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Can you take Mandanol Infant with Sulfasalazine?

1 drug interaction and 23 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

acetaminophen sulfaSALAzine

Applies to: Mandanol Infant (acetaminophen) and sulfasalazine

Both acetaminophen and sulfaSALAzine can affect the liver, and combining them may increase the risk of liver damage. Talk to your doctor before using these medications together, particularly if you have other risk factors for liver problems. Do not use more than the recommended dose of acetaminophen or take more than one medication containing acetaminophen at the same time. Contact your doctor if you experience increased side effects or symptoms that concern you. 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

Major food/lifestyle interactions

Major:

acetaminophen Food/Lifestyle

Applies to: Mandanol Infant (acetaminophen)

Acetaminophen may cause liver damage and taking it with alcohol may increase that risk. You should avoid or limit the use of alcohol while being treated with acetaminophen. Call your doctor immediately if you have fever, chills, joint pain or swelling, excessive tiredness or weakness, unusual bleeding or bruising, skin rash or itching, loss of appetite, nausea, vomiting, dark colored urine, or yellowing of the skin or the whites of your eyes, as these may be symptoms of liver damage. 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

22 potential interactions Applies to: 19 conditions, including Allergies, Asthma, Diarrhea, HIV-1 Infection, and Liver Disease.

Alcoholism

Major:

Mandanol Infant

The acetaminophen in Mandanol Infant has a major potential interaction with Alcoholism.

Chronic alcohol abusers may be at increased risk of hepatotoxicity during treatment with acetaminophen (APAP). Severe liver injury, including cases of acute liver failure resulting in liver transplant and death, has been reported in patients using acetaminophen. Therapy with acetaminophen should be administered cautiously, if at all, in patients who consume three or more alcoholic drinks a day. In general, patients should avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure. They should also be advised to seek medical attention if they experience signs and symptoms of liver injury such as fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, and jaundice.

Allergies

Major:

sulfasalazine

sulfaSALAzine has a major potential interaction with Allergies.

The use of sulfonamides is associated with large increases in the risk of Stevens-Johnson syndrome, toxic epidermal necrolysis and other serious dermatologic reactions, although these phenomena are rare as a whole. Hepatitis, pneumonitis, and interstitial nephritis have also occurred in association with sulfonamide hypersensitivity. Therapy with sulfonamides should be administered cautiously in patients with severe allergies, bronchial asthma or AIDS, since these patients may be at increased risk for potentially severe hypersensitivity reactions. Patients should be instructed to promptly report signs and symptoms that may precede the onset of cutaneous manifestations of the Stevens-Johnson syndrome, such as high fever, severe headache, stomatitis, conjunctivitis, rhinitis, urethritis, and balanitis. Sulfonamide therapy should be stopped at once if a rash develops.

Anemia, Folate Deficiency

Moderate:

sulfasalazine

sulfaSALAzine has a moderate potential interaction with Anemia, Folate Deficiency.

Sulfasalazine may interfere with the absorption of dietary folic acid. Folate deficiency and megaloblastic anemia have been reported. Therapy with sulfasalazine should be administered cautiously in patients with preexisting folate deficiency or anemia secondary to folate deficiency. Folic acid supplementation (1 mg/day) is recommended in all patients during prolonged therapy.

Asthma

Major:

sulfasalazine

sulfaSALAzine has a major potential interaction with Asthma.

The use of sulfonamides is associated with large increases in the risk of Stevens-Johnson syndrome, toxic epidermal necrolysis and other serious dermatologic reactions, although these phenomena are rare as a whole. Hepatitis, pneumonitis, and interstitial nephritis have also occurred in association with sulfonamide hypersensitivity. Therapy with sulfonamides should be administered cautiously in patients with severe allergies, bronchial asthma or AIDS, since these patients may be at increased risk for potentially severe hypersensitivity reactions. Patients should be instructed to promptly report signs and symptoms that may precede the onset of cutaneous manifestations of the Stevens-Johnson syndrome, such as high fever, severe headache, stomatitis, conjunctivitis, rhinitis, urethritis, and balanitis. Sulfonamide therapy should be stopped at once if a rash develops.

