Archive for January, 2016

Can you take Tums and Pepto Bismol together

Jan 28 2016 Published by under Drug Interactions

Tums vs Pepto Bismol basic facts

Tums is a brand name for over-the-counter supplement containing antacid calcium carbonate and sugar sucrose. It is used as an antacid for relieving the symptoms of acid indigestion, heartburn, indigestion (sour stomach) or gas such as stomach upset and burning chest pains. It can also be used as a daily calcium supplement.

Tums products on the market are: Tums Extra, Tums Chewy Delights, Tums Freshers, Tums Regular, Tums Ultra, Tums Kids, Tums Smoothies, and Children’s Pepto.

Pepto-Bismol is a brand name for over-the-counter medication containing bismuth subsalicylate as an active ingredient. It used for the treatment of temporary discomforts of gastrointestinal tract such as: diarrhea, upset stomach, nausea, indigestion, and heartburn.

Bismuth subsalicylate can be also used for the prevention of traveler’s diarrhea and for the treatment of Helicobacter pylori infection of gastrointestinal tract as a part of a quadruple drug therapy that also contain two antibiotics, and either of antagonist of histamine H2 receptor or inhibitor of a proton pump.

Bismuth subsalicylate has also other therapeutic benefits in the body including anti-bacterial, anti-inflammatory and anti-secretory actions.

Other products on the market containing bismuth subsalicylate are: Kaopectate, Kaopectate Extra Strength, Maalox Total Relief, Pepto-Bismol Maximum Strength and other.

How does Tums and Pepto Bismol work in the body

Bismuth subsalicylate is antacid and antidiarrheal agent that is used for relieving many gastro-intestinal symptoms but it also has many other actions in the body.

It can: protect irritated tissues by coating them and by reducing the expulsion of fluids into the digestive system, stimulate absorption of fluids and electrolytes, as a salicylate it can reduce inflammation of GIT through inhibition of prostaglandin synthesis and it can reduce the hypermotility of the stomach.

Bismuth subsalicylate can be also used as an antibacterial agent by binding the toxins that are produced produced by E. coli. It also contains bactericidal properties.

Calcium carbonate has antacid properties that work by neutralizing hydrochloric acid in gastric secretions. This process can increase the pH value that may also inhibit the action of pepsin.

It also has cytoprotective properties by increasing the bicarbonate ions and prostaglandins. Calcium carbonate may also be used as a nutritional supplement or for the treatment of hypocalcemia. Calcium may be a good protection against renal calculi formation by chelating with oxalate and preventing its intestinal absorption.

Can patients take Tums with Pepto Bismol

Patients can take Tums and Pepto-Bismol together since there are no interactions between them. Together they work well and they are safe for short term use. However, prolonged use can lead to problems.

Both medicines work primarily by coating the stomach tissue to help acid effects. With long term use the normal (good) bacteria in the gastrointestinal tract can be depleted and abnormal (bad) bacteria can overgrow in. Also long term use of Pepto-Bismol can cause intestinal tract discoloration along with elevated toxic levels of bismuth. So, patients always need to consult their doctors or pharmacists first before they take these drugs together. It is not a good idea to take any medication, unless it is needed.

The table below shows the incidence of side effects after Tums and Pepto-Bismol administration in recommendable doses. This incidence can be significantly increased if these drugs are taken together for a long term and in high doses.

Incidence

Side effects

Frequency Not Defined Flatulence, Anorexia, Constipation, Hypercalcemia, Nausea, Vomiting, Hypophosphatemia, Milk-alkali syndrome, Diarrhea, Abdominal pain, Melena, Upper respiratory tract infection, Asthenia, Discolored tongue, Dizziness, Stool abnormality, Sinusitis, Insomnia, Paresthesia, Gray-black stool, Muscle spasm, Tinnitus

Special precautions and warnings during Tums and Pepto-Bismol administration:

  • Before taking calcium carbonate, patients need to tell their doctor or pharmacist if they are allergic to it or if they have any other allergies.
  • They should not use Pepto-Bismol if they are allergic to aspirin or any other nonsteroidal anti-inflammatory drug (NSAID) (eg, ibuprofen, naproxen, diclofenac, celecoxib)
  • They shouldn’t use Pepto-Bismol if they already use aspirin or any other salicylate medicine.
  • They should also consult their doctor or pharmacist if they have: high calcium levels, or stomach or intestinal blockage, kidney disease such as kidney stones before using Tums.
  • Some products may contain aspartame, so patients with phenylketonuria or any other condition that requires restriction of aspartame intake should consult their doctor or pharmacist about using this drug safely.
  • Patients should tell their doctor if they are pregnant, before using these medications. Salicylates use during pregnancy has been associated with serious adverse effects on the fetus; therefore use of bismuth subsalicylate during pregnancy should be avoided. These medications may pass into breast milk. Nursing mothers should avoid these medications.
  • If patients have bleeding problems (such as hemophilia), black or bloody stools, active bleeding ulcer, Von Willebrand disease they shouldn’t use Pepto-Bismol.
  • Bismuth subsalicylate should be used cautiously in patients who are on methotrexate (Trexall) therapy. It is known that in the body bismuth subsalicylate is broken down to salicylic acid which is known to increase methotrexate blood levels. Patients at high risk are: elderly patients, patients on high-dose methotrexate therapy, and patients with reduced kidney function.
  • Pediatric patients should not be given Pepto-Bismol for 6 weeks after receiving the varicella-zoster virus live vaccine, because they are at high risk of developing a serious liver disease called Reye’s syndrome.
  • Pepto-Bismol can cause black tongue and black stool. It may also interfere with gastrointestinal radiographic tests.
  • Patients should be advised to limit intake of oxalate-rich foods such as: soy; green, leafy vegetables and animal protein, to avoid reduced absorption through calcium oxalate formation.

Information retrieved from:

http://reference.medscape.com/drug/tums-calcium-carbonate-341983#10

http://reference.medscape.com/drug/kaopectate-pepto-bismol-bismuth-subsalicylate-342037#10

http://www.drugs.com/cdi/pepto-bismol.html

http://www.drugs.com/cdi/tums-plus-chewable-tablets.html

http://www.drugbank.ca/drugs/DB06724

http://www.just-health.net/Tums-Side-Effects.html

http://www.medicinenet.com/calcium_carbonate_antacid-chewable_tablets/page3.htm

http://www.medicinenet.com/bismuth_subsalicylate-oral/article.htm

http://www.webmd.com/drugs/2/drug-9574-2123/tums-oral/calciumcarbonateantacid-oral/details

https://www.healthtap.com/topics/can-i-take-tums-and-pepto-bismol

Can you take Probiotics and Vitamins together”

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Can you take Probiotics and Vitamins together

Jan 28 2016 Published by under Drug Interactions

Probiotics and multivitamins basic facts

Probiotics are live microorganisms (“good” or “helpful” bacteria and yeasts) that can provide health benefits especially for digestive system.

Probiotics may be able to prevent and treat some illnesses by promoting a healthy digestive tract, healthy immune system and protecting the body from harmful bacteria.

Probiotics can be taken through the food (bananas, grains, onions) or beverages (yoghurt and kefir), and dietary supplements. These products may help in: treating diarrhea, especially after antibiotic treatment, preventing and treating urinary tract infections and vaginal yeast infections, speeding the treatment of intestinal infections, treating irritable bowel syndrome and preventing or reducing the severity of common colds and flu symptoms.

