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Drug Interactions between Oreticyl 50 and timothy grass pollen allergen extract

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

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Interactions between your drugs

Moderate

hydroCHLOROthiazide deserpidine

Applies to: Oreticyl 50 (deserpidine / hydrochlorothiazide) and Oreticyl 50 (deserpidine / hydrochlorothiazide)

MONITOR: The hypotensive effects of thiazide diuretics and alpha-adrenergic blockers may be additive. Postural hypotension may occur.

MANAGEMENT: Hemodynamic responses should be monitored during coadministration, especially during the first few weeks of therapy. Patients should be advised to take the alpha-blocker at bedtime and to notify their physician if they experience dizziness or syncope while awake.

References

  1. Achari R, Laddu A (1992) "Terazosin: a new alpha adrenoceptor blocking drug." J Clin Pharmacol, 32, p. 520-3
  2. Kuokkanen K, Mattila MJ (1975) "Demonstration of an additive antihypertensive effect of prazosin and polythiazide in out-patient." Curr Ther Res Clin Exp, 17, p. 431-6
  3. Pool JL (1991) "Combination antihypertensive therapy with terazosin and other antihypertensive agents: results of clinical trials." Am Heart J, 122, p. 926-31
  4. Cohen J (1991) "Long-term efficacy and safety of terazosin alone and in combination with other antihypertensive agents." Am Heart J, 122, p. 919-25
  5. (2002) "Product Information. Xatral (alfuzosin)." Sanofi-Synthelabo Canada Inc
View all 5 references

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Moderate

hydroCHLOROthiazide timothy grass pollen allergen extract

Applies to: Oreticyl 50 (deserpidine / hydrochlorothiazide) and timothy grass pollen allergen extract

MONITOR: Monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs), catechol-O-methyltransferase (COMT) inhibitors, thyroid hormone, antihistamines, cardiac glycosides (e.g. digoxin) and diuretics may potentiate the response to epinephrine, including fatal consequences, in the treatment of serious systemic reactions that may occur during immunotherapy with allergenic extracts. Vasoconstricting and hypertensive effects may be potentiated by MAOIs, tricyclic antidepressants, and COMT inhibitors. Arrhythmogenic effects may be potentiated by thyroid hormones, antihistamines, cardiac glycosides and diuretics.

MANAGEMENT: Immunotherapy with allergenic extracts may not be appropriate in patients receiving MAOIs, tricyclic antidepressants, COMT inhibitors, thyroid hormone, antihistamines and cardiac glycosides as these patients may experience an exaggerated response to the usual doses of epinephrine required to reverse a systemic reaction.

References

  1. (2014) "Product Information. Grastek (timothy grass pollen allergen extract)." Merck & Co., Inc
  2. (2014) "Product Information. Ragwitek (ragweed pollen allergen extract)." Merck & Co., Inc
  3. (2014) "Product Information. Oralair (mixed grass pollens allergen extract)." Greer Laboratories Inc
  4. Cerner Multum, Inc. (2015) "Canadian Product Information."
  5. (2023) "Product Information. Palforzia (peanut allergen extract)." Aimmune Therapeutics
  6. (2022) "Product Information. Palforzia Level 1 (peanut allergen extract)." Aimmune Therapeutics UK Ltd
View all 6 references

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Drug and food interactions

Moderate

timothy grass pollen allergen extract food

Applies to: timothy grass pollen allergen extract

ADJUST DOSING INTERVAL: Since sublingual preparations of allergenic extracts are meant to be absorbed directly from tissues under the tongue into the blood stream, consuming food or beverage during or immediately after administration may reduce the systemic bioavailability of the medication.

MONITOR: Coadministration of allergenic extracts for allergy immunotherapy with alcohol may potentiate the risk of allergic reactions, including anaphylaxis. According to some studies, alcohol is an augmenting factor influencing immunological mechanisms that can induce more severe allergic reactions and is involved in up to 15% of cases of anaphylactic reactions. Proposed mechanisms include an increase in allergen absorption from altered permeability of the intestinal epithelial barrier, enhancing mast cell and basophil activation, and an increase in serum IgE concentrations. A causal relationship with all allergenic extracts has not been established.