Bone Marrow Depression/Low Blood Counts

Major:

sulfasalazine

sulfaSALAzine has a major potential interaction with Bone Marrow Depression/Low Blood Counts.

The use of sulfonamides has been associated with hematologic toxicity, including methemoglobinemia, sulfhemoglobinemia, leukopenia, granulocytopenia, eosinophilia, hemolytic anemia, aplastic anemia, purpura, clotting disorder, thrombocytopenia, hypofibrinogenemia, and hypoprothrombinemia. Acute dose-related hemolytic anemia may occur during the first week of therapy due to sensitization, while chronic hemolytic anemia may occur with prolonged use. Patients with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency should be observed closely for signs of hemolytic anemia. Therapy with sulfonamides should be administered cautiously in patients with preexisting blood dyscrasias or bone marrow suppression. Complete blood counts should be obtained regularly, especially during prolonged therapy (>2 weeks), and patients should be instructed to immediately report any signs or symptoms suggestive of blood dyscrasia such as fever, sore throat, local infection, bleeding, pallor, dizziness, or jaundice.

Dehydration

Major:

Mandanol Infant

The acetaminophen in Mandanol Infant has a major potential interaction with Dehydration.

Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease. Patients with hepatic impairment may be at increased risk of toxicity. Severe liver injury, including cases of acute liver failure and death, have been reported in patients using this drug. Clinical monitoring of hepatic function is recommended. Caution is advised if using acetaminophen in patients with chronic malnutrition or severe hypovolemia. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.

Moderate:

sulfasalazine

sulfaSALAzine has a moderate potential interaction with Dehydration.

Crystalluria can occur during sulfonamide therapy due to precipitation of the sulfonamide and/or its N4-acetyl metabolite in the urinary tract. Renal toxicity such as uro- and nephrolithiasis, nephritis, toxic nephrosis, hematuria, proteinuria, and elevated BUN and creatinine has been reported. Hydration (8 oz. glass of water with each dose and throughout the day) and adequate urinary output (> 1.5 L/day) should be maintained during sulfonamide administration. Patients who are dehydrated (e.g., due to severe diarrhea or vomiting) may be at increased risk for the development of crystalluria and lithiasis and should be encouraged to consume additional amounts of liquid or given intravenous fluid. Renal function tests and urinalysis should be performed weekly during prolonged therapy (> 2 weeks). Rarely, alkalinization of the urine is necessary.

Diarrhea

Moderate:

sulfasalazine

sulfaSALAzine has a moderate potential interaction with Diarrhea.

Crystalluria can occur during sulfonamide therapy due to precipitation of the sulfonamide and/or its N4-acetyl metabolite in the urinary tract. Renal toxicity such as uro- and nephrolithiasis, nephritis, toxic nephrosis, hematuria, proteinuria, and elevated BUN and creatinine has been reported. Hydration (8 oz. glass of water with each dose and throughout the day) and adequate urinary output (> 1.5 L/day) should be maintained during sulfonamide administration. Patients who are dehydrated (e.g., due to severe diarrhea or vomiting) may be at increased risk for the development of crystalluria and lithiasis and should be encouraged to consume additional amounts of liquid or given intravenous fluid. Renal function tests and urinalysis should be performed weekly during prolonged therapy (> 2 weeks). Rarely, alkalinization of the urine is necessary.

Folic Acid/Cyanocobalamin Deficiency

Moderate:

sulfasalazine

sulfaSALAzine has a moderate potential interaction with Folic Acid/Cyanocobalamin Deficiency.

Sulfasalazine may interfere with the absorption of dietary folic acid. Folate deficiency and megaloblastic anemia have been reported. Therapy with sulfasalazine should be administered cautiously in patients with preexisting folate deficiency or anemia secondary to folate deficiency. Folic acid supplementation (1 mg/day) is recommended in all patients during prolonged therapy.

