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Can you take Maxichlor PSE DM with Semaglutide?

2 drug interactions and 31 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

chlorpheniramine dextromethorphan

Applies to: Maxichlor PSE DM (chlorpheniramine / dextromethorphan / pseudoephedrine) and Maxichlor PSE DM (chlorpheniramine / dextromethorphan / pseudoephedrine)

Using chlorpheniramine together with dextromethorphan may increase side effects such as:

  • dizziness
  • drowsiness
  • confusion
  • difficulty concentrating

Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination.

What to do: You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you.

Talk to your doctor if you have any questions or concerns. 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.

Moderate:

pseudoephedrine semaglutide

Applies to: Maxichlor PSE DM (chlorpheniramine / dextromethorphan / pseudoephedrine) and semaglutide

Pseudoephedrine may interfere with blood glucose control and reduce the effectiveness of semaglutide and other diabetic medications.

Monitor your blood sugar levels closely. You may need a dose adjustment of your diabetic medications during and after treatment with pseudoephedrine.

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:

chlorpheniramine Food/Lifestyle

Applies to: Maxichlor PSE DM (chlorpheniramine / dextromethorphan / pseudoephedrine)

Alcohol can increase the nervous system side effects of chlorpheniramine such as:

  • dizziness
  • drowsiness
  • difficulty concentrating

Some people may also experience impairment in thinking and judgment.

You should avoid or limit the use of alcohol while being treated with chlorpheniramine.

Do not use more than the recommended dose of chlorpheniramine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you.

Talk to your doctor or pharmacist if you have any questions or concerns.

Moderate:

dextromethorphan Food/Lifestyle

Applies to: Maxichlor PSE DM (chlorpheniramine / dextromethorphan / pseudoephedrine)

Alcohol can increase the nervous system side effects of dextromethorphan such as:

  • dizziness
  • drowsiness
  • difficulty concentrating

Some people may also experience impairment in thinking and judgment.

You should avoid or limit the use of alcohol while being treated with dextromethorphan.

Do not use more than the recommended dose of dextromethorphan, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you.

Talk to your doctor or pharmacist if you have any questions or concerns.

Moderate:

semaglutide Food/Lifestyle

Applies to: semaglutide

Food may affect the absorption of semaglutide when taken orally.

It is recommended that oral semaglutide be taken 30 minutes before first food, beverage, or other oral medications of the day with no more than 4 ounces of plain water.

You may experience more side effects including nausea, vomiting, and diarrhea if you fast longer than 30 minutes after the semaglutide dose.

Talk to a healthcare provider if you have any questions or concerns. 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.

Moderate:

pseudoephedrine Caffeine

Applies to: Maxichlor PSE DM (chlorpheniramine / dextromethorphan / pseudoephedrine)

Both pseudoephedrine 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

27 potential interactions Applies to: 23 conditions, including Asthma, Benign Prostatic Hyperplasia, COPD, Diarrhea, and Hypotension.

Asthma

Moderate:

Maxichlor PSE DM

The chlorpheniramine in Maxichlor PSE DM has a moderate potential interaction with Asthma.

It has been suggested that the anticholinergic effect of antihistamines may reduce the volume and cause thickening of bronchial secretions, resulting in obstruction of respiratory tract. Some manufacturers and clinicians recommend that therapy with antihistamines be administered cautiously in patients with asthma or chronic obstructive pulmonary disease.

Benign Prostatic Hyperplasia

Moderate:

Maxichlor PSE DM

The pseudoephedrine in Maxichlor PSE DM 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:

Maxichlor PSE DM

The pseudoephedrine in Maxichlor PSE DM 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.

Moderate:

Maxichlor PSE DM

The chlorpheniramine in Maxichlor PSE DM has a moderate potential interaction with Cardiovascular Conditions and Disorders.

Antihistamines may infrequently cause cardiovascular adverse effects related to their anticholinergic and local anesthetic (quinidine-like) activities. Tachycardia, palpitation, ECG changes, arrhythmias, hypotension, and hypertension have been reported. Although these effects are uncommon and usually limited to overdosage situations, the manufacturers and some clinicians recommend that therapy with antihistamines be administered cautiously in patients with cardiovascular disease, hypertension, and/or hyperthyroidism.

Cerebrovascular Insufficiency

Major:

Maxichlor PSE DM

The pseudoephedrine in Maxichlor PSE DM 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.

COPD

Moderate:

Maxichlor PSE DM

The chlorpheniramine in Maxichlor PSE DM has a moderate potential interaction with COPD.

It has been suggested that the anticholinergic effect of antihistamines may reduce the volume and cause thickening of bronchial secretions, resulting in obstruction of respiratory tract. Some manufacturers and clinicians recommend that therapy with antihistamines be administered cautiously in patients with asthma or chronic obstructive pulmonary disease.

Dehydration

Moderate:

semaglutide

Semaglutide has a moderate potential interaction with Dehydration.

