Interactions between Norel DM and Somatrogon
3 drug interactions and 41 additional warnings found for the following 2 drugs:
- Norel DM (chlorpheniramine/dextromethorphan/phenylephrine)
- somatrogon
Drug interactions
Moderate drug interactions
Moderate:
chlorpheniramine dextromethorphan
Applies to: Norel DM (chlorpheniramine / dextromethorphan / phenylephrine) and Norel DM (chlorpheniramine / dextromethorphan / phenylephrine)
Monitor
Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients. Sedation and impairment of attention, judgment, thinking, and psychomotor skills may increase.
Management
During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Cautious dosage titration may be required, particularly at treatment initiation. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
References (36)
- Hamilton MJ, Bush M, Smith P, Peck AW (1982) "The effects of bupropion, a new antidepressant drug, and diazepam, and their interaction in man." Br J Clin Pharmacol, 14, p. 791-7
- Stambaugh JE, Lane C (1983) "Analgesic efficacy and pharmacokinetic evaluation of meperidine and hydroxyzine, alone and in combination." Cancer Invest, 1, p. 111-7
- Sotaniemi EA, Anttila M, Rautio A, et al. (1981) "Propranolol and sotalol metabolism after a drinking party." Clin Pharmacol Ther, 29, p. 705-10
- Grabowski BS, Cady WJ, Young WW, Emery JF (1980) "Effects of acute alcohol administration on propranolol absorption." Int J Clin Pharmacol Ther Toxicol, 18, p. 317-9
- Lemberger L, Rowe H, Bosomworth JC, Tenbarge JB, Bergstrom RF (1988) "The effect of fluoxetine on the pharmacokinetics and psychomotor responses of diazepam." Clin Pharmacol Ther, 43, p. 412-9
- MacLeod SM, Giles HG, Patzalek G, Thiessen JJ, Sellers EM (1977) "Diazepam actions and plasma concentrations following ethanol ingestion." Eur J Clin Pharmacol, 11, p. 345-9
- Divoll M, Greenblatt DJ, Lacasse Y, Shader RI (1981) "Benzodiazepine overdosage: plasma concentrations and clinical outcome." Psychopharmacology (Berl), 73, p. 381-3
- Naylor GJ, McHarg A (1977) "Profound hypothermia on combined lithium carbonate and diazepam treatment." Br Med J, 2, p. 22
- Stovner J, Endresen R (1965) "Intravenous anaesthesia with diazepam." Acta Anaesthesiol Scand, 24, p. 223-7
- Driessen JJ, Vree TB, Booij LH, van der Pol FM, Crul JF (1984) "Effect of some benzodiazepines on peripheral neuromuscular function in the rat in-vitro hemidiaphragm preparation." J Pharm Pharmacol, 36, p. 244-7
- Feldman SA, Crawley BE (1970) "Interaction of diazepam with the muscle-relaxant drugs." Br Med J, 1, p. 336-8
- Ochs HR, Greenblatt DJ, Verburg-Ochs B (1984) "Propranolol interactions with diazepam, lorazepam and alprazolam." Clin Pharmacol Ther, 36, p. 451-5
- Desager JP, Hulhoven R, Harvengt C, Hermann P, Guillet P, Thiercelin JF (1988) "Possible interactions between zolpidem, a new sleep inducer and chlorpromazine, a phenothiazine neuroleptic." Psychopharmacology (Berl), 96, p. 63-6
- Tverskoy M, Fleyshman G, Ezry J, Bradley EL, Jr Kissin I (1989) "Midazolam-morphine sedative interaction in patients." Anesth Analg, 68, p. 282-5
- "Product Information. Iopidine (apraclonidine ophthalmic)." Alcon Laboratories Inc
- Greiff JMC, Rowbotham D (1994) "Pharmacokinetic drug interactions with gastrointestinal motility modifying agents." Clin Pharmacokinet, 27, p. 447-61
- Greb WH, Buscher G, Dierdorf HD, Koster FE, Wolf D, Mellows G (1989) "The effect of liver enzyme inhibition by cimetidine and enzyme induction by phenobarbitone on the pharmacokinetics of paroxetine." Acta Psychiatr Scand, 80 Suppl, p. 95-8
