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Drug Interaction Report

3 drug interactions and 28 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

dextromethorphan droPERidol

Applies to: Mucinex Nightshift Cold & Flu (acetaminophen / dextromethorphan / triprolidine), droperidol

Using dextromethorphan together with droPERidol may increase side effects such as:

  • dizziness
  • drowsiness
  • confusion
  • difficulty concentrating

Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination.

What to do: 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:

dextromethorphan triprolidine

Applies to: Mucinex Nightshift Cold & Flu (acetaminophen / dextromethorphan / triprolidine), Mucinex Nightshift Cold & Flu (acetaminophen / dextromethorphan / triprolidine)

Using dextromethorphan together with triprolidine may increase side effects such as:

  • dizziness
  • drowsiness
  • confusion
  • difficulty concentrating

Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination.

What to do: 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:

droPERidol triprolidine

Applies to: droperidol, Mucinex Nightshift Cold & Flu (acetaminophen / dextromethorphan / triprolidine)

Using droPERidol together with triprolidine may increase side effects such as:

  • dizziness
  • drowsiness
  • confusion
  • difficulty concentrating

Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination.

What to do: 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.

Food/lifestyle interactions

Major food/lifestyle interactions

Major:

Alcohol (Ethanol) droPERidol

Applies to: droperidol

Using droPERidol together with ethanol (alcohol) can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect.

You may be more susceptible if you have:

  • a heart condition called congenital long QT syndrome
  • other cardiac diseases
  • conduction abnormalities
  • electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting)

Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications.

You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone.

In addition, you should let your doctor know if you experience signs of electrolyte disturbance such as:

  • weakness
  • tiredness
  • drowsiness
  • confusion
  • muscle pain
  • cramps
  • dizziness
  • nausea
  • vomiting

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:

Food/Lifestyle acetaminophen

Applies to: Mucinex Nightshift Cold & Flu (acetaminophen / dextromethorphan / triprolidine)

Acetaminophen may cause liver damage and taking it with alcohol may increase that risk.

You should avoid or limit the use of alcohol while being treated with acetaminophen.

Call your doctor immediately if you have:

  • fever
  • chills
  • joint pain or swelling
  • excessive tiredness or weakness
  • unusual bleeding or bruising
  • skin rash or itching
  • loss of appetite
  • nausea
  • vomiting
  • dark colored urine
  • yellowing of the skin or the whites of your eyes

These may be symptoms of liver damage.

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 interactions

Moderate:

Food/Lifestyle dextromethorphan

Applies to: Mucinex Nightshift Cold & Flu (acetaminophen / dextromethorphan / triprolidine)

Alcohol can increase the nervous system side effects of dextromethorphan such as:

  • dizziness
  • drowsiness
  • 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:

Food/Lifestyle triprolidine

Applies to: Mucinex Nightshift Cold & Flu (acetaminophen / dextromethorphan / triprolidine)

Alcohol can increase the nervous system side effects of triprolidine such as:

  • dizziness
  • drowsiness
  • 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:

Nicotine droPERidol

Applies to: droperidol

As you stop smoking during treatment with nicotine, your dosage requirement of droPERidol may need to be changed. Talk to your doctor if you have any questions or concerns.

Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor 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.

Disease interactions

23 potential interactionsApplies to: 19 conditions, including Asthma, COPD, Hypokalemia, Hypotension, and Hyperthyroidism.

Alcoholism

Major:

Mucinex Nightshift Cold & Flu

The acetaminophen in Mucinex Nightshift Cold & Flu has a major potential interaction with Alcoholism.

Chronic alcohol abusers may be at increased risk of hepatotoxicity during treatment with acetaminophen (APAP). Severe liver injury, including cases of acute liver failure resulting in liver transplant and death, has been reported in patients using acetaminophen. Therapy with acetaminophen should be administered cautiously, if at all, in patients who consume three or more alcoholic drinks a day. In general, patients should avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure. They should also be advised to seek medical attention if they experience signs and symptoms of liver injury such as fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, and jaundice.

Asthma

Moderate:

Mucinex Nightshift Cold & Flu

The triprolidine in Mucinex Nightshift Cold & Flu has a moderate potential interaction with Asthma.

It has been suggested that the anticholinergic effect of antihistamines may reduce the volume and cause thickening of bronchial secretions, resulting in obstruction of respiratory tract. Some manufacturers and clinicians recommend that therapy with antihistamines be administered cautiously in patients with asthma or chronic obstructive pulmonary disease.

