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Drug Interactions between physostigmine ophthalmic and trospium

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

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Interactions between your drugs

Moderate

PHYSostigmine ophthalmic trospium

Applies to: physostigmine ophthalmic and trospium

MONITOR: Theoretically, anticholinergic agents and other agents with significant anticholinergic activity (e.g., antihistamines, antispasmodics, neuroleptics, phenothiazines, skeletal muscle relaxants, tricyclic antidepressants, class IA antiarrhythmics especially disopyramide) may antagonize the effects of topically administered cholinergic agents such as acetylcholine, carbachol, demecarium, echothiophate, isoflurophate, physostigmine, and pilocarpine. The proposed mechanism involves opposing pharmacodynamic action on muscarinic receptor sites in ocular tissue. This interaction is sometimes desirable and is the basis for using atropine in the treatment of excessive muscarinic side effects and cholinergic crisis induced by cholinergic overdose.

MANAGEMENT: Patients receiving long-term therapy with anticholinergic agents should be monitored for potentially diminished therapeutic (miotic) response to ophthalmic cholinergic therapy, and dosages adjusted as necessary.

References (2)
  1. "Multum Information Services, Inc. Expert Review Panel"
  2. "Product Information. Pilopine-HS (pilocarpine ophthalmic)." Alcon Laboratories Inc

Drug and food interactions

Moderate

trospium food

Applies to: trospium

ADJUST DOSING INTERVAL: Food may reduce the oral absorption and bioavailability of trospium chloride. According to the product labeling, administration of trospium chloride with a high fat meal reduced the peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) by 70% to 80% compared to administration while fasting.

MANAGEMENT: To ensure maximal oral absorption, trospium chloride should be administered at least 1 hour before meals or on an empty stomach. If trospium chloride is administered as a combination with xanomeline, the manufacturer recommends administering the capsules at least 1 hour before a meal or at least 2 hours after a meal. Capsules should be taken whole.

References (7)
  1. (2012) "Product Information. Sanctura (trospium)." Odyssey Pharmaceuticals
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  3. Canadian Pharmacists Association (2006) e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink
  4. (2024) "Product Information. Cobenfy (trospium-xanomeline)." Bristol-Myers Squibb
  5. (2019) "Product Information. Trosec (trospium)." Oryx Pharmaceuticals Inc
  6. (2022) "Product Information. Regurin (trospium)." Mylan Healthcare Sdn. Bhd.
  7. (2023) "Product Information. Trospium Chloride (trospium)." Padagis

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

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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