There are many probiotics bacteria with different benefits, however most come from two bacteria genus: Lactobacillus and Bifidobacterium. Lactobacillus is the most common probiotic, it can be found in yoghurt and other fermented foods.

This probiotic can help patients with diarrhea and may be helpful in patients who are lactose intolerant. Bifidobacterium can be also found in some dairy products and may be helpful for relieving the symptoms of irritable bowel disease.

Multivitamins are preparations containing multiple micronutrients, such as vitamins and dietary minerals. These preparations contain 3 or more vitamins and minerals at doses which are below the tolerable upper level, as determined by the Food and Drug Board, and they have no risk and adverse health effects.

Multivitamins do not contain drugs, herbs or hormones. These preparations are used to provide vitamins that are not taken enough by diet. They are also used to treat vitamin deficiencies caused by poor nutrition, pregnancy, illness, digestive disorders, and many other conditions.

Common commercial multivitamin supplement products usually contain the following ingredients: vitamins, B1, B2, B3, B6, B12, B5, vitamin C, folic acid, vitmains A, D, E, K, potassium iodide, zinc, calcium, manganese, magnesium, chromium, molybdenum, beta carotene, selenomethionine, and borates.

Other formulas may include additional ingredients such as lutein, lycopene, inositol, choline, PABA, trimethylglycine, vitamin K2, betaine, lecithin and higher amounts of B, C or E vitamins.

Vitamins can be used for the treatment of many health conditions such as: wound healing, canker sores, acne rosacea, alcohol withdrawal, anxiety, attention deficit hyperactivity disorder, hives, osteoporosis, indigestion, heartburn, low stomach acidity, vitiligo, anemia and other conditions.

How does Probiotics and multivitamins benefit the body

Probiotics work in the body by replacing the “bad” with “good” bacteria in digestive system, that can be lost for example after antibiotics therapy. They also keep the balance of “good” and “bad” bacteria in intestinum.

Vitamin B1 Thiamine has a central role in the production of energy from carbohydrates. It is also involved in RNA and DNA production and neurons function. Coenzyme called thiamine pyrophosphate (TPP) is thiamin’s active form which takes a significant part in metabolism.

Vitamin B2 – Riboflavin is important in the production of energy in electron transport chain, in the citric acid cycle and the catabolism of fatty acids.

Vitamin B3 – Niacin is composed of 2 structures: nicotinamide and nicotinic acid. Niacin has two co-enzyme forms: NAD – nicotinamide adenine dinucleotide and NADP – nicotinamide adenine dinucleotide phosphate. Both has important role in energy transfer in the metabolism of glucose, fats and alcohol.

Vitamin B5 – Pantothenic acid has important role in fatty acids and carbohydrates oxidation processes. Coenzyme A is formed from pantothenic acid, and it is involved in the synthesis reactions of many compounds in the body.

Vitamin B6 – composed of 3 structures: pyridoxine, pyridoxal, pyridoxamine. The active form pyridoxal 5′-phosphate is a cofactor in many enzyme reactions such as amino acid metabolism that includes neurotransmitters biosynthesis.

Vitamin B7- Biotin is important in the metabolism of lipids, proteins and carbohydrates.

Vitamin B9 – Folic acid is involved in the transfer of single-carbon units in the anabolism of nucleic and amino acids. It is needed for normal cell division, during pregnancy and infancy, and for rapid growth processes. Folic acids also has important role in erythropoiesis – the production of red blood cells.

Vitamin B12 – cobalamins is involved in the cell metabolism of carbohydrates, proteins and lipids. It is very important in production of blood cells in bone marrow, and also for proteins and nerve sheaths production.

Vitamin C is very significant for bones and connective tissues, muscles, and blood vessels. Vitamin C also helps the body to absorb iron. Vitamin C may also act as a very potent antioxidant against oxidative stress.

Vitamin A is important for the normal function of eyes, skin, and for normal growth. Body uses vitamin A for gene transcription, bone metabolism, immune cell functioning, embryonic development and reproduction, and as an antioxidant.

Vitamin D has important role in bone and homeostasis of calcium homeostasis.

Vitamin K has a key role in blood clothing and preventing excessive bleeding.

Vitamin E is important for strong immunity and healthy eyes and skin. It also has antioxidant properties.

Can patients take Probiotics and multivitamins together

Patients can take probiotics and multivitamins together, it is a good combination and many dietitians will recommend this. Probiotics and vitamins work together really well in the body. Probiotics can help vitamins to be separated and used in the body through the digestive processes. Vitamins do not impede the probiotics role, just as probiotics do not hamper the vitamins potency.

However, it is not essential to purchase probiotics and vitamins for inducing the beneficial interaction between them. This reaction occurs naturally after eating.

When food enters the intestines, digestive system immediately filters what is needed from the food and excretes the waste material. Expensive pills do not create this process.

But, if patients do not have healthy diet, rich of foods with nutrients such as fibers and healthful bacteria, their body may have a more difficult digestion time and metabolism.

Patients should not overdose probiotics. Too many probiotics can cause in some cases, mild side effects such as: stomach upset, diarrhea, gas, and bloating.

They can also trigger allergic reactions. Also, eating too many probiotic-rich foods like fatty cheese might produce health issues, like high cholesterol, high blood pressure or high fat and calorie intake.

Vitamins can also be overdosed, like A, D and K vitamins that the body can store for a long time. They can cause adverse effects if too much is present. Consuming more than one multivitamin daily can cause more harm than good.

The table below shows the recommended daily intake of vitamins and over dosage side effects:

 

Vitamins

Recommended daily intake

Over dosage

(mg or µg/d)

Biotin
(B-complex)
30 µg No information
Folate
(B-complex)
400 µg Anemia, vitamin B12 deficiency symptoms masking
Vitamin A 600 µg Loss of appetite, dry skin, fatigue, nausea, bone and joint pains and headaches
Vitamin B1 (thiamin) 1,4 mg No toxic effects have been observed
Vitamin B2 (riboflavin) 1,6 mg Urine colour alteration
Vitamin B3 (niacin) 18 mg Facial flushing, liver disease
Vitamin B5 (patothenic acid) 6 mg Nausea and heartburn
Vitamin B6 (pyridoxine) 2 mg Numbness and tingling in hands and feet
Vitamin B12 (cobalamine) 6 µg Eye conditions
Vitamin C (ascorbic acid) 75 mg No toxic effects have been observed
Vitamin D (cholecalciferol) 5 µg Eating problems, disorientation, coma and death
Vitamin E (tocopherol) 10 mg Blood clotting, haemorrhage
Vitamin K 80 µg Liver damage or anaemia

Information retrieved from:

http://www.evitamins.com/encyclopedia/assets/nutritional-supplement/vitamin-b-complex/~default

http://www.webmd.com/digestive-disorders/tc/probiotics-topic-overview

http://www.mayoclinic.org/healthy-lifestyle/consumer-health/basics/consumer-health-basics/hlv-20049491

http://www.medicinenet.com/probiotics/article.htm

http://www.webmd.com/vitamins-and-supplements/lifestyle-guide-11/probiotics?page=2

http://www.lenntech.com/recommended-daily-intake.htm

The Benefits of Vitamin B Complex, Plus Top Food Sources

http://www.webmd.com/vitamins-and-supplements/lifestyle-guide-11/supplement-guide-vitamin-e

http://www.ehow.com/about_5475875_can-probiotics-vitamins.html

http://drohhiraprobiotics.com/probiotics-faq/

http://www.drugs.com/npp/vitamin-d.html

http://www.drugs.com/mtm/vitamin-c-tr.html

http://www.drugs.com/mtm/vitamin-k.html

http://getfit.jillianmichaels.com/ok-bcomplex-vitamin-along-multivitamin-daily-2064.html

http://getfit.jillianmichaels.com/ok-bcomplex-vitamin-along-multivitamin-daily-2064.html

Vitamin B Complex VS Multivitamin

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Can you take vitamin B complex and multivitamins together

Jan 28 2016 Published by under Drug Interactions

B complex vitaimins and multivitamins basic facts

Vitamin B complex. The vitamin B-complex refers to all essential water-soluble vitamins excluding vitamin C that play important roles in cells metabolism.