Cardiovascular Conditions and Disorders

Moderate:

Mucinex Nightshift Cold & Flu

The triprolidine in Mucinex Nightshift Cold & Flu has a moderate potential interaction with Cardiovascular Conditions and Disorders.

Antihistamines may infrequently cause cardiovascular adverse effects related to their anticholinergic and local anesthetic (quinidine-like) activities. Tachycardia, palpitation, ECG changes, arrhythmias, hypotension, and hypertension have been reported. Although these effects are uncommon and usually limited to overdosage situations, the manufacturers and some clinicians recommend that therapy with antihistamines be administered cautiously in patients with cardiovascular disease, hypertension, and/or hyperthyroidism.

COPD

Moderate:

Mucinex Nightshift Cold & Flu

The triprolidine in Mucinex Nightshift Cold & Flu has a moderate potential interaction with COPD.

It has been suggested that the anticholinergic effect of antihistamines may reduce the volume and cause thickening of bronchial secretions, resulting in obstruction of respiratory tract. Some manufacturers and clinicians recommend that therapy with antihistamines be administered cautiously in patients with asthma or chronic obstructive pulmonary disease.

Dehydration

Major:

Mucinex Nightshift Cold & Flu

The acetaminophen in Mucinex Nightshift Cold & Flu has a major potential interaction with Dehydration.

Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease. Patients with hepatic impairment may be at increased risk of toxicity. Severe liver injury, including cases of acute liver failure and death, have been reported in patients using this drug. Clinical monitoring of hepatic function is recommended. Caution is advised if using acetaminophen in patients with chronic malnutrition or severe hypovolemia. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.

Electrolyte Abnormalities

Major:

droperidol

droPERidol has a major potential interaction with Electrolyte Abnormalities.

Cases of QT prolongation and/or torsade de pointes have been reported in patients receiving droperidol at doses at or below recommended doses. Extreme caution is recommended when using this agent in patients with risk factors for development of prolonged QT syndrome, such as clinically significant bradycardia, any clinically significant cardiac disease, treatment with Class I and Class III antiarrhythmics, treatment with monoamine oxidase inhibitors (MAOI's), concomitant treatment with other drug products known to prolong the QT interval, and electrolyte imbalance, in particular hypokalemia and hypomagnesemia, or concomitant treatment with drugs that may cause electrolyte imbalance. It is advisable that all patients undergo a 12-lead ECG prior to administration to determine if a prolonged QT interval (i.e., QTc greater than 440 msec. for males or 450 msec. for females) is present. If there is a prolonged QT interval, droperidol should not be administered.

Gastrointestinal Obstruction

Moderate:

Mucinex Nightshift Cold & Flu

The triprolidine in Mucinex Nightshift Cold & Flu has a moderate potential interaction with Gastrointestinal Obstruction.

Antihistamines often have anticholinergic activity, to which elderly patients are particularly sensitive. Therapy with antihistamines should be administered cautiously, if at all, in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders. Conventional, first-generation antihistamines such as the ethanolamines (bromodiphenhydramine, carbinoxamine, clemastine, dimenhydrinate, diphenhydramine, doxylamine, phenyltoloxamine) tend to exhibit substantial anticholinergic effects. In contrast, the newer, relatively nonsedating antihistamines (e.g., cetirizine, fexofenadine, loratadine) reportedly have low to minimal anticholinergic activity at normally recommended dosages and may be appropriate alternatives.

Glaucoma/Intraocular Hypertension

Moderate:

Mucinex Nightshift Cold & Flu

The triprolidine in Mucinex Nightshift Cold & Flu has a moderate potential interaction with Glaucoma/Intraocular Hypertension.

Antihistamines often have anticholinergic activity, to which elderly patients are particularly sensitive. Therapy with antihistamines should be administered cautiously, if at all, in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders. Conventional, first-generation antihistamines such as the ethanolamines (bromodiphenhydramine, carbinoxamine, clemastine, dimenhydrinate, diphenhydramine, doxylamine, phenyltoloxamine) tend to exhibit substantial anticholinergic effects. In contrast, the newer, relatively nonsedating antihistamines (e.g., cetirizine, fexofenadine, loratadine) reportedly have low to minimal anticholinergic activity at normally recommended dosages and may be appropriate alternatives.

