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Drug Interactions between licorice and MZM

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

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Interactions between your drugs

Moderate

methazolAMIDE licorice

Applies to: MZM (methazolamide) and licorice

GENERALLY AVOID: Chronic use of licorice may potentiate the hypokalemic effects of some diuretics and other drugs that deplete potassium (e.g., amphotericin B, cation exchange resins). Glycyrrhizic acid, a component of licorice, possesses mineralocorticoid activity and can induce hypokalemia. Severe hypokalemia can lead to muscle paralysis, rhabdomyolysis, metabolic alkalosis, cardiac arrhythmias, and respiratory arrest.

MANAGEMENT: Patients should consult a healthcare provider before taking any herbal or alternative medicine. In general, chronic use of licorice and licorice-containing products should be avoided in patients treated with potassium-depleting drugs. During concomitant use, patients should be advised to contact their physician if they experience signs and symptoms of hypokalemia such as fatigue, myalgia, muscle weakness, abdominal pain, hypoventilation, and irregular heartbeat.

References

  1. Cumming AM, Boddy K, Brown JJ, et al. (1980) "Severe hypokalaemia with paralysis induced by small doses of liquorice." Postgrad Med J, 56, p. 526-9
  2. Cumming A (1976) "Severe reduction of serum potassium induced by licorice." Nurs Times, 72, p. 367-70
  3. de Klerk GJ, Nieuwenhuis MG, Beutler JJ (1997) "Lesson of the week: hypokalaemia and hypertension associated with use of liquorice flavoured chewing gum." BMJ, 314, p. 731
  4. Edwards CR (1991) "Lessons from licorice." N Engl J Med, 325, p. 1242-3
  5. Stewart PM, Wallace AM, Valentino R, Burt D, Shackleton CH, Edwards CR (1987) "Mineralocorticoid activity of liquorice: 11-beta-hydroxysteroid dehydrogenase deficiency comes of age." Lancet, 2, p. 821-4
  6. Nielsen I, Pedersen RS (1984) "Life-threatening hypokalaemia caused by liquorice ingestion." Lancet, 1, p. 1305
  7. Rosseel M, Schoors D (1993) "Chewing gum and hypokalaemia." Lancet, 341, p. 175
  8. Clyburn EB, DiPette DJ (1995) "Hypertension induced by drugs and other substances." Semin Nephrol, 15, p. 72-86
  9. Farese RV, Biglieri EG, Shackleton CH, Irony I, Gomez-Fontes R (1991) "Licorice-induced hypermineralocorticoidism." N Engl J Med, 325, p. 1223-7
  10. Elinav E, Chajek-Shaul T (2003) "Licorice consumption causing severe hypokalemic paralysis." Mayo Clin Proc, 78, p. 767-8
View all 10 references

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Drug and food interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

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

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