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Drug Interactions between Panadol Menstrual Relief and treprostinil

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

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Interactions between your drugs

Moderate

pamabrom treprostinil

Applies to: Panadol Menstrual Relief (acetaminophen / pamabrom) and treprostinil

MONITOR: Coadministration of medicines targeting the prostacyclin pathway (e.g., prostacyclin (PGI2), PGI2 analogs, or selective non-prostanoid prostacyclin IP receptor agonists) with diuretics, antihypertensive agents, or other vasodilators may potentiate the hypotensive effects of these agents. The mechanism involves the additive reduction in blood pressure due to the vasodilatory effects of PGI2, PGI2 analogs or selective non-prostanoid prostacyclin IP receptor agonists on the prostacyclin pathway.

MANAGEMENT: While therapies that target the prostacyclin pathway have been used in combination with diuretics, antihypertensives, or other vasodilators in the management of pulmonary arterial hypertension, caution is recommended if they must be administered concurrently. If these drugs are used together, it is generally recommended that blood pressure be measured more frequently until a stable blood pressure pattern is observed. Patients should be advised to avoid rising abruptly from a sitting or recumbent position and to notify their doctor if they experience dizziness, lightheadedness, syncope, orthostatic hypotension, or tachycardia. Treatment guidelines should be consulted for the optimum management of pulmonary arterial hypertension.

References

  1. Buchdahl RM, Taylor P, Warner JD "Nebulised ribavirin for adenovirus pneumonia." Lancet 2 (1985): 1070-1
  2. "Product Information. Flolan (epoprostenol)." Glaxo Wellcome PROD (2001):
  3. "Product Information. Xatral (alfuzosin)." Sanofi-Synthelabo Canada Inc (2002):
  4. "Product Information. Remodulin (treprostinil)." United Therapeutics Corporation (2002):
  5. "Product Information. Ventavis (iloprost)." Actelion Pharmaceuticals US Inc (2005):
  6. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  7. Cerner Multum, Inc. "Australian Product Information." O 0
View all 7 references

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Drug and food interactions

Major

acetaminophen food

Applies to: Panadol Menstrual Relief (acetaminophen / pamabrom)

GENERALLY AVOID: Chronic, excessive consumption of alcohol may increase the risk of acetaminophen-induced hepatotoxicity, which has included rare cases of fatal hepatitis and frank hepatic failure requiring liver transplantation. The proposed mechanism is induction of hepatic microsomal enzymes during chronic alcohol use, which may result in accelerated metabolism of acetaminophen and increased production of potentially hepatotoxic metabolites.

MANAGEMENT: In general, chronic alcoholics should avoid regular or excessive use of acetaminophen. Alternative analgesic/antipyretic therapy may be appropriate in patients who consume three or more alcoholic drinks per day. However, if acetaminophen is used, these patients should be cautioned not to exceed the recommended dosage (maximum 4 g/day in adults and children 12 years of age or older).

References

  1. Kaysen GA, Pond SM, Roper MH, Menke DJ, Marrama MA "Combined hepatic and renal injury in alcoholics during therapeutic use of acetaminophen." Arch Intern Med 145 (1985): 2019-23
  2. O'Dell JR, Zetterman RK, Burnett DA "Centrilobular hepatic fibrosis following acetaminophen-induced hepatic necrosis in an alcoholic." JAMA 255 (1986): 2636-7
  3. Seeff LB, Cuccherini BA, Zimmerman HJ, Adler E, Benjamin SB "Acetaminophen hepatotoxicity in alcoholics." Ann Intern Med 104 (1986): 399-404
  4. Thummel KE, Slattery JT, Nelson SD "Mechanism by which ethanol diminishes the hepatotoxicity of acetaminophen." J Pharmacol Exp Ther 245 (1988): 129-36
  5. McClain CJ, Kromhout JP, Peterson FJ, Holtzman JL "Potentiation of acetaminophen hepatotoxicity by alcohol." JAMA 244 (1980): 251-3
  6. Kartsonis A, Reddy KR, Schiff ER "Alcohol, acetaminophen, and hepatic necrosis." Ann Intern Med 105 (1986): 138-9
  7. Prescott LF, Critchley JA "Drug interactions affecting analgesic toxicity." Am J Med 75 (1983): 113-6
  8. "Product Information. Tylenol (acetaminophen)." McNeil Pharmaceutical PROD (2002):
  9. Whitcomb DC, Block GD "Association of acetaminopphen hepatotoxicity with fasting and ethanol use." JAMA 272 (1994): 1845-50
  10. Bonkovsky HL "Acetaminophen hepatotoxicity, fasting, and ethanol." JAMA 274 (1995): 301
  11. Nelson EB, Temple AR "Acetaminophen hepatotoxicity, fasting, and ethanol." JAMA 274 (1995): 301
  12. Zimmerman HJ, Maddrey WC "Acetaminophen (paracetamol) hepatotoxicity with regular intake of alcohol: analysis of instances of therapeutic misadventure." Hepatology 22 (1995): 767-73
View all 12 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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