There have been postmarketing reports of acute kidney injury (sometimes requiring hemodialysis) in patients treated with semaglutide. The majority of events occurred in patients with gastrointestinal adverse reactions leading to dehydration (e.g., nausea, vomiting, diarrhea); therefore, semaglutide is not recommended in patients with severe gastroparesis. It is recommended to monitor renal function in patients reporting adverse reactions to semaglutide that may lead to volume depletion, especially when initiating or escalating doses of semaglutide.

Diabetes Mellitus

Moderate:

Maxichlor PSE DM

The pseudoephedrine in Maxichlor PSE DM 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.

Diabetic Retinopathy

Moderate:

semaglutide

Semaglutide has a moderate potential interaction with Diabetic Retinopathy.

Patients with history of diabetic retinopathy should be monitored for progression of diabetic retinopathy during treatment with semaglutide. Rapid improvement in glucose control has been associated with a temporary worsening of diabetic retinopathy.

Diarrhea

Moderate:

semaglutide

Semaglutide has a moderate potential interaction with Diarrhea.

There have been postmarketing reports of acute kidney injury (sometimes requiring hemodialysis) in patients treated with semaglutide. The majority of events occurred in patients with gastrointestinal adverse reactions leading to dehydration (e.g., nausea, vomiting, diarrhea); therefore, semaglutide is not recommended in patients with severe gastroparesis. It is recommended to monitor renal function in patients reporting adverse reactions to semaglutide that may lead to volume depletion, especially when initiating or escalating doses of semaglutide.

Gastrointestinal Obstruction

Moderate:

Maxichlor PSE DM

The chlorpheniramine in Maxichlor PSE DM has a moderate potential interaction with Gastrointestinal Obstruction.

Antihistamines often have anticholinergic activity, to which elderly patients are particularly sensitive. Therapy with antihistamines should be administered cautiously, if at all, in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders. Conventional, first-generation antihistamines such as the ethanolamines (bromodiphenhydramine, carbinoxamine, clemastine, dimenhydrinate, diphenhydramine, doxylamine, phenyltoloxamine) tend to exhibit substantial anticholinergic effects. In contrast, the newer, relatively nonsedating antihistamines (e.g., cetirizine, fexofenadine, loratadine) reportedly have low to minimal anticholinergic activity at normally recommended dosages and may be appropriate alternatives.

Moderate:

Maxichlor PSE DM

The pseudoephedrine in Maxichlor PSE DM has a moderate potential interaction with Gastrointestinal Obstruction.

The extended-release formulation of pseudoephedrine (Sudafed 24 Hour) contains a non-deformable material. There have been rare reports of obstructive symptoms in patients with known strictures following the ingestion of similar sustained-release products. Therapy with the extended-release formulation of pseudoephedrine should be administered cautiously in patients with preexisting severe gastrointestinal narrowing or obstruction, whether pathologic or iatrogenic.

Gastroparesis

Moderate:

semaglutide

Semaglutide has a moderate potential interaction with Gastroparesis.

There have been postmarketing reports of acute kidney injury (sometimes requiring hemodialysis) in patients treated with semaglutide. The majority of events occurred in patients with gastrointestinal adverse reactions leading to dehydration (e.g., nausea, vomiting, diarrhea); therefore, semaglutide is not recommended in patients with severe gastroparesis. It is recommended to monitor renal function in patients reporting adverse reactions to semaglutide that may lead to volume depletion, especially when initiating or escalating doses of semaglutide.

Glaucoma/Intraocular Hypertension

Moderate:

Maxichlor PSE DM

The pseudoephedrine in Maxichlor PSE DM has a moderate potential interaction with Glaucoma/Intraocular Hypertension.

Sympathomimetic agents can induce transient mydriasis via stimulation of alpha-1 adrenergic receptors. In patients with anatomically narrow angles or narrow-angle glaucoma, pupillary dilation can provoke an acute attack. In patients with other forms of glaucoma, mydriasis may occasionally increase intraocular pressure. Therapy with sympathomimetic agents should be administered cautiously in patients with or predisposed to glaucoma, particularly narrow-angle glaucoma.

Moderate:

Maxichlor PSE DM

The chlorpheniramine in Maxichlor PSE DM has a moderate potential interaction with Glaucoma/Intraocular Hypertension.

Antihistamines often have anticholinergic activity, to which elderly patients are particularly sensitive. Therapy with antihistamines should be administered cautiously, if at all, in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders. Conventional, first-generation antihistamines such as the ethanolamines (bromodiphenhydramine, carbinoxamine, clemastine, dimenhydrinate, diphenhydramine, doxylamine, phenyltoloxamine) tend to exhibit substantial anticholinergic effects. In contrast, the newer, relatively nonsedating antihistamines (e.g., cetirizine, fexofenadine, loratadine) reportedly have low to minimal anticholinergic activity at normally recommended dosages and may be appropriate alternatives.

Hyperthyroidism

Major:

Maxichlor PSE DM

The pseudoephedrine in Maxichlor PSE DM 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.

Moderate:

Maxichlor PSE DM

The chlorpheniramine in Maxichlor PSE DM has a moderate potential interaction with Hyperthyroidism.