These vitamins are: vitamin B1 (thiamine), vitamin B2 (riboflavin), vitamin B3 (niacin), vitamin B5 (pantothenic acid, vitamin B6 (pyridoxine), vitamin B7 or vitamin H (biotin), vitamin B9 (folic acid) and the cobalamins (vitamin B12).

Each vitamin of the B-complex has a unique chemical structure and has specific functions in the human body. Vitamins B1, B2, B3, and B7 have important role in energy production, vitamin B6 is essential vitamin for the metabolism of amino acids, and vitamin B12 and folic acid enable steps that are required for the division of cells.

However, each of these vitamins has many other functions. It is important to know that no functions require all B-complex vitamins simultaneously actions.

These preparations are used to provide B vitamins that are not taken enough through the diet or for treating vitamin deficiencies caused by different diseases.

Multivitamins are preparations containing multiple micronutrients, such as vitamins and dietary minerals. These preparations contain 3 or more vitamins and minerals at doses which are below the tolerable upper level, as determined by the Food and Drug Board, and they have no risk and adverse health effects.

Multivitamins do not contain drugs, herbs or hormones. These preparations are used to provide vitamins that are not taken enough by diet. They are also used to treat vitamin deficiencies caused by poor nutrition, pregnancy, illness, digestive disorders, and many other conditions.

Common commercial multivitamin supplement products usually contain the following ingredients: vitamins, B1, B2, B3, B6, B12, B5, vitamin C, folic acid, vitmains A, D, E, K, potassium iodide, zinc, calcium, manganese, magnesium, chromium, molybdenum, beta carotene, selenomethionine, and borates.

Other formulas may include additional ingredients such as lutein, lycopene, inositol, choline, PABA, trimethylglycine, vitamin K2, betaine, lecithin and higher amounts of B, C or E vitamins.

Vitamins can be used for the treatment of many health conditions such as: wound healing, canker sores, acne rosacea, alcohol withdrawal, anxiety, attention deficit hyperactivity disorder, hives, osteoporosis, indigestion, heartburn, low stomach acidity, vitiligo, anemia and other conditions.

How does vitamin B complex and multivitamins work in the body

Vitamin B1 Thiamine has a central role in the production of energy from carbohydrates. It is also involved in RNA and DNA production and neurons function. Coenzyme called thiamine pyrophosphate (TPP) is thiamin’s active form which takes a significant part in metabolism.

Vitamin B2 – Riboflavin is important in the production of energy in electron transport chain, in the citric acid cycle and the catabolism of fatty acids.

Vitamin B3 – Niacin is composed of 2 structures: nicotinamide and nicotinic acid. Niacin has two co-enzyme forms: NAD – nicotinamide adenine dinucleotide and NADP – nicotinamide adenine dinucleotide phosphate. Both has important role in energy transfer in the metabolism of glucose, fats and alcohol.

Vitamin B5 – Pantothenic acid has important role in fatty acids and carbohydrates oxidation processes. Coenzyme A is formed from pantothenic acid, and it is involved in the synthesis reactions of many compounds in the body.

Vitamin B6 – composed of 3 structures: pyridoxine, pyridoxal, pyridoxamine. The active form pyridoxal 5′-phosphate is a cofactor in many enzyme reactions such as amino acid metabolism that includes neurotransmitters biosynthesis.

Vitamin B7- Biotin is important in the metabolism of lipids, proteins and carbohydrates.

Vitamin B9 – Folic acid is involved in the transfer of single-carbon units in the anabolism of nucleic and amino acids. It is needed for normal cell division, during pregnancy and infancy, and for rapid growth processes. Folic acids also has important role in erythropoiesis – the production of red blood cells.

Vitamin B12 – cobalamins is involved in the cell metabolism of carbohydrates, proteins and lipids. It is very important in production of blood cells in bone marrow, and also for proteins and nerve sheaths production.

Vitamin C is very significant for bones and connective tissues, muscles, and blood vessels. Vitamin C also helps the body to absorb iron. Vitamin C may also act as a very potent antioxidant against oxidative stress.

Vitamin A is important for the normal function of eyes, skin, and for normal growth. Body uses vitamin A for gene transcription, immune cell functioning, embryonic development and reproduction, bone metabolism and as an antioxidant.

Vitamin D has important role in bone and homeostasis of calcium homeostasis.

Vitamin K has a key role in blood clothing and preventing excessive bleeding.

Vitamin E is important for strong immunity and healthy eyes and skin. It also has antioxidant properties.

Can patients take vitamin B complex and multivitamins together

Taking vitamins on a daily basis is a healthy habit, however, if patients are taking vitamins in amounts that are more than they need, this can be trouble, especially for a liver and gastrointestinal health. So, patient should always consult their doctors first and check nutrition facts labels, before they take any Vitamin B complex and multivitamins together.

Many multivitamins contain appropriate amounts of B vitamins, but there are many preparations that can contain higher doses of certain B vitamins. If such preparations are taken together with vitamin B complex there is a high probability of exceeding high upper levels for any of the B vitamins.

Too much of certain B vitamins, can cause toxicity symptoms such as: increased risk of heart disease, stroke, stomach ulcers and liver damage.

Niacin and vitamin B-6 are two B-vitamins that have toxicity concerns. By taking both, a B-complex vitamin and a multivitamin, tolerable upper intake level for niacin can be exceeded. The recommended dietary allowance for vitamin B-6 for adults is 1.3 mg, compared to an upper limit of 100mg.

The recommended dietary allowance for niacin, however, is 16 mg daily for men and 14 milligrams daily for women, and the upper limit for adults is only 35 mg daily.

Thus, taking two different supplements that each contains the recommended dietary allowance will put patients almost at the limit, without counting niacin that patient may take from food. Niacin overdose can cause vomiting, nausea, liver problems, blurred vision, and high-blood sugar.