G-6-PD Deficiency

Moderate:

sulfasalazine

sulfaSALAzine has a moderate potential interaction with G-6-PD Deficiency.

Sulfasalazine may cause hemolytic anemia in patients with glucose-6 phosphate dehydrogenase deficiency. This reaction is frequently dose related. It is recommended to observe these patients closely for signs of hemolytic anemia, and if toxic reactions occur, the drug should be discontinued immediately.

HIV-1 Infection

Major:

sulfasalazine

sulfaSALAzine has a major potential interaction with HIV-1 Infection.

The use of sulfonamides is associated with large increases in the risk of Stevens-Johnson syndrome, toxic epidermal necrolysis and other serious dermatologic reactions, although these phenomena are rare as a whole. Hepatitis, pneumonitis, and interstitial nephritis have also occurred in association with sulfonamide hypersensitivity. Therapy with sulfonamides should be administered cautiously in patients with severe allergies, bronchial asthma or AIDS, since these patients may be at increased risk for potentially severe hypersensitivity reactions. Patients should be instructed to promptly report signs and symptoms that may precede the onset of cutaneous manifestations of the Stevens-Johnson syndrome, such as high fever, severe headache, stomatitis, conjunctivitis, rhinitis, urethritis, and balanitis. Sulfonamide therapy should be stopped at once if a rash develops.

Intestinal Obstruction

Major:

sulfasalazine

sulfaSALAzine has a major potential interaction with Intestinal Obstruction.

The use of sulfasalazine is contraindicated in patients with intestinal obstruction. Approximately one-third of orally administered sulfasalazine is systemically absorbed from the small intestine, while the majority is metabolized by intestinal bacteria to 5-aminosalicylic acid (5-ASA) that remains in the colonic lumen and gets excreted in the feces.

Liver Disease

Major:

Mandanol Infant

The acetaminophen in Mandanol Infant has a major potential interaction with Liver Disease.

Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease. Patients with hepatic impairment may be at increased risk of toxicity. Severe liver injury, including cases of acute liver failure and death, have been reported in patients using this drug. Clinical monitoring of hepatic function is recommended. Caution is advised if using acetaminophen in patients with chronic malnutrition or severe hypovolemia. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.

Major:

sulfasalazine

sulfaSALAzine has a major potential interaction with Liver Disease.

Hepatotoxicity, including jaundice, diffuse hepatocellular necrosis, hypersensitivity hepatitis and hepatic failure, has rarely been reported in patients receiving sulfonamides. In addition, sulfonamides are partially metabolized by the liver and may accumulate in patients with hepatic impairment. Therapy with sulfonamides should be administered cautiously in patients with liver disease.

Malnourishment

Major:

Mandanol Infant

The acetaminophen in Mandanol Infant has a major potential interaction with Malnourishment.

Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease. Patients with hepatic impairment may be at increased risk of toxicity. Severe liver injury, including cases of acute liver failure and death, have been reported in patients using this drug. Clinical monitoring of hepatic function is recommended. Caution is advised if using acetaminophen in patients with chronic malnutrition or severe hypovolemia. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.

Noninfectious Colitis

Major:

sulfasalazine

sulfaSALAzine has a major potential interaction with Noninfectious Colitis.

Clostridioides difficile-associated diarrhea (CDAD), formerly pseudomembranous colitis, has been reported with almost all antibacterial drugs and may range from mild diarrhea to fatal colitis. The most common culprits include clindamycin and lincomycin. Antibacterial therapy alters the normal flora of the colon, leading to overgrowth of C difficile, whose toxins A and B contribute to CDAD development. Morbidity and mortality are increased with hypertoxin-producing strains of C difficile; these infections can be resistant to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea after antibacterial use. Since CDAD has been reported to occur more than 2 months after antibacterial use, careful medical history is necessary. Therapy with broad-spectrum antibacterials and other agents with significant antibacterial activity should be administered cautiously in patients with history of gastrointestinal disease, particularly colitis; pseudomembranous colitis (generally characterized by severe, persistent diarrhea and severe abdominal cramps, and sometimes associated with the passage of blood and mucus), if it occurs, may be more severe in these patients and may be associated with flares in underlying disease activity. Antibacterial drugs not directed against C difficile may need to be stopped if CDAD is suspected or confirmed. Appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C difficile, and surgical evaluation should be started as clinically indicated.

