents.
Myasthenia Gravis
Moderate:
iopamidol
Iopamidol has a moderate potential interaction with Myasthenia Gravis.
The administration of iodinated contrast media may aggravate the symptoms of myasthenia gravis. Caution is advised when using these agents in patients with this condition.
Pheochromocytoma
Major:
iopamidol
Iopamidol has a major potential interaction with Pheochromocytoma.
Administration of radiopaque materials to patients known or suspected of having pheochromocytoma should be performed with extreme caution. If, in the opinion of the physician, the possible benefits of such procedures outweigh the considered risk, the procedures should be performed with the absolute minimum amount of injected radiopaque medium. The blood pressure should be assessed throughout the procedure and measures for treatment of a hypertensive crisis should be available.
Major:
Primatene
The ePHEDrine in Primatene has a major potential interaction with Pheochromocytoma.
Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.
Prostate Tumor, Benign
Moderate:
Primatene
The ePHEDrine in Primatene has a moderate potential interaction with Prostate Tumor, Benign.
Sympathomimetic agents may cause or worsen urinary difficulty in patients with prostate enlargement due to smooth muscle contraction in the bladder neck via stimulation of alpha-1 adrenergic receptors. Therapy with sympathomimetic agents should be administered cautiously in patients with hypertrophy or neoplasm of the prostate.
Renal Dysfunction
Moderate:
iopamidol
Iopamidol has a moderate potential interaction with Renal Dysfunction.
In patients with advanced renal disease, iodinated contrast media should be used with caution, and only when the need for the examination dictates, since the excretion of the medium may be impaired. Patients with combined renal and hepatic disease, severe hypertension or congestive heart failure, and those with recent renal transplant may present an additional risk.
Sickle Cell Anemia
Moderate:
iopamidol
Iopamidol has a moderate potential interaction with Sickle Cell Anemia.
Some contrast agents have shown to promote the phenomenon of sickling (blood cell rupture) in individuals who are homozygous for sickle cell disease when administered intravenously or intra- arterially. Caution is advised.
Urinary Tract Obstruction
Moderate:
Primatene
The ePHEDrine in Primatene has a moderate potential interaction with Urinary Tract Obstruction.
Sympathomimetic agents such as ephedrine have the potential for producing clinically significant systemic effects, particularly during prolonged or indiscriminate use. In patients with prostate enlargement, urinary difficulty may develop or worsen due to smooth muscle contraction in the bladder neck via stimulation of alpha-1 adrenergic receptors. Therapy with ephedrine should be administered cautiously in patients with difficulty for urination due to hypertrophy or neoplasm of the prostate. It is important that the recommended dosages are not exceeded.
More resources
iopamidol
A total of 333 drugs are known to interact with iopamidol.
- Iopamidol is in the drug class non-ionic iodinated contrast media.
- Iopamidol is used to treat Endoscopy or Radiology Premedication.
Primatene
A total of 243 drugs are known to interact with Primatene.
- Primatene is in the drug class upper respiratory combinations.
- Primatene is used to treat Cold Symptoms.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.