- Markowitz JS, Wells BG, Carson WH (1995) "Interactions between antipsychotic and antihypertensive drugs." Ann Pharmacother, 29, p. 603-9
- (2001) "Product Information. Ultram (tramadol)." McNeil Pharmaceutical
- (2001) "Product Information. Artane (trihexyphenidyl)." Lederle Laboratories
- (2001) "Product Information. Ultiva (remifentanil)." Mylan Institutional (formally Bioniche Pharma USA Inc)
- (2001) "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals
- (2001) "Product Information. Meridia (sibutramine)." Knoll Pharmaceutical Company
- (2001) "Product Information. Tasmar (tolcapone)." Valeant Pharmaceuticals
- Miller LG (1998) "Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions." Arch Intern Med, 158, p. 2200-11
- (2001) "Product Information. Precedex (dexmedetomidine)." Abbott Pharmaceutical
- (2001) "Product Information. Trileptal (oxcarbazepine)." Novartis Pharmaceuticals
- Ferslew KE, Hagardorn AN, McCormick WF (1990) "A fatal interaction of methocarbamol and ethanol in an accidental poisoning." J Forensic Sci, 35, p. 477-82
- Plushner SL (2000) "Valerian: valeriana officinalis." Am J Health Syst Pharm, 57, p. 328-35
- (2002) "Product Information. Xatral (alfuzosin)." Sanofi-Synthelabo Canada Inc
- (2002) "Product Information. Lexapro (escitalopram)." Forest Pharmaceuticals
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- Cerner Multum, Inc. "Australian Product Information."
- (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
- (2014) "Product Information. Belsomra (suvorexant)." Merck & Co., Inc
- (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka America Pharmaceutical, Inc.
Moderate:
chlorpheniramine somatrogon
Applies to: Norel DM (chlorpheniramine / dextromethorphan / phenylephrine) and somatrogon
Monitor
Coadministration with human growth hormone (hGH) receptor agonists may alter the clearance and plasma concentrations of medicinal products that are metabolized by CYP450 isoenzymes. The mechanism of this interaction may be mediated via the effects of hGH receptor agonists on expression of different CYP450 isoenzymes. The labeling of some hGH receptor agonists specify that this interaction may be the most significant for substrates of CYP450 3A4 and/or 1A2 and indicate that their clearance may be increased. However, clinical data are limited, and clinical significance is unknown. In a study of 11 growth hormone (GH)-deficient adults randomized to GH or placebo for 6 months followed by 3 months of GH for all subjects, antipyrine clearance, a non-specific marker of hepatic CYP450 activity, increased in all subjects who received GH treatment compared to placebo. In vitro studies have indicated that GH enhanced CYP450 3A4 gene expression; however, other studies have suggested that when administered in a pulsatile fashion, CYP450 3A4 activity is reduced. A study in healthy elderly men did not reveal any effects on CYP450 3A4 or 2D6 but did demonstrate induction of 1A2 and inhibition of 2C19. Given that studies have varied in the type of growth hormone used, dosing regimens, ages and sexes of the patients and/or cell lines utilized, it is difficult to predict how coadministration may affect the CYP450 substrate.
Management
Careful monitoring is advised when drugs that are metabolized by CYP450 isoenzymes are used in combination with hGH receptor agonists. As this interaction's clinical significance is unknown, the label of the specific hGH receptor agonist and CYP450 substrate(s) being coadministered should be consulted for more specific guidance.
