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Drug Interactions between ragweed pollen allergen extract and Sudafed 12 Hour Pressure+Pain

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

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Interactions between your drugs

Moderate

naproxen ragweed pollen allergen extract

Applies to: Sudafed 12 Hour Pressure+Pain (naproxen / pseudoephedrine) and ragweed pollen allergen extract

MONITOR: Coadministration of allergenic extracts for allergy immunotherapy with NSAIDS may potentiate the risk of allergic reactions, including anaphylaxis. According to some studies, NSAID use is an augmenting factor influencing immunological mechanisms that can induce more severe allergic reactions and is involved in up to 22% of cases of anaphylactic reactions. The precise mechanism by which NSAIDs can induce anaphylaxis has not been established but may involve enhanced allergen absorption due to increased gastrointestinal permeability related to inhibition of prostaglandin synthesis by NSAIDs. Another proposed mechanism involves a direct impact on the IgE activation of mast cells and basophils, resulting in enhanced degranulation and release of chemical mediators such as histamine, prostaglandins, leukotrienes, and thromboxane. A causal relationship with all allergenic extracts has not been established.

MANAGEMENT: The manufacturer for peanut allergen extract recommends considering using alternatives to NSAIDs or temporarily withholding immunotherapy with allergenic extracts. Individual prescribing information should be consulted for further guidance and clinical monitoring may be considered.

References

  1. (2023) "Product Information. Palforzia (peanut allergen extract)." Aimmune Therapeutics
  2. (2022) "Product Information. Palforzia Level 1 (peanut allergen extract)." Aimmune Therapeutics UK Ltd
  3. 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

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Drug and food interactions

Moderate

ragweed pollen allergen extract food

Applies to: ragweed 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

naproxen food

Applies to: Sudafed 12 Hour Pressure+Pain (naproxen / pseudoephedrine)

GENERALLY AVOID: The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.

MANAGEMENT: Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.

References

  1. (2002) "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn

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Moderate

pseudoephedrine food

Applies to: Sudafed 12 Hour Pressure+Pain (naproxen / pseudoephedrine)

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