The table below shows the recommended daily intake of vitamins and over dosage side effects:

Vitamins

Recommended daily intake

Over dosage

(mg or µg/d)

Biotin
(B-complex)
30 µg No information
Folate
(B-complex)
400 µg Anemia, vitamin B12 deficiency symptoms masking
Vitamin A 600 µg Loss of appetite, dry skin, fatigue, nausea, bone and joint pains and headaches
Vitamin B1 (thiamin) 1,4 mg No toxic effects have been observed
Vitamin B2 (riboflavin) 1,6 mg Urine colour alteration
Vitamin B3 (niacin) 18 mg Facial flushing, liver disease
Vitamin B5 (patothenic acid) 6 mg Nausea and heartburn
Vitamin B6 (pyridoxine) 2 mg Numbness and tingling in hands and feet
Vitamin B12 (cobalamine) 6 µg Eye conditions
Vitamin C (ascorbic acid) 75 mg No toxic effects have been observed
Vitamin D (cholecalciferol) 5 µg Eating problems, disorientation, coma and death
Vitamin E (tocopherol) 10 mg Blood clotting, haemorrhage
Vitamin K 80 µg Liver damage or anaemia

Information retrieved from:

http://www.evitamins.com/encyclopedia/assets/nutritional-supplement/vitamin-b-complex/~default

http://www.lenntech.com/recommended-daily-intake.htm

http://dailyburn.com/life/health/benefits-vitamin-b-complex/

http://www.lenntech.es/vitamins/vitamin-b1.htm

http://www.lenntech.com/vitamins/vitamin-b3.htm

http://www.lenntech.com/vitamins/vitamin-b2.htm

http://www.lenntech.com/vitamins/vitamin-b5.htm

http://www.lenntech.com/vitamins/vitamin-b6.htm

http://www.lenntech.com/vitamins/vitamin-b12.htm

http://www.lenntech.com/vitamins/folate.htm

http://www.webmd.com/vitamins-and-supplements/lifestyle-guide-11/supplement-guide-vitamin-e

http://www.drugs.com/npp/vitamin-d.html

http://www.drugs.com/mtm/vitamin-c-tr.html

http://www.drugs.com/mtm/vitamin-k.html

http://getfit.jillianmichaels.com/ok-bcomplex-vitamin-along-multivitamin-daily-2064.html

http://getfit.jillianmichaels.com/ok-bcomplex-vitamin-along-multivitamin-daily-2064.html

Can you take Benadryl with Allegra

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Can you take Benadryl with Allegra

Jan 28 2016 Published by under Drug Interactions

Mixing Diphenhydramine and Fexofenadine

Benadryl is a Brand name for antihistamine drug that contains diphenhydramine as an active ingredient. This drug reduces the effects of natural histamine during allergic reaction in the body.

It is used for relieving the symptoms of allergy, hay fever and the common cold such as: itching, ash, runny nose, sneezing, watery eyes, itchy eyes, nose or throat, and cough.

It can be also used for the prevention and treatment of nausea, vomiting and dizziness that can be caused by motion sickness. Diphenhydramine also has hypnotic effects and it can help to relax and fall asleep.

This drug can also be used alone or in combination with other medications for the treatment of tremor and muscle stiffness caused by Parkinson’s disease. Certain side effects of psychiatric drugs such as involuntary movements and muscle stiffness can also be treated with this medication.

There are many products on the market containing diphenhydramine such as: Benadryl Allergy Dye-Free LiquiGels, Children’s Triaminic Thin Strips Allergy, Children’s Benadryl Allergy, Alka-Seltzer Plus Allergy, PediaCare Children’s Allergy, Nytol, Simply Sleep, Sominex, QlearQuil Nighttime Allergy Relief, Unisom SleepGels, Unisom SleepMelts, Tranquil Nighttime Sleep Aid, ZzzQuil

Allegra is a Brand name for antihistamine drug that contains fexofenadine as an active ingredient. This drug reduces the effects of natural histamine in the body, that can produce allergy symptoms such as: itching, watery eyes, sneezing, and runny nose.

It is used for the treatment of seasonal allergies (hay fever) in children and adults. Allegra can be also used for the treatment of hives and skin itching caused by chronic idiopathic urticaria.

Other products on the market containing fexofenadine are: Allegra Allergy 24 Hour, Allegra Allergy 12 Hour, Children’s Allegra Allergy, Mucinex Allergy

How does Benadryl and Allegra work in the body

Diphenhydramine is first-generation antihistamine with anticholinergic, antiemetic, sedative and antitussive properties. It is histamine – H1 receptor antagonist. Diphenhydramine can reduce the intensity of allergic symptoms, by reducing the effects of histamine on the capillaries.

This drug crosses the blood–brain barrier in the CNS, where also antagonizes H1 receptors, causing sedation, relaxation and drowsiness. Diphenhydramine is also a potent competitive antagonist of muscarinic acetylcholine receptors.

In high doses it can cause anticholinergic syndrome. This anticholinergic property is used for the treatment of Parkinson’s disease. Diphenhydramine can also act as a sodium channel blocker in cells, so it can be also used as a local anesthetic.

It has been shown that diphenhydramine can inhibit the reuptake of serotonin. Studies on rats showed that this drug is a good potentiator of analgesia induced by morphine, however this is not the case for endogenous opioids.

Fexofenadine is a second-generation antihistamine. This category of antihistamines is less able to pass through the blood-brain barrier in CNS and cause sedation, comparing to first-generation antihistamines.

It is a peripheral high selective antagonist of H1 receptors that blocks H1 receptor activation by histamine, preventing the allergy symptoms to occur. Fexofenadine has no anticholinergic, antidopaminergic, alpha1-adrenergic, or beta-adrenergic-receptor blocking effects; this is why this drug is much safer than older antihistamines.

Can patients take Benadryl and Allegra together

Patients can take Benadryl and Allegra together in recommendable doses if there are no contraindications. They are both antihistamines, their effects will become additive and they will reduce allergic symptoms.

Benadryl can cross into the brain, while Allerga can cross only in small amounts, so if these drugs are taken in recommendable doses there is no significant risk of causing sedation and other CNS side effects.

However, there are no special advantages of this combination and there are more effective treatment strategies compared with this one. If patients have uncontrolled allergies, they should see allergist or dermatologist.

Cough and cold products containing these antihistamines have not been shown to be effective or safe in children younger than 6 years.

Therefore these products and their combinations should not be used to treat cough and cold symptoms in children who are younger than 6 years unless it is specifically directed by the doctor. There are also some products such as long-acting tablets or capsules which are not recommended for use in children younger than 12 years.

The table below shows the incidence of side effects after Benadryl and Allegra administration in recommendable doses. The incidence can be increased if these drugs are overdosed or taken together.

Incidence

Side effects

10-15% (very common) Vomiting
1-10% (common) Headache, Diarrhea, Back pain, Cough, Dysmenorrhea, Dizziness, Pain in extremity, Somnolence, Rhinorrhea, Pyrexia, Stomach discomfort
Postmarketing Reports Nervousness, Sleep disorders (insomnia, paranoia) and Hypersensitivity reactions (urticaria, anaphylaxis, angioedema, dyspnea, chest tightness, flushing, pruritus, rash)
Frequency Not Defined Xerostomia, Confusion, Dry nasal mucosa, Pharyngeal dryness, Agranulocytosis, Thrombocytopenia, Hemolytic anemia, Convulsions, Hypotension, Palpitations, Urinary retention, Neuritis, Diplopia, Tinnitus

Special precautions and warnings during Benadryl and Allegra administration:

  • These products shouldn’t be used to make a child sleepy.
  • Before taking diphenhydramine or fexofenadine patients should tell their doctor or pharmacist if they are allergic to it or if they have any other allergies. These products may have some inactive ingredients, which can also cause allergic reactions or other side effects.
  • Before taking these medications patients should tell their doctors or pharmacists if they have some health issues in the past such as: breathing problems (asthma or emphysema), high blood pressure, glaucoma, heart problems, liver disease, stomach or intestine problems, seizures, hyperthyroidism, or enlarged prostate.
  • These drugs can make patients dizzy or drowsy. They should not drive, use machinery, or do any activity that requires alertness.
  • Alcohol may potentiate effects of antihistamines. Patients should limit alcoholic beverages while using these drugs.
  • In elderly patients there is a high-risk after administration of these medications because they may increase: the risk of falls and incidence of anticholinergic effects (exacerbation of existing lower urinary tract conditions, benign prostatic hyperplasia, insomnia, tolerance)
  • Pregnant patients shouldn’t use these medications without medical advice. These medicines should not be used if mother is breast-feeding a baby.
  • Coadministration of Allegra and fruit juice may decrease efficacy of Allegra.