References (20)
- (2003) "Product Information. Humatrope (somatropin)." Lilly, Eli and Company
- (2004) "Product Information. Zorbtive (somatropin)." Serono Laboratories Inc
- (2025) "Product Information. Skytrofa (lonapegsomatropin)." Ascendis Pharma, Inc., DailyMed
- (2025) "Product Information. Norditropin (somatropin)." Novo Nordisk Pharmaceuticals Inc
- (2024) "Product Information. Norditropin FlexPro (somatropin)." Novo Nordisk Ltd
- (2020) "Product Information. Genotropin Miniquick (somatropin)." Pfizer Canada ULC
- (2025) "Product Information. Ngenla (somatrogon)." Pfizer U.S. Pharmaceuticals Group
- (2025) "Product Information. Ngenla (somatrogon)." Pfizer Canada ULC
- (2026) "Product Information. Ngenla (somatrogon)." Pfizer Australia Pty Ltd
- (2025) "Product Information. Sogroya (somapacitan)." Novo Nordisk Pharmaceuticals Pty Ltd
- (2025) "Product Information. Sogroya (somapacitan)." Novo Nordisk Pharmaceuticals Inc
- (2023) "Product Information. Sogroya (somapacitan)." Novo Nordisk Canada Inc
- (2025) "Product Information. Sogroya (somapacitan)." Novo Nordisk Ltd, 2
- (2026) "Product Information. Ngenla (somatrogon)." Pfizer Ltd
- Cheung NW, Liddle C, Coverdale S, Lou JC, boyages sc (1996) "Growth hormone treatment increases cytochrome P450-mediated antipyrine clearance in man" The Journal of Clinical Endocrinology & Metabolism, 81, p. 1996-2001
- Dhir RN, Dworakowski W, Thangavel C, Shapiro BH (2006) "Sexually dimorphic regulation of hepatic isoforms of human cytochrome P450 by growth hormone" The Journal of Pharmacology and Experimental Therapeutics, 316, p. 87-94
- Jurgens G, Lange KHW, Reuther LO, et al (2002) "Effect of growth hormone on hepatic cytochrome P450 activity in healthy elderly men" Clin Pharmacol and Therapeutic, 71, p. 162-8
- jaffe ca, turgeon dk, Demott-Friberg R, Watkins PB (2002) "Growth hormone secretion pattern is an independent regulator of growth hormone actions in humans" American Journal of Physiology-Endocrinology and Metabolism, 283, E1008-E1015
- (2025) "Product Information. Saizen (somatropin)." Merck Serono Australia Pty Ltd, A015-0925
- (2025) "Product Information. Skytrofa (lonapegsomatropin)." Specialised Therapeutics Pharma Pty Ltd
Moderate:
dextromethorphan somatrogon
Applies to: Norel DM (chlorpheniramine / dextromethorphan / phenylephrine) and somatrogon
Monitor
Coadministration with human growth hormone (hGH) receptor agonists may alter the clearance and plasma concentrations of medicinal products that are metabolized by CYP450 isoenzymes. The mechanism of this interaction may be mediated via the effects of hGH receptor agonists on expression of different CYP450 isoenzymes. The labeling of some hGH receptor agonists specify that this interaction may be the most significant for substrates of CYP450 3A4 and/or 1A2 and indicate that their clearance may be increased. However, clinical data are limited, and clinical significance is unknown. In a study of 11 growth hormone (GH)-deficient adults randomized to GH or placebo for 6 months followed by 3 months of GH for all subjects, antipyrine clearance, a non-specific marker of hepatic CYP450 activity, increased in all subjects who received GH treatment compared to placebo. In vitro studies have indicated that GH enhanced CYP450 3A4 gene expression; however, other studies have suggested that when administered in a pulsatile fashion, CYP450 3A4 activity is reduced. A study in healthy elderly men did not reveal any effects on CYP450 3A4 or 2D6 but did demonstrate induction of 1A2 and inhibition of 2C19. Given that studies have varied in the type of growth hormone used, dosing regimens, ages and sexes of the patients and/or cell lines utilized, it is difficult to predict how coadministration may affect the CYP450 substrate.
Management
Careful monitoring is advised when drugs that are metabolized by CYP450 isoenzymes are used in combination with hGH receptor agonists. As this interaction's clinical significance is unknown, the label of the specific hGH receptor agonist and CYP450 substrate(s) being coadministered should be consulted for more specific guidance.