Hyperthyroidism

Moderate:

Mucinex Nightshift Cold & Flu

The triprolidine in Mucinex Nightshift Cold & Flu has a moderate potential interaction with Hyperthyroidism.

Antihistamines may infrequently cause cardiovascular adverse effects related to their anticholinergic and local anesthetic (quinidine-like) activities. Tachycardia, palpitation, ECG changes, arrhythmias, hypotension, and hypertension have been reported. Although these effects are uncommon and usually limited to overdosage situations, the manufacturers and some clinicians recommend that therapy with antihistamines be administered cautiously in patients with cardiovascular disease, hypertension, and/or hyperthyroidism.

Hypokalemia

Major:

droperidol

droPERidol has a major potential interaction with Hypokalemia.

Cases of QT prolongation and/or torsade de pointes have been reported in patients receiving droperidol at doses at or below recommended doses. Extreme caution is recommended when using this agent in patients with risk factors for development of prolonged QT syndrome, such as clinically significant bradycardia, any clinically significant cardiac disease, treatment with Class I and Class III antiarrhythmics, treatment with monoamine oxidase inhibitors (MAOI's), concomitant treatment with other drug products known to prolong the QT interval, and electrolyte imbalance, in particular hypokalemia and hypomagnesemia, or concomitant treatment with drugs that may cause electrolyte imbalance. It is advisable that all patients undergo a 12-lead ECG prior to administration to determine if a prolonged QT interval (i.e., QTc greater than 440 msec. for males or 450 msec. for females) is present. If there is a prolonged QT interval, droperidol should not be administered.

Hypotension

Moderate:

Mucinex Nightshift Cold & Flu

The triprolidine in Mucinex Nightshift Cold & Flu has a moderate potential interaction with Hypotension.

Antihistamines may infrequently cause cardiovascular adverse effects related to their anticholinergic and local anesthetic (quinidine-like) activities. Tachycardia, palpitation, ECG changes, arrhythmias, hypotension, and hypertension have been reported. Although these effects are uncommon and usually limited to overdosage situations, the manufacturers and some clinicians recommend that therapy with antihistamines be administered cautiously in patients with cardiovascular disease, hypertension, and/or hyperthyroidism.

Liver Disease

Major:

Mucinex Nightshift Cold & Flu

The acetaminophen in Mucinex Nightshift Cold & Flu has a major potential interaction with Liver Disease.

Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease. Patients with hepatic impairment may be at increased risk of toxicity. Severe liver injury, including cases of acute liver failure and death, have been reported in patients using this drug. Clinical monitoring of hepatic function is recommended. Caution is advised if using acetaminophen in patients with chronic malnutrition or severe hypovolemia. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.

Moderate:

droperidol

droPERidol has a moderate potential interaction with Liver Disease.

Droperidol should be administered with caution in patients with liver and kidney dysfunction because of the importance of these organs in the metabolism and excretion of drugs.

Moderate:

Mucinex Nightshift Cold & Flu

The triprolidine in Mucinex Nightshift Cold & Flu has a moderate potential interaction with Liver Disease.

Limited pharmacokinetic data are available for the older, first-generation antihistamines. Many appear to be primarily metabolized by the liver, and both parent drugs and metabolites are excreted in the urine. Patients with renal and/or liver disease may be at greater risk for adverse effects from antihistamines due to drug and metabolite accumulation. Therapy with antihistamines should be administered cautiously in such patients. Lower initial dosages may be appropriate.

Long QT Syndrome

Major:

droperidol

droPERidol has a major potential interaction with Long QT Syndrome.

The use of droperidol is contraindicated in patients with known or suspected QT prolongation (i.e., QTc interval greater than 440 msec. for males or 450 msec. for females), including those patients with congenital long QT syndrome.

Major:

droperidol

droPERidol has a major potential interaction with Long QT Syndrome.

Cases of QT prolongation and/or torsade de pointes have been reported in patients receiving droperidol at doses at or below recommended doses. Extreme caution is recommended when using this agent in patients with risk factors for development of prolonged QT syndrome, such as clinically significant bradycardia, any clinically significant cardiac disease, treatment with Class I and Class III antiarrhythmics, treatment with monoamine oxidase inhibitors (MAOI's), concomitant treatment with other drug products known to prolong the QT interval, and electrolyte imbalance, in particular hypokalemia and hypomagnesemia, or concomitant treatment with drugs that may cause electrolyte imbalance. It is advisable that all patients undergo a 12-lead ECG prior to administration to determine if a prolonged QT interval (i.e., QTc greater than 440 msec. for males or 450 msec. for females) is present. If there is a prolonged QT interval, droperidol should not be administered.

