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Drug Interactions between Poly-Tussin EX Syrup and Zydelig

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

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Interactions between your drugs

Moderate

dihydrocodeine idelalisib

Applies to: Poly-Tussin EX Syrup (dihydrocodeine / guaifenesin / phenylephrine) and Zydelig (idelalisib)

GENERALLY AVOID: Coadministration with idelalisib may increase the plasma concentrations of drugs that are substrates of CYP450 3A4. Idelalisib has been shown to be a potent inhibitor of this isoenzyme. In healthy volunteers, administration of a single 5 mg dose of midazolam, a CYP450 3A4 probe substrate, with idelalisib 150 mg for 15 doses increased mean midazolam peak plasma concentration (Cmax) by 2.4-fold and systemic exposure (AUC) by 5.4-fold.

MANAGEMENT: Use of idelalisib should generally be avoided with drugs that are primarily metabolized by CYP450 3A4, particularly those with a narrow therapeutic range (e.g., antiarrhythmics, anticonvulsants, antineoplastics, immunosuppressants) or those that are considered sensitive substrates (e.g., ergot derivatives, statins, oral midazolam, triazolam). Dosage adjustments as well as clinical and laboratory monitoring may be appropriate for some drugs whenever idelalisib is added to or withdrawn from therapy, if coadministration is required.

References

  1. "Product Information. Zydelig (idelalisib)." Gilead Sciences (2014):

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Drug and food interactions

Moderate

phenylephrine food

Applies to: Poly-Tussin EX Syrup (dihydrocodeine / guaifenesin / phenylephrine)

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

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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

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

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