References (20)
- (2003) "Product Information. Humatrope (somatropin)." Lilly, Eli and Company
- (2004) "Product Information. Zorbtive (somatropin)." Serono Laboratories Inc
- (2025) "Product Information. Skytrofa (lonapegsomatropin)." Ascendis Pharma, Inc., DailyMed
- (2025) "Product Information. Norditropin (somatropin)." Novo Nordisk Pharmaceuticals Inc
- (2024) "Product Information. Norditropin FlexPro (somatropin)." Novo Nordisk Ltd
- (2020) "Product Information. Genotropin Miniquick (somatropin)." Pfizer Canada ULC
- (2025) "Product Information. Ngenla (somatrogon)." Pfizer U.S. Pharmaceuticals Group
- (2025) "Product Information. Ngenla (somatrogon)." Pfizer Canada ULC
- (2026) "Product Information. Ngenla (somatrogon)." Pfizer Australia Pty Ltd
- (2025) "Product Information. Sogroya (somapacitan)." Novo Nordisk Pharmaceuticals Pty Ltd
- (2025) "Product Information. Sogroya (somapacitan)." Novo Nordisk Pharmaceuticals Inc
- (2023) "Product Information. Sogroya (somapacitan)." Novo Nordisk Canada Inc
- (2025) "Product Information. Sogroya (somapacitan)." Novo Nordisk Ltd, 2
- (2026) "Product Information. Ngenla (somatrogon)." Pfizer Ltd
- Cheung NW, Liddle C, Coverdale S, Lou JC, boyages sc (1996) "Growth hormone treatment increases cytochrome P450-mediated antipyrine clearance in man" The Journal of Clinical Endocrinology & Metabolism, 81, p. 1996-2001
- Dhir RN, Dworakowski W, Thangavel C, Shapiro BH (2006) "Sexually dimorphic regulation of hepatic isoforms of human cytochrome P450 by growth hormone" The Journal of Pharmacology and Experimental Therapeutics, 316, p. 87-94
- Jurgens G, Lange KHW, Reuther LO, et al (2002) "Effect of growth hormone on hepatic cytochrome P450 activity in healthy elderly men" Clin Pharmacol and Therapeutic, 71, p. 162-8
- jaffe ca, turgeon dk, Demott-Friberg R, Watkins PB (2002) "Growth hormone secretion pattern is an independent regulator of growth hormone actions in humans" American Journal of Physiology-Endocrinology and Metabolism, 283, E1008-E1015
- (2025) "Product Information. Saizen (somatropin)." Merck Serono Australia Pty Ltd, A015-0925
- (2025) "Product Information. Skytrofa (lonapegsomatropin)." Specialised Therapeutics Pharma Pty Ltd
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
chlorpheniramine Food/Lifestyle
Applies to: Norel DM (chlorpheniramine / dextromethorphan / phenylephrine)
Generally avoid
Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.
Management
Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
References (4)
- Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
- Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
- (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
- (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka America Pharmaceutical, Inc.
Moderate:
dextromethorphan Food/Lifestyle
Applies to: Norel DM (chlorpheniramine / dextromethorphan / phenylephrine)
Generally avoid
Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.
Management
Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
References (4)
- Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
- Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
- (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
- (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka America Pharmaceutical, Inc.
Moderate:
phenylephrine Caffeine
Applies to: Norel DM (chlorpheniramine / dextromethorphan / phenylephrine)
Monitor
Coadministration of two or more sympathomimetic or noradrenergic agents may increase the risk of nervousness, irritability, tachycardia, and/or increased blood pressure. Central nervous system (CNS) stimulants, particularly amphetamines, can potentiate the adrenergic response to vasopressors and other sympathomimetic and/or noradrenergic agents, including norepinephrine transporter inhibitors. Additive increases in blood pressure and heart rate may occur due to enhanced peripheral sympathetic activity.
Management
Caution is advised if two or more sympathomimetic or noradrenergic agents are coadministered. Pulse and blood pressure should be closely monitored. Consultation with individual product labeling, as well as relevant institutional protocols, may be advisable for further guidance.