MANAGEMENT: Food or beverage should not be taken with, or for at least 5 minutes after, the administration of sublingual allergenic extracts. Patients should also avoid swallowing for about 1 minute following placement of the allergen extract under the tongue. Caution is advised if allergenic extracts for immunotherapy are used concomitantly with alcohol. Some manufacturers of peanut allergen extract recommend alcohol not be consumed for 2 hours before, or 2 hours after taking peanut allergen extract and if alcohol use cannot be avoided, that withholding or decreasing peanut allergen dosage should be considered. Individual prescribing information should be consulted for further guidance and clinical monitoring may be considered.

References

  1. (2014) "Product Information. Grastek (timothy grass pollen allergen extract)." Merck & Co., Inc
  2. (2014) "Product Information. Ragwitek (ragweed pollen allergen extract)." Merck & Co., Inc
  3. (2014) "Product Information. Oralair (mixed grass pollens allergen extract)." Greer Laboratories Inc
  4. Cerner Multum, Inc. (2015) "Canadian Product Information."
  5. (2023) "Product Information. Palforzia (peanut allergen extract)." Aimmune Therapeutics
  6. (2022) "Product Information. Palforzia Level 1 (peanut allergen extract)." Aimmune Therapeutics UK Ltd
  7. Munoz-Cano R, Pascal M, Araujo G, et al. (2023) Mechanisms, Cofactors, and Augmenting Factors Involved in Anaphylaxis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5623009/pdf/fimmu-08-01193.pdf
  8. (2023) "Product Information. Odactra (house dust mite allergen extract)." ALK-Abello Inc
View all 8 references

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Moderate

hydroCHLOROthiazide food

Applies to: Oreticyl 50 (deserpidine / hydrochlorothiazide)

MONITOR: Many psychotherapeutic and CNS-active agents (e.g., anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics, opioids, alcohol, muscle relaxants) exhibit hypotensive effects, especially during initiation of therapy and dose escalation. Coadministration with antihypertensives and other hypotensive agents, in particular vasodilators and alpha-blockers, may result in additive effects on blood pressure and orthostasis.

MANAGEMENT: Caution and close monitoring for development of hypotension is advised during coadministration of these agents. Some authorities recommend avoiding alcohol in patients receiving vasodilating antihypertensive drugs. Patients should be advised to avoid rising abruptly from a sitting or recumbent position and to notify their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia.

References

  1. Sternbach H (1991) "Fluoxetine-associated potentiation of calcium-channel blockers." J Clin Psychopharmacol, 11, p. 390-1
  2. Shook TL, Kirshenbaum JM, Hundley RF, Shorey JM, Lamas GA (1984) "Ethanol intoxication complicating intravenous nitroglycerin therapy." Ann Intern Med, 101, p. 498-9
  3. Feder R (1991) "Bradycardia and syncope induced by fluoxetine." J Clin Psychiatry, 52, p. 139
  4. Ellison JM, Milofsky JE, Ely E (1990) "Fluoxetine-induced bradycardia and syncope in two patients." J Clin Psychiatry, 51, p. 385-6
  5. Rodriguez de la Torre B, Dreher J, Malevany I, et al. (2001) "Serum levels and cardiovascular effects of tricyclic antidepressants and selective serotonin reuptake inhibitors in depressed patients." Ther Drug Monit, 23, p. 435-40
  6. Cerner Multum, Inc. "Australian Product Information."
  7. Pacher P, Kecskemeti V (2004) "Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns?" Curr Pharm Des, 10, p. 2463-75
  8. Andrews C, Pinner G (1998) "Postural hypotension induced by paroxetine." BMJ, 316, p. 595
View all 8 references

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

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