Information retrieved from:

http://reference.medscape.com/drug/allegra-fexofenadine-343393#0

http://reference.medscape.com/drug/benadryl-nytol-diphenhydramine-343392#0

http://www.drugs.com/mtm/benadryl-allergy-cold.html

http://www.drugs.com/search.php?searchterm=Allegra&a=1

http://www.webmd.com/drugs/2/drug-5680/benadryl-oral/details

http://www.webmd.com/search/search_results/default.aspx?query=allegra

https://www.healthtap.com/topics/can-you-take-allegra-and-benadryl-together

Is it safe to take sudafed and zyrtec together?

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Can you take Sudafed and Zyrtec together

Jan 28 2016 Published by under Drug Interactions

Pseudoephedrine and Cetirizine

Sudafed is a Brand name for a medication containing pseudoephedrine as an active ingredient that is used as a decongestant for shrinking dilated blood vessels that can cause congestion in the nasal, sinus or ear (Eustachian tube) passages.

Sudafed is used for the temporary relief of stuffy nose and sinus pain/pressure caused by common cold, flu or other breathing illnesses such as allergies, hay fever or bronchitis.

For immediate release dosage forms, usual doses are: 30 to 60 mg orally every 4 to 6 hours, for sustained release dosage forms usual doses are 120 mg orally on every 12 hours and for the sustained release suspension usual doses are 45 to 100 mg orally every 12 hours.

There are many products on the market containing pseudoephedrine such as: Nasofed, Chlor Trimeton Nasal Decongestant, Contac Cold, Drixoral Decongestant Non-Drowsy, Elixsure Decongestant, Entex, Genaphed, Kid Kare Drops, Seudotabs, Silfedrine, Sudodrin, SudoGest, SudoGest 12 Hour, Suphedrin, Triaminic Softchews Allergy Congestion, Unifed.

Zyrtec is a Brand name for antihistamine drug that contains cetirizine as an active ingredient. This drug reduces the effects of natural histamine in the body.

It is used for relieving allergy symptoms such as: itching, watery eyes, sneezing, and runny nose. It can be also used for the treatment of swelling and itching caused by hives (chronic urticaria). Usual daily oral doses of Zyrtec are 5-10mg.

Other products on the market containing cetirizine are: Zyrtec Allergy, PediaCare Children’s 24 Hour Allergy, Children’s Zyrtec Allergy, Children’s Zyrtec Hives Relief, Aller-Tec, Wal-Zyr.

How does Sudafed and Zyrtec work in the body

Pseudoephedrine is sympathomimetic amine with direct action on the adrenergic receptor system. The vasoconstriction is produced after α-adrenergic receptors activation that are located on the muscles lining of the walls of blood vessels.

The constricted blood vessels allow less fluid to leave the blood vessels and enter the nose, throat and sinuses, so results are: decreased inflammation of nasal membranes and decreased mucus production.

In bronchi, due to β2-adrenergic receptors activation, this substance can produce relaxation of smooth muscle, causing bronchial dilation and decreasing congestion and breathing difficulties.

Cetirizine competes with histamine for H1-receptor binding sites on the cell surface, which results with suppression of histaminic edema, flare, and pruritus.

Cetirizine can slightly pass through the blood-brain barrier into the CNS, due to its less lipophilic chemical structure than older antihistamines.

However, this can cause, in lower incidence, CNS side effects, such as: sedation, drowsiness or memory problems. Studies shown that in higher doses (20mg or more), cetirizine can inhibit the expression of VCAM-1 adhesion proteins in patients with atopic dermatitis. Unlike many other antihistamines, cetirizine doesn’t have anticholinergic properties.

Can patients take Sudafed and Zyrtec together

It is safe to take together Sudafed and Zyrtec. There are no dangerous interactions between these two medications. However, patients should always talk with their doctors or pharmacists first before taking these medications together.

On the market there is a Zyrtec product with a Brand name Zyrtec D that already contains the combination of cetirizine and pseudoephedrine. There are also other products on the market containing the same combination as well: All Day Allergy-D and Goodsense Cetirizine D-12 Hour.

So, if patients are already taking some of these products, there is no need for taking Sudafed together with them, because they will double the dose of pseudoephedrine and there is a higher chance of side effects to happen.

Patients with heart or blood pressure issues should always talk with their doctors first before they take these drugs together! In these patients, pseudoephedrine’s sympathomimetic effects on the heart and blood vessels can make their symptoms far worse.

Patient should look for medical help if they experience some of the following symptoms: fast, irregular, pounding heartbeat, mental or mood changes like anxiety, confusion, restlessness, shaking, difficulty urinating, as well as swelling, and difficulty breathing.

The table below shows the incidence of side effects after Sudafed and Zyrtec administration in recommendable doses. The incidence can be significantly increased if these drugs are overdosed.

Incidence

Side effects

10-15% (very common) Somnolence, Headache
1-10% (common) Fatigue, Malaise, Dry mouth, Diarrhea, Vomiting, Bronchospasm, Epistaxis, Dizziness
<1 % (rare) Drowsiness, Fussiness, Stomach pain, Hallucinations, Angioedema,

Hypotension, Tremor, Tongue discoloration

Frequency Not Defined Insomnia, Hypertension, Myocardial infarction, Ventricular premature beats, Ischemic colitis

Special precautions and warnings during Sudafed and Zyrtec administration:

  • Patients shouldn’t use these medicines if they have used MAO inhibitors drugs such as furazolidone (Furoxone), phenelzine (Nardil), isocarboxazid (Marplan), selegiline (Eldepryl, Emsam, Zelapar), rasagiline (Azilect), or tranylcypromine (Parnate) in the last 14 days. Drug interactions can occur, leading to serious side effects.
  • Patients should not use Zyrtec if they are allergic to hydroxyzine or levocetirizine.
  • Pregnant patients shouldn’t use Sudafed without medical advice. It is not known whether this drug will harm an unborn baby. However, Zyrtec isn’t expected to be harmful to an unborn baby. These medicines should not be used if mother is breast-feeding a baby.
  • Patients should also limit alcoholic beverages while using these drugs.
  • Before administration of Zyrtec, patients should tell their doctors if they have difficulties with urinating, enlarged prostate, kidney disease or liver disease.
  • Patients should ask their doctor or pharmacist before using Sudafed if they have: high blood pressure, some heart disease, diabetes or a thyroid disorder.
  • Older patients can be more sensitive to the side effects after Sudafed administration, especially for: fast/irregular heartbeat, problems urinating, dizziness, confusion or trouble sleeping.
  • This drug can make patients dizzy or drowsy. They should not drive, use machinery, or do any activity that requires alertness.
  • Children and elderly may be more sensitive to the side effects of these drugs.
  • Patients with phenylketonuria should avoid these medicines.