References (20)
- Rosenblatt JE, Lake CR, van Kammen DP, Ziegler MG, Bunney WE Jr (1979) "Interactions of amphetamine, pimozide, and lithium on plasma norepineophrine and dopamine-beta-hydroxylase in schizophrenic patients." Psychiatry Res, 1, p. 45-52
- Cavanaugh JH, Griffith JD, Oates JA (1970) "Effect of amphetamine on the pressor response to tyramine: formation of p-hydroxynorephedrine from amphetamine in man." Clin Pharmacol Ther, 11, p. 656
- (2001) "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc
- (2001) "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals
- (2001) "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals
- (2001) "Product Information. Focalin (dexmethylphenidate)." Mikart Inc
- (2024) "Product Information. Ephedrine (ephedrine)." Hameln Pharma Ltd
- (2023) "Product Information. Ephedrine Hydrochloride (ephedrine)." Wockhardt UK Ltd
- (2026) "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company
- (2025) "Product Information. Atomoxetine (atomoxetine)." Zentiva Pharma UK Ltd
- (2026) "Product Information. Atomoxetine (Apo) (atomoxetine)." Arrotex Pharmaceuticals Pty Ltd
- Angita Pharma, Inc (2026) AG-ATOMOXETINE Product Monograph (Health Canada) https://pdf.hres.ca/dpd_pm/00059014.PDF
- (2026) "Product Information. Boots Decongestant (Pseudoephedrine) (pseudoephedrine)." The Boots Company Plc
- (2023) "Product Information. Sinus and Nasal Decongestant (Trust) (pseudoephedrine)." Noumed Pharmaceuticals Pty Ltd
- (2019) "Product Information. Ephedrine (ephedrine)." Pfizer Australia Pty Ltd
- (2024) "Product Information. EPHEDrine Sulfate (ePHEDrine)." Amneal Pharmaceuticals LLC
- (2024) "Product Information. Lemsip Cough Max for Mucus Cough and Cold (guaifenesin/paracetamol/phenylephrine)." Reckitt Benckiser Healthcare (UK) Ltd
- emc (2026) Product information: sudafed plus blocked nose 1mg/50mg/ml nasal spray. https://www.medicines.org.uk/emc/product/14256/smpc?utm_source=chatgpt.com
- (2023) "Product Information. EPHEDrine Sulfate (ePHEDrine)." Baxter Corporation
- Neo Health (OTC) Pty Ltd (2026) Product information: pseudoephedrine hydrochloride-paracetamol capsules. https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2024-PI-02603-1&d=20260804172310101&d=20260827172310101
Disease interactions
38 potential interactions Applies to: 30 conditions, including Weight Loss, Asthma, Benign Prostatic Hyperplasia, COPD, and Breast Cancer.
Acute Abdomen
Major:
somatrogon
Somatrogon has a major potential interaction with Acute Abdomen.
Treatment with somatropin and somatrogon is contraindicated in patients with acute critical illness due to any complications following open heart surgery, abdominal surgery, multiple trauma, or acute respiratory failure. Patients with these conditions have an increased risk of mortality.
Asthma
Moderate:
Norel DM
The chlorpheniramine in Norel 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:
Norel DM
The phenylephrine in Norel 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.
Bladder Cancer
Major:
somatrogon
Somatrogon has a major potential interaction with Bladder Cancer.
Somatropin and somatrogon are contraindicated in the presence of any active malignancy. Any preexistent malignancy should be inactive and its treatment should be completed prior to somatropin therapy. This includes the presence of any intracranial tumor. Somatropin and somatrogon should be discontinued if there is any evidence of recurrence.
Brain Tumor
Major:
somatrogon
Somatrogon has a major potential interaction with Brain Tumor.
Somatropin and somatrogon are contraindicated in the presence of any active malignancy. Any preexistent malignancy should be inactive and its treatment should be completed prior to somatropin therapy. This includes the presence of any intracranial tumor. Somatropin and somatrogon should be discontinued if there is any evidence of recurrence.
Breast Cancer
Major:
somatrogon
Somatrogon has a major potential interaction with Breast Cancer.
Somatropin and somatrogon are contraindicated in the presence of any active malignancy. Any preexistent malignancy should be inactive and its treatment should be completed prior to somatropin therapy. This includes the presence of any intracranial tumor. Somatropin and somatrogon should be discontinued if there is any evidence of recurrence.
Cardiovascular Conditions and Disorders
Major:
Norel DM
The phenylephrine in Norel 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:
Norel DM
The chlorpheniramine in Norel 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:
Norel DM
The phenylephrine in Norel 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:
Norel DM
The chlorpheniramine in Norel 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.
Diabetes Mellitus
Moderate:
Norel DM
The phenylephrine in Norel 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.
Moderate:
somatrogon
Somatrogon has a moderate potential interaction with Diabetes Mellitus.