Antihistamines may infrequently cause cardiovascular adverse effects related to their anticholinergic and local anesthetic (quinidine-like) activities. Tachycardia, palpitation, ECG changes, arrhythmias, hypotension, and hypertension have been reported. Although these effects are uncommon and usually limited to overdosage situations, the manufacturers and some clinicians recommend that therapy with antihistamines be administered cautiously in patients with cardiovascular disease, hypertension, and/or hyperthyroidism.

Hypotension

Moderate:

Maxichlor PSE DM

The chlorpheniramine in Maxichlor PSE DM has a moderate potential interaction with Hypotension.

Antihistamines may infrequently cause cardiovascular adverse effects related to their anticholinergic and local anesthetic (quinidine-like) activities. Tachycardia, palpitation, ECG changes, arrhythmias, hypotension, and hypertension have been reported. Although these effects are uncommon and usually limited to overdosage situations, the manufacturers and some clinicians recommend that therapy with antihistamines be administered cautiously in patients with cardiovascular disease, hypertension, and/or hyperthyroidism.

Liver Disease

Moderate:

Maxichlor PSE DM

The chlorpheniramine in Maxichlor PSE DM has a moderate potential interaction with Liver Disease.

Limited pharmacokinetic data are available for the older, first-generation antihistamines. Many appear to be primarily metabolized by the liver, and both parent drugs and metabolites are excreted in the urine. Patients with renal and/or liver disease may be at greater risk for adverse effects from antihistamines due to drug and metabolite accumulation. Therapy with antihistamines should be administered cautiously in such patients. Lower initial dosages may be appropriate.

Multiple Endocrine Neoplasia Type II

Major:

semaglutide

Semaglutide has a major potential interaction with Multiple Endocrine Neoplasia Type II.

The use semaglutide is contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or in patients with multiple endocrine neoplasia syndrome type 2 (MEN 2). Patients with elevated serum calcitonin or thyroid nodules noted on physical examination or neck imaging should be further evaluated. It is recommended to counsel patients regarding the potential risk for MTC with the use of semaglutide and inform them of symptoms of thyroid tumors.

Phenylketonuria

Moderate:

Maxichlor PSE DM

The pseudoephedrine in Maxichlor PSE DM has a moderate potential interaction with Phenylketonuria.

Chewable products frequently may contain aspartame, which is metabolized in the gastrointestinal tract to phenylalanine. Sudafed (brand of pseudoephedrine) chewable 15 mg tablets provide the equivalent of 0.78 mg of phenylalanine per each tablet. The aspartame/phenylalanine content should be considered when this and similar products are used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics).

Pheochromocytoma

Major:

Maxichlor PSE DM

The pseudoephedrine in Maxichlor PSE DM 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:

Maxichlor PSE DM

The pseudoephedrine in Maxichlor PSE DM 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:

Maxichlor PSE DM

The chlorpheniramine in Maxichlor PSE DM has a moderate potential interaction with Renal Dysfunction.

Limited pharmacokinetic data are available for the older, first-generation antihistamines. Many appear to be primarily metabolized by the liver, and both parent drugs and metabolites are excreted in the urine. Patients with renal and/or liver disease may be at greater risk for adverse effects from antihistamines due to drug and metabolite accumulation. Therapy with antihistamines should be administered cautiously in such patients. Lower initial dosages may be appropriate.

Thyroid Tumor

Major:

semaglutide

Semaglutide has a major potential interaction with Thyroid Tumor.

The use semaglutide is contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or in patients with multiple endocrine neoplasia syndrome type 2 (MEN 2). Patients with elevated serum calcitonin or thyroid nodules noted on physical examination or neck imaging should be further evaluated. It is recommended to counsel patients regarding the potential risk for MTC with the use of semaglutide and inform them of symptoms of thyroid tumors.

Urinary Retention

Moderate:

Maxichlor PSE DM

The chlorpheniramine in Maxichlor PSE DM has a moderate potential interaction with Urinary Retention.

Antihistamines often have anticholinergic activity, to which elderly patients are particularly sensitive. Therapy with antihistamines should be administered cautiously, if at all, in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders. Conventional, first-generation antihistamines such as the ethanolamines (bromodiphenhydramine, carbinoxamine, clemastine, dimenhydrinate, diphenhydramine, doxylamine, phenyltoloxamine) tend to exhibit substantial anticholinergic effects. In contrast, the newer, relatively nonsedating antihistamines (e.g., cetirizine, fexofenadine, loratadine) reportedly have low to minimal anticholinergic activity at normally recommended dosages and may be appropriate alternatives.

Vomiting

Moderate:

semaglutide

Semaglutide has a moderate potential interaction with Vomiting.

There have been postmarketing reports of acute kidney injury (sometimes requiring hemodialysis) in patients treated with semaglutide. The majority of events occurred in patients with gastrointestinal adverse reactions leading to dehydration (e.g., nausea, vomiting, diarrhea); therefore, semaglutide is not recommended in patients with severe gastroparesis. It is recommended to monitor renal function in patients reporting adverse reactions to semaglutide that may lead to volume depletion, especially when initiating or escalating doses of semaglutide.

More resources

Maxichlor PSE DM

A total of 613 drugs are known to interact with Maxichlor PSE DM.

semaglutide

A total of 404 drugs are known to interact with semaglutide.

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.