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Drug Interactions between ropeginterferon alfa-2b and Tussi-Organidin-S NR

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

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Interactions between your drugs

Moderate

codeine ropeginterferon alfa-2b

Applies to: Tussi-Organidin-S NR (codeine / guaifenesin) and ropeginterferon alfa-2b

GENERALLY AVOID: Coadministration with narcotics, hypnotics, or sedatives may potentiate the neuropsychiatric side effects of ropeginterferon alfa-2b. Serious and life-threatening or fatal neuropsychiatric reactions have been reported in patients receiving interferon alfa products, including ropeginterferon alfa-2b. These reactions may occur in patients with or without previous psychiatric illness. Serious neuropsychiatric reactions were observed in 3% of patients treated with ropeginterferon alfa-2b during the clinical development program. In two open label trials consisting of 178 patients receiving ropeginterferon alfa-2b monotherapy (dosed every 2 to 4 weeks) for the treatment of polycythemia vera, 80% of whom were exposed for 12 months or longer, there were 17 reported cases of depression, depressive symptoms, depressed mood, and listlessness. Of these seventeen cases, 3.4% of the patients recovered with temporary treatment interruption and 2.8% discontinued treatment. Other central nervous system effects, including suicidal ideation, attempted suicide, aggression, bipolar disorder, mania and confusion, have been reported with other interferon alfa products.

MANAGEMENT: Concomitant use of ropeginterferon alfa-2b with narcotics, hypnotics, or sedatives should be avoided when possible. Otherwise, patients should be closely monitored for effects of excessive central nervous system toxicity and symptoms of psychiatric disorders. Consider psychiatric consultation and treatment if such symptoms emerge, and discontinuation of ropeginterferon alfa-2b in patients with persistently severe or worsening neuropsychiatric signs or symptoms.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. (2021) "Product Information. BESREMi (ropeginterferon alfa-2b)." PharmaEssentia USA Corp

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Drug and food interactions

Moderate

codeine food

Applies to: Tussi-Organidin-S NR (codeine / guaifenesin)

GENERALLY AVOID: Ethanol may potentiate the central nervous system (CNS) depressant effects of opioid analgesics. Concomitant use may result in additive CNS depression and impairment of judgment, thinking, and psychomotor skills. In more severe cases, hypotension, respiratory depression, profound sedation, coma, or even death may occur.

MANAGEMENT: Concomitant use of opioid analgesics with ethanol should be avoided.

References

  1. Linnoila M, Hakkinen S (1974) "Effects of diazepam and codeine, alone and in combination with alcohol, on simulated driving." Clin Pharmacol Ther, 15, p. 368-73
  2. Sturner WQ, Garriott JC (1973) "Deaths involving propoxyphene: a study of 41 cases over a two-year period." JAMA, 223, p. 1125-30
  3. Girre C, Hirschhorn M, Bertaux L, et al. (1991) "Enhancement of propoxyphene bioavailability by ethanol: relation to psychomotor and cognitive function in healthy volunteers." Eur J Clin Pharmacol, 41, p. 147-52
  4. Levine B, Saady J, Fierro M, Valentour J (1984) "A hydromorphone and ethanol fatality." J Forensic Sci, 29, p. 655-9
  5. Sellers EM, Hamilton CA, Kaplan HL, Degani NC, Foltz RL (1985) "Pharmacokinetic interaction of propoxyphene with ethanol." Br J Clin Pharmacol, 19, p. 398-401
  6. Carson DJ (1977) "Fatal dextropropoxyphene poisoning in Northern Ireland. Review of 30 cases." Lancet, 1, p. 894-7
  7. Rosser WW (1980) "The interaction of propoxyphene with other drugs." Can Med Assoc J, 122, p. 149-50
  8. Edwards C, Gard PR, Handley SL, Hunter M, Whittington RM (1982) "Distalgesic and ethanol-impaired function." Lancet, 2, p. 384
  9. Kiplinger GF, Sokol G, Rodda BE (1974) "Effect of combined alcohol and propoxyphene on human performance." Arch Int Pharmacodyn Ther, 212, p. 175-80
View all 9 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.