Drug Interaction Report
1 drug interaction and 15 additional warnings found for the following 2 drugs:
- safinamide
- Sitrex (guaifenesin / phenylephrine)
Drug interactions
Moderate drug interactions
Moderate:phenylephrine safinamide
Applies to: Sitrex (guaifenesin / phenylephrine), safinamide
Using safinamide together with phenylephrine may increase cardiovascular side effects such as blood pressure elevations and increased heart rate.
While these effects are not expected to be dangerous in most people, there is a possibility for high blood pressure to occur which may require medical attention.
Talk to your doctor if you have any questions or concerns, especially if you have a history of:
- high blood pressure
- irregular heart rhythm
- heart disease
Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications.
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.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:Caffeine phenylephrine
Applies to: Sitrex (guaifenesin / phenylephrine)
Both phenylephrine 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.
Moderate:Food/Lifestyle safinamide
Applies to: safinamide
Safinamide may be taken with or without food.
While there is no need to strictly avoid most foods and beverages that contain tyramine (usually aged, fermented, cured, smoked, or pickled foods such as air-dried and fermented meats or fish, aged cheeses, most soybean products, yeast extracts, red wine, beer, and sauerkraut) during treatment with safinamide, certain foods such as some of the aged cheeses (for example, Boursault, Liederkrantz, Mycella, and Stilton) and pickled herring may contain very high amounts of tyramine and should generally be avoided if possible.
Consumption of very high levels of tyramine (greater than 150 mg) while on safinamide treatment may lead to dangerous increases in your blood pressure, a condition known as hypertensive crisis.
Talk to your doctor or pharmacist if you are uncertain about what foods, if any, to avoid.
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 safinamide, as these may be signs and symptoms of a hypertensive crisis.
Do not take larger doses or use the medication more frequently than prescribed.
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.
Disease interactions
13 potential interactionsApplies to: 13 conditions, including High Blood Pressure, Benign Prostatic Hyperplasia, Hyperthyroidism, Psychosis, and Diabetes Mellitus.
Benign Prostatic Hyperplasia
Moderate:Sitrex
The phenylephrine in Sitrex has a moderate potential interaction with Benign Prostatic Hyperplasia.
Sympathomimetic agents may cause or worsen urinary difficulty in patients with prostate enlargement due to smooth muscle contraction in the bladder neck via stimulation of alpha-1 adrenergic receptors. Therapy with sympathomimetic agents should be administered cautiously in patients with hypertrophy or neoplasm of the prostate.
Cardiovascular Conditions and Disorders
Major:Sitrex
The phenylephrine in Sitrex has a major potential interaction with Cardiovascular Conditions and Disorders.
Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.
Cerebrovascular Insufficiency
Major:Sitrex
The phenylephrine in Sitrex has a major potential interaction with Cerebrovascular Insufficiency.
Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.
Diabetes Mellitus
Moderate:Sitrex
The phenylephrine in Sitrex has a moderate potential interaction with Diabetes Mellitus.
Sympathomimetic agents may cause increases in blood glucose concentrations. These effects are usually transient and slight but may be significant with dosages higher than those normally recommended. Therapy with sympathomimetic agents should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate.
Glaucoma/Intraocular Hypertension
Moderate:Sitrex
The phenylephrine in Sitrex has a moderate potential interaction with Glaucoma/Intraocular Hypertension.
Sympathomimetic agents can induce transient mydriasis via stimulation of alpha-1 adrenergic receptors. In patients with anatomically narrow angles or narrow-angle glaucoma, pupillary dilation can provoke an acute attack. In patients with other forms of glaucoma, mydriasis may occasionally increase intraocular pressure. Therapy with sympathomimetic agents should be administered cautiously in patients with or predisposed to glaucoma, particularly narrow-angle glaucoma.
High Blood Pressure
Moderate:safinamide
Safinamide has a moderate potential interaction with High Blood Pressure.
Safinamide may cause hypertension or exacerbate existing hypertension. Patients should be monitored for new onset hypertension or hypertension that is not adequately controlled after starting treatment. Dosage adjustment may be necessary if elevation of blood pressure is sustained.
Hyperthyroidism
Major:Sitrex
The phenylephrine in Sitrex has a major potential interaction with Hyperthyroidism.
Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.
Liver Disease
Major:safinamide
Safinamide has a major potential interaction with Liver Disease.
Safinamide is contraindicated in patients with severe hepatic dysfunction (Child-Pugh C). In patients with moderate hepatic impairment the maximum recommended dose is 50 mg orally once a day. If a patient taking this dose progresses from moderate to severe hepatic impairment, safinamide should be discontinued.
Pheochromocytoma
Major:Sitrex
The phenylephrine in Sitrex has a major potential interaction with Pheochromocytoma.
Sympathomimetic agents may cause adverse cardiovascular effects, particularly when used in high dosages and/or in susceptible patients. In cardiac tissues, these agents may produce positive chronotropic and inotropic effects via stimulation of beta- 1 adrenergic receptors. Cardiac output, oxygen consumption, and the work of the heart may be increased. In the peripheral vasculature, vasoconstriction may occur via stimulation of alpha-1 adrenergic receptors. Palpitations, tachycardia, arrhythmia, hypertension, reflex bradycardia, coronary occlusion, cerebral vasculitis, myocardial infarction, cardiac arrest, and death have been reported. Some of these agents, particularly ephedra alkaloids (ephedrine, ma huang, phenylpropanolamine), may also predispose patients to hemorrhagic and ischemic stroke. Therapy with sympathomimetic agents should generally be avoided or administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, or underlying cardiovascular or cerebrovascular disorders. These agents should not be used in patients with severe coronary artery disease or severe/uncontrolled hypertension.
Prostate Tumor, Benign
Moderate:Sitrex
The phenylephrine in Sitrex has a moderate potential interaction with Prostate Tumor, Benign.
Sympathomimetic agents may cause or worsen urinary difficulty in patients with prostate enlargement due to smooth muscle contraction in the bladder neck via stimulation of alpha-1 adrenergic receptors. Therapy with sympathomimetic agents should be administered cautiously in patients with hypertrophy or neoplasm of the prostate.
Psychosis
Moderate:safinamide
Safinamide has a moderate potential interaction with Psychosis.
Ordinarily, patients with major psychotic disorder should not be treated with dopaminergic antiparkinsonian agents, because of the risk of exacerbating psychosis. Hallucinations and psychotic-like behavior have been reported with dopaminergic medications. In addition, certain medications used to treat psychosis may exacerbate the symptoms of Parkinson's disease and may decrease the effectiveness of these drugs. The use of bromocriptine in patients with severe psychotic disorders is not recommended.
Retinal Disorders
Moderate:safinamide
Safinamide has a moderate potential interaction with Retinal Disorders.
Animal studies with safinamide showed retinal degeneration, loss of photoreceptor cells, cataracts, and retinal scarring. Patients should be periodically monitored for visual changes, especially if they have a history of retinal/macular degeneration, uveitis, inherited retinal conditions, family history of retinal disease, albinism, retinitis pigmentosa, or active retinopathy (e.g., diabetic retinopathy).
Uveitis
Moderate:safinamide
Safinamide has a moderate potential interaction with Uveitis.
Animal studies with safinamide showed retinal degeneration, loss of photoreceptor cells, cataracts, and retinal scarring. Patients should be periodically monitored for visual changes, especially if they have a history of retinal/macular degeneration, uveitis, inherited retinal conditions, family history of retinal disease, albinism, retinitis pigmentosa, or active retinopathy (e.g., diabetic retinopathy).
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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