Drug Interactions between Meprozine and Metvixia
This report displays the potential drug interactions for the following 2 drugs:
- Meprozine (meperidine/promethazine)
- Metvixia (methyl aminolevulinate topical)
Interactions between your drugs
meperidine promethazine
Applies to: Meprozine (meperidine / promethazine) and Meprozine (meperidine / promethazine)
ADJUST DOSE: The central nervous system and respiratory depressant effects of meperidine may be potentiated by concomitant use of other agents with CNS depressant effects. An increased risk of serious adverse reactions such as respiratory depression, hypotension, profound sedation, syncope, coma, and even death should be considered, particularly in elderly or debilitated patients.
MANAGEMENT: Caution and dosage adjustments are advisable when meperidine is used in combination with other narcotic analgesics, general anesthetics, phenothiazines, sedative-hypnotics, tranquilizers, tricyclic antidepressants, or other CNS depressants such as alcohol. A lower dosage of meperidine should be considered initially, then titrated carefully according to pain level and clinical response. Meperidine dosage reductions of 25% to 50% have been recommended for patients receiving phenothiazines and other tranquilizers. Patients should be advised to avoid rising abruptly from a sitting or recumbent position, and to notify their physician if they experience dizziness, lightheadedness, orthostasis, syncope, tachycardia, or excessive CNS effects that interfere with their normal activities. Patients should also avoid driving or operating hazardous machinery until they know how these medications affect them.
References
- Lambertsen CJ, Wendel H, Longenhagen JB (1961) "The separate and combined respiratory effects of chlorpromazine and meperidine in normal men controlled at 46 mm Hg alveolar pCO2." J Pharmacol Exp Ther, 131, p. 381-93
- Hoffman JC, Smith TC (1970) "The respiratory effects of meperidine and propiomazine in man." Anesthesiology, 32, p. 325-31
- Stambaugh JE, Wainer IW (1981) "Drug interaction: meperidine and chlorpromazine, a toxic combination." J Clin Pharmacol, 21, p. 140-6
- (2002) "Product Information. Demerol (meperidine)." Sanofi Winthrop Pharmaceuticals
- (2022) "Product Information. Meperidine Hydrochloride (meperidine)." Astra-Zeneca Pharmaceuticals
promethazine methyl aminolevulinate topical
Applies to: Meprozine (meperidine / promethazine) and Metvixia (methyl aminolevulinate topical)
MONITOR: Concomitant use of aminolevulinate topical preparations with other known photosensitizing agents may enhance the phototoxic reaction to photodynamic therapy. These agents have each been individually associated with photosensitivity reactions and may have additive effects if administered concurrently. Medicinal products with known phototoxic or photoallergic potential include fluoroquinolones, phenothiazines, retinoids, sulfonamides, sulfonylureas, tetracyclines, thiazide diuretics, griseofulvin, and hypericin extracts (e.g., St John's Wort).
MANAGEMENT: Caution is advised and pharmacologic response to photodynamic therapy should be carefully monitored if concomitant use of other photosensitizing agents cannot be avoided. Patients should be advised to avoid exposure of treated areas to sunlight or bright indoor lights (e.g., examination lamps, operating room lamps, tanning beds, lights at close proximity) during the period between application of aminolevulinic acid or methyl aminolevulinate and photoactivation, and for 48 hours post-illumination. As sunscreen is not effective in protecting treated areas of skin, patients should be counseled to wear protective apparel, such as a wide-brimmed hat, long sleeve shirt, and gloves to protect themselves. Concomitant use with other topical medicinal products should be avoided. Some authorities recommend avoiding use of hypericin-containing products for 2 weeks prior to treatment with topical aminolevulinic acid.
References
- (2001) "Product Information. Levulan Kerastick (aminolevulinic acid)." Berlex Laboratories
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- Cerner Multum, Inc. "Australian Product Information."