Treatment with growth hormone may decrease insulin sensitivity, inducing a state of insulin resistance and hyperglycemia, especially at higher doses. New onset type 2 diabetes mellitus (DM) or worsened glycemic control in patients with undiagnosed pre-diabetes or DM has been reported in patients receiving growth hormone. Monitor glucose levels in all patients during therapy with somatrogon, especially in those with who have glucose intolerance, or additional risk factors for diabetes (e.g., obesity, Turner syndrome, family history). Initiation of somatrogon in patients who have type 1 or 2 diabetes mellitus may require dose adjustment of anti-diabetic therapy.
Moderate:
somatrogon
Somatrogon has a moderate potential interaction with Diabetes Mellitus.
Somatrogon may increase the risk of diabetes mellitus (DM) in patients with Turner syndrome. Monitor blood glucose levels periodically to assess for new onset diabetes in these patients. In patients with Turner syndrome and preexisting DM, monitor blood glucose more closely as adjustment of antidiabetic agents may be required when somatrogon is initiated.
Diabetic Retinopathy
Major:
somatrogon
Somatrogon has a major potential interaction with Diabetic Retinopathy.
Somatropin, somatrogon , and lonapegsomatropin are contraindicated in patients with active proliferative or severe non-proliferative diabetic retinopathy since treatment may worsen condition.
Gastrointestinal Obstruction
Moderate:
Norel DM
The chlorpheniramine in Norel 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.
Glaucoma/Intraocular Hypertension
Moderate:
Norel DM
The chlorpheniramine in Norel 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.
Moderate:
Norel DM
The phenylephrine in Norel 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.
Hyperthyroidism
Major:
Norel DM
The phenylephrine in Norel 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:
Norel DM
The chlorpheniramine in Norel 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:
Norel DM
The chlorpheniramine in Norel 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:
Norel DM
The chlorpheniramine in Norel 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.
Lung Cancer
Major:
somatrogon
Somatrogon has a major potential interaction with Lung Cancer.
Somatropin and somatrogon are contraindicated in the presence of any active malignancy. Any preexistent malignancy should be inactive and its treatment should be completed prior to somatropin therapy. This includes the presence of any intracranial tumor. Somatropin and somatrogon should be discontinued if there is any evidence of recurrence.
Papilledema Associated with Increased Intracranial Pressure
Moderate:
somatrogon
Somatrogon has a moderate potential interaction with Papilledema Associated with Increased Intracranial Pressure.
Intracranial hypertension with papilledema, visual changes, nausea and/or vomiting has been reported in a small number of patients treated with somatropin, somatrogon , and lonapegsomatropin . Fundoscopic examination should be performed before treatment initiation to exclude preexisting papilledema, and should be continued periodically during treatment. If papilledema is observed during treatment, therapy should be stopped. Treatment could be restarted at a lower dose once intracranial hypertension has been resolved. Patients with Turner Syndrome might be at increased risk of developing intracranial hypertension.
Pheochromocytoma
Major:
Norel DM
The phenylephrine in Norel 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 Cancer
Major:
somatrogon
Somatrogon has a major potential interaction with Prostate Cancer.
Somatropin and somatrogon are contraindicated in the presence of any active malignancy. Any preexistent malignancy should be inactive and its treatment should be completed prior to somatropin therapy. This includes the presence of any intracranial tumor. Somatropin and somatrogon should be discontinued if there is any evidence of recurrence.
Prostate Tumor, Benign
Moderate:
Norel DM
The phenylephrine in Norel 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.
Pulmonary Impairment
Major:
somatrogon
Somatrogon has a major potential interaction with Pulmonary Impairment.
Treatment with somatropin and somatrogon is contraindicated in patients with acute critical illness due to any complications following open heart surgery, abdominal surgery, multiple trauma, or acute respiratory failure. Patients with these conditions have an increased risk of mortality.
Major:
somatrogon
Somatrogon has a major potential interaction with Pulmonary Impairment.
Somatropin and somatrogon is contraindicated in patients with Prader-Willi Syndrome who are severely obese, have a history of upper airway obstruction or sleep apnea, or have severe respiratory impairment. There have been reports of sudden death when somatropin was used in such patients.
Renal Dysfunction
Moderate:
Norel DM
The chlorpheniramine in Norel 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.
