Drug Interaction Report
3 potential interactions and/or warnings found for the following 2 drugs:
- ambenonium
- trospium / xanomeline
Interactions between your drugs
ambenonium trospium
Applies to: ambenonium, trospium / xanomeline
GENERALLY AVOID: Anticholinergic agents and other agents with significant anticholinergic activity (e.g., clozapine, class IA antiarrhythmics especially disopyramide) may antagonize the effects of cholinergic skeletal muscle stimulants (e.g., ambenonium, edrophonium, guanidine, neostigmine, pyridostigmine). Although this interaction may be desirable in some situations, such as when atropine is used to treat excessive muscarinic side effects and cholinergic crisis induced by anticholinesterase overdose, unintentional or indiscriminate use of anticholinergic agents in the treatment of myasthenia gravis may exacerbate symptoms. In addition, such use may mask the less serious, gastrointestinal signs of cholinergic overdose and lead to inadvertent induction of cholinergic crisis, which can produce respiratory paralysis and death.
MANAGEMENT: Agents with potent anticholinergic activity should preferably be avoided in patients receiving cholinergic skeletal muscle stimulants. If concurrent use is necessary, patients treated for myasthenia gravis should be monitored for potential exacerbation of symptoms. Caution is advised not only because anticholinergic agents may mask the signs of a cholinergic overdose, but also because increasing muscle weakness associated with disease aggravation may be difficult to distinguish from that due to cholinergic crisis.
References (1)
- (2001) "Product Information. Mestinon (pyridostigmine)." ICN Pharmaceuticals Inc
Drug and food interactions
trospium food
Applies to: trospium / xanomeline
ADJUST DOSING INTERVAL: Food may reduce the oral absorption and bioavailability of trospium chloride. According to the product labeling, administration of trospium chloride with a high fat meal reduced the peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) by 70% to 80% compared to administration while fasting.
MANAGEMENT: To ensure maximal oral absorption, trospium chloride should be administered at least 1 hour before meals or on an empty stomach. If trospium chloride is administered as a combination with xanomeline, the manufacturer recommends administering the capsules at least 1 hour before a meal or at least 2 hours after a meal. Capsules should be taken whole.
References (5)
- (2012) "Product Information. Sanctura (trospium)." Odyssey Pharmaceuticals
- (2024) "Product Information. Cobenfy (trospium-xanomeline)." Bristol-Myers Squibb
- (2019) "Product Information. Trosec (trospium)." Oryx Pharmaceuticals Inc
- (2022) "Product Information. Regurin (trospium)." Mylan Healthcare Sdn. Bhd.
- (2023) "Product Information. Trospium Chloride (trospium)." Padagis
Therapeutic duplication warnings
Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.
Cholinergics
Therapeutic duplication
The recommended maximum number of medicines in the 'cholinergics' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'cholinergics' category:
- ambenonium
- trospium / xanomeline
Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
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Rystiggo
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Mestinon
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Vyvgart
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Soliris
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Vyvgart Hytrulo
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Regonol
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Further information
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