Phenylketonuria

Moderate:

Mandanol Infant

The acetaminophen in Mandanol Infant has a moderate potential interaction with Phenylketonuria.

Several oral acetaminophen and acetaminophen-combination products, particularly flavored chewable tablets, contain the artificial sweetener, aspartame (NutraSweet). Aspartame is converted to phenylalanine in the gastrointestinal tract following ingestion. Chewable and effervescent formulations of acetaminophen products may also contain phenylalanine. The aspartame/phenylalanine content should be considered when these products are used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics).

Porphyria

Major:

sulfasalazine

sulfaSALAzine has a major potential interaction with Porphyria.

The use of sulfonamides is contraindicated in patients with porphyria, since these drugs can precipitate an acute attack.

Renal Dysfunction

Major:

sulfasalazine

sulfaSALAzine has a major potential interaction with Renal Dysfunction.

Sulfonamides and their metabolites are eliminated by the kidney. Patients with renal impairment may be at greater risk for adverse effects from sulfonamides due to decreased drug clearance. Dosage adjustments may be necessary and modifications should be based on the degree of renal impairment and severity of infection. Additionally, sulfonamides may cause renal toxicity secondary to crystalluria, including uro- and nephrolithiasis, nephritis, toxic nephrosis, hematuria, proteinuria, and elevated BUN and creatinine. Hydration (8 oz. glass of water with each dose and throughout the day) and adequate urinary output (> 1.5 L/day) should be maintained during sulfonamide administration. Renal function tests and urinalysis should be performed weekly or as often as indicated by the patient's status. Rarely, alkalinization of the urine is necessary.

Moderate:

sulfasalazine

sulfaSALAzine has a moderate potential interaction with Renal Dysfunction.

The use of mesalamine and other compounds which contain or are converted to mesalamine has rarely been associated with renal adverse effects, including minimal change nephropathy, acute and chronic interstitial nephritis, and nephrogenic diabetes insipidus. Renal lesions such as renal infarct, papillary necrosis, tubular necrosis and interstitial fibrosis have been reported in high-dose animal studies. Therapy with mesalamine and prodrugs of mesalamine should be administered cautiously in patients with impaired renal function or a history of renal disease. Renal function should be evaluated prior to initiation of therapy and periodically during therapy.

Urinary Tract Obstruction

Major:

sulfasalazine

sulfaSALAzine has a major potential interaction with Urinary Tract Obstruction.

The use of sulfasalazine tablets is contraindicated in patients with urinary obstruction.

Vomiting

Moderate:

sulfasalazine

sulfaSALAzine has a moderate potential interaction with Vomiting.

Crystalluria can occur during sulfonamide therapy due to precipitation of the sulfonamide and/or its N4-acetyl metabolite in the urinary tract. Renal toxicity such as uro- and nephrolithiasis, nephritis, toxic nephrosis, hematuria, proteinuria, and elevated BUN and creatinine has been reported. Hydration (8 oz. glass of water with each dose and throughout the day) and adequate urinary output (> 1.5 L/day) should be maintained during sulfonamide administration. Patients who are dehydrated (e.g., due to severe diarrhea or vomiting) may be at increased risk for the development of crystalluria and lithiasis and should be encouraged to consume additional amounts of liquid or given intravenous fluid. Renal function tests and urinalysis should be performed weekly during prolonged therapy (> 2 weeks). Rarely, alkalinization of the urine is necessary.

More resources

Mandanol Infant

A total of 540 drugs are known to interact with Mandanol Infant.

sulfasalazine

A total of 294 drugs are known to interact with sulfasalazine.

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.