Magnesium Imbalance

Major:

droperidol

droPERidol has a major potential interaction with Magnesium Imbalance.

Cases of QT prolongation and/or torsade de pointes have been reported in patients receiving droperidol at doses at or below recommended doses. Extreme caution is recommended when using this agent in patients with risk factors for development of prolonged QT syndrome, such as clinically significant bradycardia, any clinically significant cardiac disease, treatment with Class I and Class III antiarrhythmics, treatment with monoamine oxidase inhibitors (MAOI's), concomitant treatment with other drug products known to prolong the QT interval, and electrolyte imbalance, in particular hypokalemia and hypomagnesemia, or concomitant treatment with drugs that may cause electrolyte imbalance. It is advisable that all patients undergo a 12-lead ECG prior to administration to determine if a prolonged QT interval (i.e., QTc greater than 440 msec. for males or 450 msec. for females) is present. If there is a prolonged QT interval, droperidol should not be administered.

Malnourishment

Major:

Mucinex Nightshift Cold & Flu

The acetaminophen in Mucinex Nightshift Cold & Flu has a major potential interaction with Malnourishment.

Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease. Patients with hepatic impairment may be at increased risk of toxicity. Severe liver injury, including cases of acute liver failure and death, have been reported in patients using this drug. Clinical monitoring of hepatic function is recommended. Caution is advised if using acetaminophen in patients with chronic malnutrition or severe hypovolemia. Instruct patients to avoid drinking alcohol while taking acetaminophen-containing medications. Patients should be warned not to exceed the maximum recommended total daily dosage of acetaminophen (4 g/day in adults and children 12 years of age or older), and to read all prescription and over-the-counter medication labels to ensure they are not taking multiple acetaminophen-containing products, or check with a healthcare professional if they are unsure.

Phenylketonuria

Moderate:

Mucinex Nightshift Cold & Flu

The acetaminophen in Mucinex Nightshift Cold & Flu has a moderate potential interaction with Phenylketonuria.

Several oral acetaminophen and acetaminophen-combination products, particularly flavored chewable tablets, contain the artificial sweetener, aspartame (NutraSweet). Aspartame is converted to phenylalanine in the gastrointestinal tract following ingestion. Chewable and effervescent formulations of acetaminophen products may also contain phenylalanine. The aspartame/phenylalanine content should be considered when these products are used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics).

Pheochromocytoma

Moderate:

droperidol

droPERidol has a moderate potential interaction with Pheochromocytoma.

Droperidol should be used with caution in patients with diagnosed or suspected pheochromocytoma as severe hypertension and tachycardia have been observed after its administration.

Renal Dysfunction

Moderate:

droperidol

droPERidol has a moderate potential interaction with Renal Dysfunction.

Droperidol should be administered with caution in patients with liver and kidney dysfunction because of the importance of these organs in the metabolism and excretion of drugs.

Moderate:

Mucinex Nightshift Cold & Flu

The triprolidine in Mucinex Nightshift Cold & Flu has a moderate potential interaction with Renal Dysfunction.

Limited pharmacokinetic data are available for the older, first-generation antihistamines. Many appear to be primarily metabolized by the liver, and both parent drugs and metabolites are excreted in the urine. Patients with renal and/or liver disease may be at greater risk for adverse effects from antihistamines due to drug and metabolite accumulation. Therapy with antihistamines should be administered cautiously in such patients. Lower initial dosages may be appropriate.

Urinary Retention

Moderate:

Mucinex Nightshift Cold & Flu

The triprolidine in Mucinex Nightshift Cold & Flu has a moderate potential interaction with Urinary Retention.

Antihistamines often have anticholinergic activity, to which elderly patients are particularly sensitive. Therapy with antihistamines should be administered cautiously, if at all, in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders. Conventional, first-generation antihistamines such as the ethanolamines (bromodiphenhydramine, carbinoxamine, clemastine, dimenhydrinate, diphenhydramine, doxylamine, phenyltoloxamine) tend to exhibit substantial anticholinergic effects. In contrast, the newer, relatively nonsedating antihistamines (e.g., cetirizine, fexofenadine, loratadine) reportedly have low to minimal anticholinergic activity at normally recommended dosages and may be appropriate alternatives.

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.

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Further information

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