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Drug Interactions between Phosphasal and Viravan-PDM

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

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Interactions between your drugs

Major

dextromethorphan methylene blue

Applies to: Viravan-PDM (dextromethorphan / pseudoephedrine / pyrilamine) and Phosphasal (hyoscyamine / methenamine / methylene blue / phenyl salicylate / sodium biphosphate)

Using methylene blue together with dextromethorphan is not recommended. Combining these medications can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. In general, you should wait at least 14 days after stopping methylene blue before you start treatment with dextromethorphan. Conversely, if you have recently been on dextromethorphan and are now starting treatment with methylene blue, you should check with your doctor or pharmacist to see how long you should wait before it is safe for you to use methylene blue, as some medications can take a while to clear from your body. 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.

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Major

pseudoephedrine methylene blue

Applies to: Viravan-PDM (dextromethorphan / pseudoephedrine / pyrilamine) and Phosphasal (hyoscyamine / methenamine / methylene blue / phenyl salicylate / sodium biphosphate)

Using methylene blue together with pseudoephedrine is not recommended. Combining these medications can cause dangerously high blood pressure and even death. You may use pseudoephedrine only after you have been off methylene blue for at least 14 days. You should seek immediate medical attention if you experience sudden and severe headache, blurred vision, confusion, seizures, chest pain, nausea or vomiting, sudden numbness or weakness (especially on one side of the body), speech difficulties, fever, sweating, lightheadedness, and/or fainting during treatment with methylene blue, as these may be signs and symptoms of excessively high blood pressure. 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.

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Major

sodium biphosphate phenyl salicylate

Applies to: Phosphasal (hyoscyamine / methenamine / methylene blue / phenyl salicylate / sodium biphosphate) and Phosphasal (hyoscyamine / methenamine / methylene blue / phenyl salicylate / sodium biphosphate)

The following interaction applies only to products containing sodium biphosphate that are used for bowel cleansing. It does not apply to products containing sodium biphosphate that are used for other, non-laxative related purposes.

Bowel cleansing with sodium biphosphate can cause kidney failure, in some cases up to several months after the procedure. Although it rarely occurs, the risk is increased in individuals receiving treatment with phenyl salicylate, especially if they are also elderly or frail. You may need a dose adjustment or special tests to safely use both medications. Combining these medications may also increase the risk of dehydration and electrolyte abnormalities. In severe cases, dehydration and electrolyte abnormalities can lead to irregular heart rhythm, seizures, and kidney problems. You should use sodium biphosphate exactly as prescribed by your doctor, and drink plenty of clear fluids before, during, and after the cleansing process to keep yourself hydrated. Your doctor may also recommend an electrolyte rehydration solution that you can use. Talk to your doctor if you have any 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.

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Moderate

dextromethorphan pyrilamine

Applies to: Viravan-PDM (dextromethorphan / pseudoephedrine / pyrilamine) and Viravan-PDM (dextromethorphan / pseudoephedrine / pyrilamine)

Using dextromethorphan together with pyrilamine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. 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.

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Moderate

pyrilamine hyoscyamine

Applies to: Viravan-PDM (dextromethorphan / pseudoephedrine / pyrilamine) and Phosphasal (hyoscyamine / methenamine / methylene blue / phenyl salicylate / sodium biphosphate)

Using pyrilamine together with hyoscyamine may increase side effects such as drowsiness, blurred vision, dry mouth, heat intolerance, flushing, decreased sweating, difficulty urinating, abdominal cramping, constipation, irregular heartbeat, confusion, and memory problems. Side effects may be more likely to occur in the elderly or those with a debilitating condition. 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.

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Drug and food interactions

Moderate

dextromethorphan food

Applies to: Viravan-PDM (dextromethorphan / pseudoephedrine / pyrilamine)

Alcohol can increase the nervous system side effects of dextromethorphan such as dizziness, drowsiness, and 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.

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Moderate

pyrilamine food

Applies to: Viravan-PDM (dextromethorphan / pseudoephedrine / pyrilamine)

Alcohol can increase the nervous system side effects of pyrilamine such as dizziness, drowsiness, and 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 pyrilamine. Do not use more than the recommended dose of pyrilamine, 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.

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Moderate

sodium biphosphate food

Applies to: Phosphasal (hyoscyamine / methenamine / methylene blue / phenyl salicylate / sodium biphosphate)

Oral medications may not be properly absorbed when they are taken within one hour before starting sodium biphosphate for bowel cleansing. Talk to your doctor or pharmacist to see if you should adjust the dosing schedule of your other medications before you begin bowel cleansing treatment. 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.

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Moderate

hyoscyamine food

Applies to: Phosphasal (hyoscyamine / methenamine / methylene blue / phenyl salicylate / sodium biphosphate)

Ask your doctor before using hyoscyamine together with ethanol. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking hyoscyamine. You should be warned not to exceed recommended dosages and to avoid activities requiring mental alertness. If your doctor prescribes these medications together, you may need a dose adjustment to safely take this combination. 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.

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Moderate

pseudoephedrine food

Applies to: Viravan-PDM (dextromethorphan / pseudoephedrine / pyrilamine)

Consumer information for this interaction is not currently available.

MONITOR: Coadministration of two or more sympathomimetic agents may increase the risk of adverse effects such as nervousness, irritability, and increased heart rate. Central nervous system (CNS) stimulants, particularly amphetamines, can potentiate the adrenergic response to vasopressors and other sympathomimetic agents. 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 agents are coadministered. Pulse and blood pressure should be closely monitored.

References

  1. Rosenblatt JE, Lake CR, van Kammen DP, Ziegler MG, Bunney WE Jr "Interactions of amphetamine, pimozide, and lithium on plasma norepineophrine and dopamine-beta-hydroxylase in schizophrenic patients." Psychiatry Res 1 (1979): 45-52
  2. Cavanaugh JH, Griffith JD, Oates JA "Effect of amphetamine on the pressor response to tyramine: formation of p-hydroxynorephedrine from amphetamine in man." Clin Pharmacol Ther 11 (1970): 656
  3. "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc PROD (2001):
  4. "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals PROD (2001):
  5. "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals PROD (2001):
  6. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):
  7. "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company (2002):
View all 7 references

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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