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Drug interactions between Trimal DH and Zomacton

Results for the following 2 drugs:
Trimal DH (hydrocodone/phenylephrine/pyrilamine)
Zomacton (somatropin)

Interactions between your drugs


somatropin HYDROcodone

Applies to: Zomacton (somatropin) and Trimal DH (hydrocodone / phenylephrine / pyrilamine)

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with inducers of CYP450 3A4 may decrease the plasma concentrations of opioids that are metabolized by the isoenzyme such as butorphanol, fentanyl, hydrocodone, methadone, and oxycodone. Reduced efficacy or withdrawal symptoms may occur in patients maintained on their narcotic pain regimen following the addition of a CYP450 3A4 inducer. Conversely, discontinuation of the inducer may increase opioid plasma concentrations and potentiate the risk of overdose and fatal respiratory depression.

MANAGEMENT: Pharmacologic response to the opioid should be monitored more closely whenever a CYP450 3A4 inducer is added to or withdrawn from therapy, and the opioid dosage adjusted as necessary.


  1. Liu S-J, Wang RI "Case report of barbiturate-induced enhancement of methadone metabolism and withdrawal syndrome." Am J Psychiatry 141 (1984): 1287-8
  2. Tong TG, Pond SM, Kreek MJ, et al "Phenytoin-induced methadone withdrawal." Ann Intern Med 94 (1981): 349-51
  3. "Product Information. Butorphanol Tartrate (butorphanol)." Apotex Corporation, Weston, FL.
  4. "Product Information. Diskets (methadone)." Cebert Pharmaceuticals Inc, Birmingham, AL.
  5. Altice FL, Friedland GH, Cooney EL "Nevirapine induced opiate withdrawal among injection drug users with HIV infection receiving methadone." AIDS 13 (1999): 957-62
  6. Bell J, Seres V, Bowron P, Lewis J, Batey R "The use of serum methadone levels in patients receiving methadone maintenance." Clin Pharmacol Ther 43 (1988): 623-9
  7. "Product Information. Zohydro ER (HYDROcodone)." Zogenix, Inc, San Diego, CA.
  8. Holmes VF "Rifampin-induced methadone withdrawal in AIDS." J Clin Psychopharmacol 10 (1991): 443-4
  9. "Product Information. Ionsys (fentanyl)." Ortho McNeil Pharmaceutical, Raritan, NJ.
  10. "Product Information. Duragesic Transdermal System (fentanyl)." Janssen Pharmaceutica, Titusville, NJ.
  11. Bending MR, Skacel PO "Rifampicin and methadone withdrawal." Lancet 1 (1977): 1211
  12. Raistrick D, Hay A, Wolff K "Methadone maintenance and tuberculosis treatment." BMJ 313 (1996): 925-6
  13. Cerner Multum, Inc. "Australian Product Information." O 0
  14. Pinzani V, Faucherre V, Peyriere H, Blayac JP "Methadone withdrawal symptoms with nevirapine and efavirenz." Ann Pharmacother 34 (2000): 405-7
  15. Finelli PF "Phenytoin and methadone tolerance." N Engl J Med 294 (1976): 227
  16. Otero MJ, Fuertes A, Sanchez R, Luna G "Nevirapine-induced withdrawal symptoms in HIV patients on methadone maintenance programme: an alert." AIDS 13 (1999): 1004-5
  17. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  18. "Product Information. OxyContin (oxycodone)." Purdue Frederick Company, Norwalk, CT.
  19. Kreek MJ, Garfield JW, Gutjahr CL, Giusti LM "Rifampin-induced methadone withdrawal." N Engl J Med 294 (1976): 1104-6
View all 19 references

Drug and food interactions


HYDROcodone food

Applies to: Trimal DH (hydrocodone / phenylephrine / pyrilamine)

Do not use alcohol or medications that contain alcohol while you are receiving treatment with HYDROcodone. This may increase nervous system side effects such as drowsiness, dizziness, lightheadedness, difficulty concentrating, and impairment in thinking and judgment. In severe cases, low blood pressure, respiratory distress, fainting, coma, or even death may occur. If you are taking certain long-acting formulations of hydrocodone, consumption of alcohol may also cause rapid release of the drug, resulting in high blood levels that may be potentially lethal. Likewise, you should avoid consuming grapefruit and grapefruit juice, as this may increase the blood levels and effects of hydrocodone. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. Do not use more than the recommended dose of HYDROcodone, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medication without first talking to your doctor.

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pyrilamine food

Applies to: Trimal DH (hydrocodone / phenylephrine / pyrilamine)

Alcohol can increase the nervous system side effects of pyrilamine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with pyrilamine. Do not use more than the recommended dose of pyrilamine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

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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.

Drug Interaction Classification

The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
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 information available.

Do not stop taking any medications without consulting your healthcare provider.

Further information

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