- (2008) "Product Information. Metvixia (methyl aminolevulinate topical)." Galderma Laboratories Inc
- Hoffman GA, Gradl G, Schulz M, Haidinger G, Tanew A, Weber B (2020) "The frequency of photosensitizing drug dispensings in Austria and Germany: A correlation with their photosensitizing potential based on published literature." J Eur Acad Dermatol Venereol, 34, p. 589-600
- Blakely KM, Drucker AM, Rosen CF (2019) "Drug-induced photosensitivity—an update: Culprit drugs, prevention and management." Drug Saf, 42, p. 827-47
- (2022) "Product Information. Metvix (methyl aminolevulinate topical)." Galderma (UK) Ltd
- (2022) "Product Information. Metvix (methyl aminolevulinate topical)." Galderma Australia Pty Ltd
- (2023) "Product Information. Metvix (methyl aminolevulinate topical)." Galderma Canada Inc
- (2021) "Product Information. Ameluz (aminolevulinic acid topical)." Biofrontera Inc.
- (2006) "Product Information. Levulan Kerastick (aminolevulinic acid topical)." DUSA Pharmaceuticals Inc
- (2021) "Product Information. Ameluz (aminolevulinic acid topical)." Biofrontera Pharma GmbH
- (2016) "Product Information. Alacare (aminolevulinic acid topical)." Link Medical Products Pty Ltd T/A Link Pharmaceuticals
- (2018) "Product Information. Alacare (aminolevulinic acid topical)." medac UK
Drug and food interactions
meperidine food
Applies to: Meprozine (meperidine / promethazine)
GENERALLY AVOID: Ethanol may potentiate the central nervous system (CNS) depressant effects of opioid analgesics. Concomitant use may result in additive CNS depression and impairment of judgment, thinking, and psychomotor skills. In more severe cases, hypotension, respiratory depression, profound sedation, coma, or even death may occur.
MANAGEMENT: Concomitant use of opioid analgesics with ethanol should be avoided.
References
- Linnoila M, Hakkinen S (1974) "Effects of diazepam and codeine, alone and in combination with alcohol, on simulated driving." Clin Pharmacol Ther, 15, p. 368-73
- Sturner WQ, Garriott JC (1973) "Deaths involving propoxyphene: a study of 41 cases over a two-year period." JAMA, 223, p. 1125-30
- Girre C, Hirschhorn M, Bertaux L, et al. (1991) "Enhancement of propoxyphene bioavailability by ethanol: relation to psychomotor and cognitive function in healthy volunteers." Eur J Clin Pharmacol, 41, p. 147-52
- Levine B, Saady J, Fierro M, Valentour J (1984) "A hydromorphone and ethanol fatality." J Forensic Sci, 29, p. 655-9
- Sellers EM, Hamilton CA, Kaplan HL, Degani NC, Foltz RL (1985) "Pharmacokinetic interaction of propoxyphene with ethanol." Br J Clin Pharmacol, 19, p. 398-401
- Carson DJ (1977) "Fatal dextropropoxyphene poisoning in Northern Ireland. Review of 30 cases." Lancet, 1, p. 894-7
- Rosser WW (1980) "The interaction of propoxyphene with other drugs." Can Med Assoc J, 122, p. 149-50
- Edwards C, Gard PR, Handley SL, Hunter M, Whittington RM (1982) "Distalgesic and ethanol-impaired function." Lancet, 2, p. 384
- Kiplinger GF, Sokol G, Rodda BE (1974) "Effect of combined alcohol and propoxyphene on human performance." Arch Int Pharmacodyn Ther, 212, p. 175-80
promethazine food
Applies to: Meprozine (meperidine / promethazine)
GENERALLY AVOID: Concurrent use of ethanol and phenothiazines may result in additive CNS depression and psychomotor impairment. Also, ethanol may precipitate dystonic reactions in patients who are taking phenothiazines. The two drugs probably act on different sites in the brain, although the exact mechanism of the interaction is not known.
MANAGEMENT: Patients should be advised to avoid alcohol during phenothiazine therapy.
References
- Lutz EG (1976) "Neuroleptic-induced akathisia and dystonia triggered by alcohol." JAMA, 236, p. 2422-3
- Freed E (1981) "Alcohol-triggered-neuroleptic-induced tremor, rigidity and dystonia." Med J Aust, 2, p. 44-5
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.
See also
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
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