Informations retrieved from:

  1. http://www.drugs.com/sudafed.html
  2. http://reference.medscape.com/drug/zyrtec-cetirizine-343384#4
  3. http://www.drugs.com/zyrtec.html
  4. http://reference.medscape.com/drug/sudafed-nexafed-pseudoephedrine-343412#10
  5. http://www.webmd.com/drugs/2/drug-6573/sudafed-oral/details#precautions
  6. http://www.drugbank.ca/drugs/DB00341
  7. http://www.webmd.com/drugs/2/drug-6573/sudafed-oral/details
  8. http://www.peacehealth.org/medical-topics/content/multum/d04764a1.html
  9. https://www.healthtap.com/user_questions/332886

Can you take Mucinex and DayQuil together

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Can you take Mucinex and DayQuil together

Jan 23 2016 Published by under Drug Interactions

Mixing Mucinex and DayQuil together

Mucinex is a Brand name for a medication containing guaifenesin as an active ingredient that is used as expectorant for relieving the symptoms of cough and mucus in the chest due to flu, colds or hay fever.

This drug reduces congestion in chest and makes coughs more productive by thinning mucus in the lungs and making it less sticky and easier to cough up.

For regular (short-acting) oral dosage forms usual doses are 100-400mg 3-4 times a day, and for extended-release dosage forms usual doses are 600 to 1200 mg two times a day. Mucinex works best when it is taken with plenty of water.

Other Brand names for preparations containing guaifenesin are: Bidex 400, Organidin NR, Antitussin, Guaifenex, Robitussin, Allfen, Altarussin and Amibid LA.

DayQuil is a brand name for OTC medication which is used for relieving symptoms of common cold and flu. There are several formulations of DayQuil on the market: DayQuil Cough
(liquid dosage form containing dextromethorphan 15mg), DayQuil Cold & Flu (liquid and liquicaps containing dextromethorphan 10mg, acetaminophen 325 mg and phenylephrine 5 mg), DayQuil Severe Cold & Flu (liquid and caplets containing acetaminophen 325 mg, dextromethorphan 10 mg, guaifenesin 200 mg and phenylephrine 5 mg), DayQuil Mucus Control DM (liquid containing dextromethorphan 10 mg and guaifenesin 200 mg) and Dayquil Sinex (liquicaps containing acetaminophen 325 mg and phenylephrine 5 mg and nasal spray containing oxymetazoline HCl 0.05%)

Other Brand names on the market containing similar combination are: NyQuil, Alka-Seltzer Plus Day Cold, Theraflu, Tylenol Alka-Seltzer Plus Day Sinus Congestion, Allergy & Cough, Alka-Seltzer Plus Severe Sinus Congestion & Cough and others.

How does Mucinex and DayQuil work in the body

Guaifenesin acts by reducing the viscosity and increasing the volume of secretions in the trachea and bronchi. By reducing the adhesiveness and viscosity of secretions, guaifenesin increases the mucociliary mechanism efficacy in removing secretions which has been accumulated in the upper and lower airways. Studies have also shown that guaifenesin has muscle relaxant and anticonvulsant properties due to antagonism effects on NMDA receptors.

Pseudoephedrine is sympathomimetic amine with direct action on the adrenergic receptor system. The vasoconstriction is produced after α-adrenergic receptors activation that are located on the muscles lining of the walls of blood vessels.

The constricted blood vessels allow less fluid to leave the blood vessels and enter the nose, throat and sinuses, so results are: decreased inflammation of nasal membranes and decreased mucus production.

In bronchi, due to β2-adrenergic receptors activation, this substance can produce relaxation of smooth muscle, causing bronchial dilation and decreasing congestion and breathing difficulties.

Acetaminophen is highly selective COX-2 inhibitor that inhibits prostaglandin synthesis. It can inhibit COX-2 in CNS. Acetaminophen also acts on the hypothalamic heat regulating centers to produce antipyresis.

Dextromethorphan acts on cough center in medulla by decreasing sensitivity of cough receptors and by interrupting impulse transmission.

Phenylephrine is sympathomimetic with direct action on the adrenergic receptor system. The vasoconstriction is produced after α-adrenergic receptors activation.

Can patients take Mucinex and DayQuil together

Patients must talk with their doctors or pharmacists first before they take some of Mucinex or DayQuil product together. Some Mucinex and DayQuil formulations can contain the same active ingredient or active ingredients with same effects.

For example Mucinex DM and DayQuil Cold & Flu, both contain the same active ingredient-dextromethorphan, or Mucinex D (contain pseudoephedrine) and DayQuil Cold & Flu (contain phenylephrine), both contain active ingredients with same effects (they are both sympathomimetics).

Hence, patients could double the doses of the same drug or drug effects will become additive if they take these products at the same time.  This is why patients should always look at the PIL (Patient Information Leaflet) and talk with their doctors or pharmacists first, before they combine these two medications.

By mixing Mucinex and DayQuil products that contain dextromethorphan, there is a higher risk of side dextromethorphan’s effects to occur. High amounts of dextrometorphan can shut down the central nervous system.

Typical side effects are: impaired vision, sweating and fever, rapid breathing, nausea, vomiting and diarrhea, slurred speech, impaired judgment and mental function and rapid eye movement.

Some of the Mucinex products already contain vasoconstrictor – pseudoephedrine like Mucinex D, or Mucinex D Max Strength and the same goes for DayQuil products such as DayQuil Cold & Flu and Dayquil Sinex that contain phenylephrine as vasoconstrictor. By mixing these products together patients may get too much of the drugs with same effects and there is a high probability of side effects to occur.

Patients with heart or blood pressure issues should always talk with their doctors first before taking these drugs together! In these patients, pseudoephedrine’s and phenylephrine’s sympathomimetic effects on the heart and blood vessels can make their symptoms far worse.

Patient should look for medical help if they experience some of the following symptoms: fast, irregular, pounding heartbeat, mental or mood changes like anxiety, confusion, restlessness, shaking, difficulty urinating, as well as swelling, and difficulty breathing.

The table below shows side effects after Mucinex and DayQuil administration in recommendable doses. The incidence of side effects can be significantly increased if these drugs are overdosed.

Incidence

Side effects

Frequency Not Defined Hypertension, Tachycardia, Hypotension, Reflex tachycardia, Severe peripheral and visceral vasoconstriction, Tremor, Dizziness, Excitability, Headache, Sedation, Sleepiness, Restlessness, Dermatologic rash, Increased appetite, Xerostomia, Anemia blood dyscrasias (neutropenia, pancytopenia, leukopenia), Bilirubin and alkaline phosphatase may increase, Urinary retentionRash, Itching, Hives.

