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Drug Interactions between Tears Again Hydrate and Teramine ER

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

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Interactions between your drugs

Minor

phentermine evening primrose

Applies to: Teramine ER (phentermine) and Tears Again Hydrate (bilberry / evening primrose / flax)

Some clinicians have suggested that evening primrose and borage oil, both of which contain the omega-6 fatty acid gamma linolenic acid (GLA), may lower the seizure threshold and increase the risk of seizures during co-administration with other epileptogenic agents. However, data regarding the effect of gamma linolenic acid on seizure threshold are conflicting and limited.

References

  1. Miller LG "Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions." Arch Intern Med 158 (1998): 2200-11
  2. Therapeutic Research Faculty "Natural Medicines Comprehensive Database. http://www.naturaldatabase.com" (2008):
  3. N. A. Michael Eskin "Borage and evening primrose oil." European Journal of Lipid Science and Technology 110 (2008): 1
  4. Asadi-Samani M, Bahmani M, Rafieian-Kopaei M "The chemical composition, botanical characteristic and biological activities of Borago officinalis: a review." Asian Pac J Trop Med 7S1 (2014): S22-8
View all 4 references

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Drug and food interactions

Moderate

phentermine food

Applies to: Teramine ER (phentermine)

GENERALLY AVOID: Alcohol may potentiate the central nervous system and cardiovascular effects of centrally-acting appetite suppressants. In one study, concurrent administration of methamphetamine (30 mg intravenously) and ethanol (1 gm/kg orally over 30 minutes) increased heart rate by 24 beats/minute compared to methamphetamine alone. This increases cardiac work and myocardial oxygen consumption, which may lead to more adverse cardiovascular effects than either agent alone. Subjective effects of ethanol were diminished in the eight study subjects, but those of methamphetamine were not affected. The pharmacokinetics of methamphetamine were also unaffected except for a decrease in the apparent volume of distribution at steady state.

MANAGEMENT: Concomitant use of centrally-acting appetite suppressants and alcohol should be avoided if possible, especially in patients with a history of cardiovascular disease. Patients should be counselled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. Mendelson J, Jones RT, Upton R, Jacob P 3rd "Methamphetamine and ethanol interactions in humans." Clin Pharmacol Ther 57 (1995): 559-68
  2. "Product Information. Didrex (benzphetamine)." Pharmacia and Upjohn PROD (2001):
  3. "Product Information. Suprenza (phentermine)." Akrimax Pharmaceuticals (2012):

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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.

See also

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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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