Skip to main content

Drug Interaction Report

11 potential interactions and/or warnings found for the following 2 drugs:

Filter by interaction and/or warning

Interactions between your drugs

Major

dextromethorphan methylene blue

Applies to: dextromethorphan / pseudoephedrine / triprolidine, hyoscyamine / methenamine / methylene blue / phenyl salicylate / sodium biphosphate

Using methylene blue together with dextromethorphan is not recommended. Combining these medications can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. In general, you should wait at least 14 days after stopping methylene blue before you start treatment with dextromethorphan. Conversely, if you have recently been on dextromethorphan and are now starting treatment with methylene blue, you should check with your doctor or pharmacist to see how long you should wait before it is safe for you to use methylene blue, as some medications can take a while to clear from your body. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Major

pseudoephedrine methylene blue

Applies to: dextromethorphan / pseudoephedrine / triprolidine, hyoscyamine / methenamine / methylene blue / phenyl salicylate / sodium biphosphate

Using methylene blue together with pseudoephedrine is not recommended. Combining these medications can cause dangerously high blood pressure and even death. You may use pseudoephedrine only after you have been off methylene blue for at least 14 days. You should seek immediate medical attention if you experience sudden and severe headache, blurred vision, confusion, seizures, chest pain, nausea or vomiting, sudden numbness or weakness (especially on one side of the body), speech difficulties, fever, sweating, lightheadedness, and/or fainting during treatment with methylene blue, as these may be signs and symptoms of excessively high blood pressure. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Major

sodium biphosphate phenyl salicylate

Applies to: hyoscyamine / methenamine / methylene blue / phenyl salicylate / sodium biphosphate, hyoscyamine / methenamine / methylene blue / phenyl salicylate / sodium biphosphate

The following interaction applies only to products containing sodium biphosphate that are used for bowel cleansing. It does not apply to products containing sodium biphosphate that are used for other, non-laxative related purposes.

Bowel cleansing with sodium biphosphate can cause kidney failure, in some cases up to several months after the procedure. Although it rarely occurs, the risk is increased in individuals receiving treatment with phenyl salicylate, especially if they are also elderly or frail. You may need a dose adjustment or special tests to safely use both medications. Combining these medications may also increase the risk of dehydration and electrolyte abnormalities. In severe cases, dehydration and electrolyte abnormalities can lead to irregular heart rhythm, seizures, and kidney problems. You should use sodium biphosphate exactly as prescribed by your doctor, and drink plenty of clear fluids before, during, and after the cleansing process to keep yourself hydrated. Your doctor may also recommend an electrolyte rehydration solution that you can use. Talk to your doctor if you have any concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Moderate

dextromethorphan triprolidine

Applies to: dextromethorphan / pseudoephedrine / triprolidine, dextromethorphan / pseudoephedrine / triprolidine

Using dextromethorphan together with triprolidine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Moderate

pseudoephedrine sodium biphosphate

Applies to: dextromethorphan / pseudoephedrine / triprolidine, hyoscyamine / methenamine / methylene blue / phenyl salicylate / sodium biphosphate

Consumer information for this interaction is not currently available.

MONITOR: The following interaction applies only to products containing sodium biphosphate that are used for bowel cleansing. It does not apply to products containing sodium biphosphate that are used for other, non-laxative related purposes.

The risk of seizures induced by the use of bowel cleansing preparations may be increased in patients on concomitant medications that can lower the seizure threshold such as selective serotonin reuptake inhibitors (SSRI antidepressants or anorectics), monoamine oxidase inhibitors, neuroleptic agents, central nervous system stimulants, opioids, tricyclic antidepressants, other tricyclic compounds (e.g., cyclobenzaprine, phenothiazines), systemic steroids, carbapenems, cholinergic agents, fluoroquinolones, interferons, chloroquine, mefloquine, lindane, and theophylline. Rare cases of generalized tonic-clonic seizures and/or loss of consciousness in association with low serum osmolality and electrolyte abnormalities (e.g., hyponatremia, hypokalemia, hypocalcemia, hypomagnesemia) have been reported with the use of bowel cleansing products in patients with no prior history of seizures. The condition resolved with correction of fluid and electrolyte abnormalities.

MANAGEMENT: Caution is advised when bowel cleansing preparations are prescribed in patients treated with agents that can lower the seizure threshold. Bowel cleansing preparations should not be used if these patients have impaired renal function or perfusion, dehydration, or uncorrected electrolyte abnormalities. Baseline and postprocedure labs including serum electrolytes, calcium, phosphate, BUN, and creatinine should be considered, particularly in the elderly. Patients should be advised not to exceed the recommended dosage of their bowel cleansing preparation and to drink sufficient quantities of clear fluids before, during, and after the bowel preparation process. Administration of an electrolyte rehydration solution may help attenuate the electrolyte abnormalities and hypovolemia.

Moderate

triprolidine hyoscyamine

Applies to: dextromethorphan / pseudoephedrine / triprolidine, hyoscyamine / methenamine / methylene blue / phenyl salicylate / sodium biphosphate

Using triprolidine together with hyoscyamine may increase side effects such as drowsiness, blurred vision, dry mouth, heat intolerance, flushing, decreased sweating, difficulty urinating, abdominal cramping, constipation, irregular heartbeat, confusion, and memory problems. Side effects may be more likely to occur in the elderly or those with a debilitating condition. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Drug and food interactions

Moderate

dextromethorphan food

Applies to: dextromethorphan / pseudoephedrine / triprolidine

Alcohol can increase the nervous system side effects of dextromethorphan 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 dextromethorphan. Do not use more than the recommended dose of dextromethorphan, 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.

Moderate

triprolidine food

Applies to: dextromethorphan / pseudoephedrine / triprolidine

Alcohol can increase the nervous system side effects of triprolidine 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 triprolidine. Do not use more than the recommended dose of triprolidine, 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.

Moderate

sodium biphosphate food

Applies to: hyoscyamine / methenamine / methylene blue / phenyl salicylate / sodium biphosphate

Oral medications may not be properly absorbed when they are taken within one hour before starting sodium biphosphate for bowel cleansing. Talk to your doctor or pharmacist to see if you should adjust the dosing schedule of your other medications before you begin bowel cleansing treatment. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Moderate

hyoscyamine food

Applies to: hyoscyamine / methenamine / methylene blue / phenyl salicylate / sodium biphosphate

Ask your doctor before using hyoscyamine together with ethanol (alcohol). Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking hyoscyamine. You should be warned not to exceed recommended dosages and to avoid activities requiring mental alertness. If your doctor prescribes these medications together, you may need a dose adjustment to safely take this combination. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Moderate

pseudoephedrine food

Applies to: dextromethorphan / pseudoephedrine / triprolidine

Both pseudoephedrine and caffeine can increase blood pressure and heart rate, and combining them may enhance these effects. Talk to your doctor before using these medications, especially if you have a history of high blood pressure or heart disease. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Therapeutic duplication warnings

No duplication 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.


Report options

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.

See also:

Learn more

Further information

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