Special precautions and warnings during Mucinex and DayQuil administration:

  • Patients shouldn’t use these medicines if they have used MAO inhibitors drugs such as furazolidone (Furoxone), phenelzine (Nardil), isocarboxazid (Marplan), selegiline (Eldepryl, Emsam, Zelapar), rasagiline (Azilect), or tranylcypromine (Parnate) in the last 14 days. Drug interactions can occur, leading to serious side effects.
  • Patients should ask their doctor or pharmacist before using these products if they have: high blood pressure, some heart disease, diabetes or a thyroid disorder.
  • Pregnant patients shouldn’t use these medications without medical advice. It is not known whether these drugs will harm an unborn baby. These medicines should not be used if mother is breast-feeding a baby.
  • Patients should also limit alcoholic beverages while using these drugs.
  • This drug can make patients dizzy or drowsy. They should not drive, use machinery, or do any activity that requires alertness.
  • Patients should avoid these medications if they also take caffeine pills, diet pills, or other stimulants. Taking decongestants (pseudoefedrine, phenylephrine) together with stimulants can increase the risk of unpleasant side effects.
  • Medicines such as sedatives, sleeping pills, narcotic pain medicines, medicine for seizures, anxiety or depression, and muscle relaxers can add sedation and sleepiness that can be also caused by dextromethorphan, phenylephrine and pseudoephedrine.
  • Children and elderly may be more sensitive to the side effects of these drugs.
  • Patients with phenylketonuria should avoid these medicines.
  • Children younger than 4 years should also avoid these medicines. These medicines shouldn’t be taken for longer than 7 days in a row

Informations retrieved from:

http://www.drugs.com/mucinex.html
http://reference.medscape.com/drug/alka-seltzer-plus-day-cold-theraflu-daytime-severe-cold-cough-acetaminophen-dextromethorphan-phenylephrine-iv-999372#10
http://www.drugs.com/otc/125732/vicks-dayquil-and-vicks-nyquil-severe-cold-and-flu.html
http://reference.medscape.com/drug/mucinex-organidin-nr-guaifenesin-343403#10
http://www.webmd.com/drugs/2/drug-63818/mucinex-oral/details
http://www.webmd.com/parenting/teen-abuse-cough-medicine-9/teens-and-dxm-drug-abuse?page=3
http://www.mayoclinic.org/drugs-supplements/guaifenesin-oral-route/description/drg-20068720
https://www.nlm.nih.gov/medlineplus/ency/article/002628.htm

Can you take Mucinex and Sudafed

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Can you take Mucinex and Sudafed

Jan 23 2016 Published by under Drug Interactions

Mucinex and Sudafed 12-Hour Drug Interactions

Mucinex is a Brand name for a medication containing guaifenesin as an active ingredient that is used as expectorant for relieving the symptoms of cough and mucus in the chest due to flu, colds or hay fever.

This drug reduces congestion in chest and makes coughs more productive by thinning mucus in the lungs and making it less sticky and easier to cough up.

For regular (short-acting) oral dosage forms usual doses are 100-400mg 3-4 times a day, and for extended-release dosage forms usual doses are 600 to 1200 mg two times a day. Mucinex works best when it is taken with plenty of water.

Other Brand names for preparations containing guaifenesin are: Bidex 400, Organidin NR, Antitussin, Guaifenex, Robitussin, Allfen, Altarussin and Amibid LA.

Sudafed is a Brand name for a medication containing pseudoephedrine as an active ingredient that is used as a decongestant for shrinking dilated blood vessels that can cause congestion in the nasal, sinus or ear (Eustachian tube) passages.

Sudafed is used for the temporary relief of stuffy nose and sinus pain/pressure caused by common cold, flu or other breathing illnesses such as allergies, hay fever or bronchitis.

For immediate release dosage forms, usual doses are: 30 to 60 mg orally every 4 to 6 hours, for sustained release dosage forms usual doses are 120 mg orally on every 12 hours and for the sustained release suspension usual doses are 45 to 100 mg orally every 12 hours.

There are many products on the market containing pseudoephedrine such as: Nasofed, Chlor Trimeton Nasal Decongestant, Contac Cold, Drixoral Decongestant Non-Drowsy, Elixsure Decongestant, Entex, Genaphed, Kid Kare Drops, Seudotabs, Silfedrine, Sudodrin, SudoGest, SudoGest 12 Hour, Suphedrin, Triaminic Softchews Allergy Congestion, Unifed.

How does Mucinex and Sudafed work in the body

Guaifenesin acts by reducing the viscosity and increasing the volume of secretions in the trachea and bronchi. By reducing the adhesiveness and viscosity of secretions, guaifenesin increases the mucociliary mechanism efficacy in removing secretions which has been accumulated in the upper and lower airways.

Studies have also shown that guaifenesin has muscle relaxant and anticonvulsant properties due to antagonism effects on NMDA receptors.

Pseudoephedrine is sympathomimetic amine with direct action on the adrenergic receptor system. The vasoconstriction is produced after α-adrenergic receptors activation that are located on the muscles lining of the walls of blood vessels.

The constricted blood vessels allow less fluid to leave the blood vessels and enter the nose, throat and sinuses, so results are: decreased inflammation of nasal membranes and decreased mucus production.

In bronchi, due to β2-adrenergic receptors activation, this substance can produce relaxation of smooth muscle, causing bronchial dilation and decreasing congestion and breathing difficulties.

Can patients take Mucinex and Sudafed together

Patients can take Mucinex and Sudafed together and there are many companies that produce these drugs as a combination into one pill (Ambifed-G, Despec-SR, Entex T, ExeFen-IR, Maxifed, Mucinex D, Mucinex D Max Strength, Poly-Vent IR, Respaire-30, Robitussin Severe Congestion, Sinutab Non Drying etc…).

Sudafed is a very good decongestant and Mucinex can help mucus to break up in nose sinuses or lungs, so if they are taken together, both can make higher efficacy in removing secretions which has been accumulated in the upper and lower airways.

However, patients should always look at the PIL (Patient Information Leaflet) and talk with their doctors first, before they combine these two medications.

Some of the Mucinex products already contain pseudoephedrine in the combination with guaifenesin like Mucinex D, or Mucinex D Max Strength and the same goes for Sudafed product such as Sudafed Non Drying Sinus. By mixing these products together patients may get too much of the same drugs and there is a high probability of side effects to occur.

Patients with heart or blood pressure issues should always talk with their doctors first before they take these drugs together! In these patients, pseudoephedrine’s sympathomimetic effects on the heart and blood vessels can make their symptoms far worse.

Patient should look for medical help if they experience some of the following symptoms: fast, irregular, pounding heartbeat, mental or mood changes like anxiety, confusion, restlessness, shaking, difficulty urinating, as well as swelling, and difficulty breathing.

The table below shows the incidence of side effects after Mucinex and Sudafed administration in recommendable doses. This Incidence can be significantly increased if these drugs are taken together.

Incidence

Side effects

Frequency Not Defined  Tremor, Restlessness, Insomnia, Nausea, Vomiting, Nervousness, Atrial fibrillation, Hypertension, Myocardial infarction, Ventricular premature beats, Ischemic colitis, Rash, Itching, Hives.