Scoliosis
Moderate:
somatrogon
Somatrogon has a moderate potential interaction with Scoliosis.
Progression of scoliosis can occur in patients who experience rapid growth. Since somatropin and somatrogon increase growth rate, children with a history of scoliosis should be monitored for progression of this condition. Physicians should be alert for this skeletal abnormality which can be commonly seen in patients with Turner and Prader-Willi syndromes, and can manifest during somatropin and somatrogon treatment.
Sepsis
Major:
somatrogon
Somatrogon has a major potential interaction with Sepsis.
Treatment with somatropin and somatrogon is contraindicated in patients with acute critical illness due to any complications following open heart surgery, abdominal surgery, multiple trauma, or acute respiratory failure. Patients with these conditions have an increased risk of mortality.
Skin Cancer
Major:
somatrogon
Somatrogon has a major potential interaction with Skin Cancer.
Somatropin and somatrogon are contraindicated in the presence of any active malignancy. Any preexistent malignancy should be inactive and its treatment should be completed prior to somatropin therapy. This includes the presence of any intracranial tumor. Somatropin and somatrogon should be discontinued if there is any evidence of recurrence.
Sleep Apnea
Major:
somatrogon
Somatrogon has a major potential interaction with Sleep Apnea.
Somatropin and somatrogon is contraindicated in patients with Prader-Willi Syndrome who are severely obese, have a history of upper airway obstruction or sleep apnea, or have severe respiratory impairment. There have been reports of sudden death when somatropin was used in such patients.
Turner Syndrome
Moderate:
somatrogon
Somatrogon has a moderate potential interaction with Turner Syndrome.
Somatrogon may increase the risk of diabetes mellitus (DM) in patients with Turner syndrome. Monitor blood glucose levels periodically to assess for new onset diabetes in these patients. In patients with Turner syndrome and preexisting DM, monitor blood glucose more closely as adjustment of antidiabetic agents may be required when somatrogon is initiated.
Moderate:
somatrogon
Somatrogon has a moderate potential interaction with Turner Syndrome.
Treatment with growth hormone may decrease insulin sensitivity, inducing a state of insulin resistance and hyperglycemia, especially at higher doses. New onset type 2 diabetes mellitus (DM) or worsened glycemic control in patients with undiagnosed pre-diabetes or DM has been reported in patients receiving growth hormone. Monitor glucose levels in all patients during therapy with somatrogon, especially in those with who have glucose intolerance, or additional risk factors for diabetes (e.g., obesity, Turner syndrome, family history). Initiation of somatrogon in patients who have type 1 or 2 diabetes mellitus may require dose adjustment of anti-diabetic therapy.
Urinary Retention
Moderate:
Norel DM
The chlorpheniramine in Norel 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.
Weight Loss
Major:
somatrogon
Somatrogon has a major potential interaction with Weight Loss.
Somatropin and somatrogon is contraindicated in patients with Prader-Willi Syndrome who are severely obese, have a history of upper airway obstruction or sleep apnea, or have severe respiratory impairment. There have been reports of sudden death when somatropin was used in such patients.
Moderate:
somatrogon
Somatrogon has a moderate potential interaction with Weight Loss.
Treatment with growth hormone may decrease insulin sensitivity, inducing a state of insulin resistance and hyperglycemia, especially at higher doses. New onset type 2 diabetes mellitus (DM) or worsened glycemic control in patients with undiagnosed pre-diabetes or DM has been reported in patients receiving growth hormone. Monitor glucose levels in all patients during therapy with somatrogon, especially in those with who have glucose intolerance, or additional risk factors for diabetes (e.g., obesity, Turner syndrome, family history). Initiation of somatrogon in patients who have type 1 or 2 diabetes mellitus may require dose adjustment of anti-diabetic therapy.
More resources
Norel DM
A total of 603 drugs are known to interact with Norel DM.
- Norel dm is in the drug class upper respiratory combinations.
- Norel dm is used to treat Cough and Nasal Congestion.
somatrogon
A total of 654 drugs are known to interact with somatrogon.
- Somatrogon is in the drug class growth hormones.
- Somatrogon is used to treat Pediatric Growth Hormone Deficiency.
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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