Special precautions and warnings during Mucinex and Sudafed administration:

  • Patients shouldn’t use these medicines if they have used MAO inhibitors drugs such as furazolidone (Furoxone), phenelzine (Nardil), isocarboxazid (Marplan), selegiline (Eldepryl, Emsam, Zelapar), rasagiline (Azilect), or tranylcypromine (Parnate) in the last 14 days. Drug interactions can occur, leading to serious side effects.
  • Patients should ask their doctor or pharmacist before using these products if they have: high blood pressure, some heart disease, diabetes or a thyroid disorder.
  • Pregnant patients shouldn’t use these medications without medical advice. It is not known whether these drugs will harm an unborn baby. These medicines should not be used if mother is breast-feeding a baby.
  • Sudafed may make patients dizzy. They should not drive, use machinery, or do any activity that requires alertness.
  • Patients should also limit alcoholic beverages while using these drugs.
  • Older patients can be more sensitive to the side effects after Sudafed administration, especially for: fast/irregular heartbeat, problems urinating, dizziness, confusion or trouble sleeping.
    Children may be more sensitive to the restlessness side effect.
  • Before taking products that contain pseudoephedrine, patients should tell their doctor or pharmacist if they are allergic them or if they have any other allergies. Also they should tell doctor if they ever had negative reactions to other sympathomimetics (for example ephedrine or phenylephrine). Inactive ingredients that can be found in these products can also cause allergic reactions or other problems.

Informations retrieved from:

http://www.drugs.com/mucinex.html
http://www.drugs.com/sudafed.html
http://reference.medscape.com/drug/mucinex-organidin-nr-guaifenesin-343403#10
http://reference.medscape.com/drug/sudafed-nexafed-pseudoephedrine-343412#10
http://www.webmd.com/drugs/2/drug-63818/mucinex-oral/details
http://www.webmd.com/drugs/2/drug-6573/sudafed-oral/details
http://www.mayoclinic.org/drugs-supplements/guaifenesin-oral-route/description/drg-20068720
http://www.drugbank.ca/drugs/DB00874
https://www.healthtap.com/user_questions/614184

Can you mix advil and vicodin”

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Can you take Advil and Vicodin together

Jan 14 2016 Published by under Drug Interactions

Advil and Vicodin interaction

Advil (ibuprofen) is nonsteroidal anti-inflammatory drug (NSAID). Advil contains 200mg of ibuprofen as active ingredients.

It is used as a pain reliever for various conditions such as: headaches, dental pain, muscle pain, tendinitis (inflammation or irritation of a tendon, a thick cord that attaches bone to muscle), menstrual cramps, and for the treatment of pain, swelling and joint stiffness caused by arthritis, osteoarthritis, juvenile arthritis, bursitis, ankylosing spondylitis and gout.

It can also be used to temporarily reduce fever and for the treatment of common cold symptoms.

Advil products on the market are: Advil tablets, Advil film coated tablets, Advil Liqui-Gels capsules, Advil Migraine-solubilized capsules and Advil easy open arthritis caps. Other Brand names for medications containing ibuprofen are: Brufen, Calprofen, Genpril, Ibu, Midol, Nuprin, Cuprofen, Nurofen, and Motrin.

Vicodin is a Brand named for opioid pain reliever tablets that contains a combination of two active substances – hydrocodone and acetaminophen (paracetamol).

It is available in three strengths as: Vicodin (5mg hydrocodone bitartrate, 300mg acetaminophen), Vicodin ES (7.5mg hydrocodone bitartrate, 300mg acetaminophen) and Vicodin HP (10mg hydrocodone bitartrate, 300mg acetaminophen).

Hydrocodone is an opioid (narcotic) very potent pain reliever while acetaminophen (paracetamol) is a less potent pain reliever substance that increases the effects of hydrocodone. Vicodin is used for the treatment of moderate to severe, acute, chronic or postoperative pain.

Other common Brand names for medications containing the combination of hydrocodone/acetaminophen are: Hycet, Lorcet, Lortab, Norco, Xodol, and Zolvit. Hydrocodone/acetaminophen combination is also available in the forms of: solutions, elixirs, syrups, capsules and liquids.
vicodin and advil together safe

Mechanisms of action – How Advil and Vicodin work in the body?

Ibuprofen inhibits synthesis of prostaglandins (substances in the body that play a key role in pain and inflammation processes in body tissues) by inhibiting at least 2 cyclooxygenase (COX) isoenzymes, COX-1 and COX-2.

Inhibition of COX-2 leads to the anti-inflammatory, analgesic and antipyretic effects while the inhibition of COX-1 may cause gastrointestinal bleeding and ulcers.

COX-1-dependent prostaglandins play a crucial homeostatic role in physiological functions (gastrointestinal cytoprotection, aggregation of platelets and modulation of vascular muscle tone) while COX-2-dependent prostaglandins play dominant roles in pathophysiologic processes (inflammation and cancer, or physiological processes such as endothelial vasoprotection). If NSAID drug less inhibits the COX-1, less side effect would be caused.

Ibuprofen has the lowest risk of causing gastrointestinal bleeding of all NSAID, producing balanced inhibitory effects on both COX-1 and COX-2 isoenzymes. But, this advantage is lost at high doses.

This drug may also inhibit chemotaxis, decrease proinflammatory cytokine activity, alter lymphocyte activity, and inhibit neutrophil aggregation – these effects may also contribute to anti-inflammatory activity.

Hydrocodone is an opioid agonist of opioid receptors within the CNS. This morphinans structure substance blocks pain perception in the cerebral cortex of the brain.

Hydrocodone decreases synaptic chemical transmission in the CNS, which in turn inhibits pain sensation into the higher centers of the brain.

Hydrocodone can produce inhibition at the chemoreceptors through μ-opioid receptors and in the medulla through μ and δ receptors which can lead to dose-related respiratory depression.

Acetaminophen is a mild non-NSAID analgesic that inhibits prostaglandin synthesis through the inhibition of cyclooxygenase – COX (a highly selective COX- 2 inhibitor).

It also acts on the hypothalamic heat regulating centers to produce antipyresis. Acetaminophen’s reactive metabolite N-acetyl-p-benzoquinone imine (NAPQI) can cause a potentially fatal, hepatic necrosis through the process of lipid peroxidation if acetaminophen is overdosed (more than 4g daily).

Can patients take Advil and Vicodin together?

From a pharmacology standpoint, there is no harm if ibuprofen is taken together with hydrocodone and acetaminophen, so if Vicodin isn’t controlling the pain, patients can use Advil and Vicodin together.

However, patients may take them together only with physician instructions. Ibuprofen is a blood thinner and may cause bleeding in predisposed patients, so if patient is already taking Vicodin for the treatment of post-surgical pain, in that case, Advil and Vicodin shouldn’t be used together.

There are also many other factors that can exclude the usage of Advil and Vicodin combination such as: age, past medical history, pregnancy and breast-feeding, and possible interactions with other medications, food or alcohol.

Vicodin can interrupt breathing and high doses may lead to fatal respiratory depression.

If hydrocodone is used for a long period of time, it may become habit-forming, causing physical or mental dependence. Mental dependence – addiction will not occur when this drug is used for its purpose.

If treatment is stopped suddenly physical dependence may lead to withdrawal side effects such as: tingling, numbness, paresthesia, and tinnitus. However, severe withdrawal side effects can usually be prevented by gradually reducing the dose over a period of time before treatment is stopped completely.

Acetaminophen and ibuprofen are both COX inhibitors. If these drug are taken together their effects will become additive, so there is a higher probability of causing adverse effects especially in predisposed individuals.

The table below shows the incidence of side effects after Advil or Vicodin administration in recommendable doses. This Incidence can be significantly increased if these drugs are overdosed or if they are taken together.

Incidence

Side effects

10-40% (very common) Upset stomach, Heartburn, Nausea, Vomiting, Edema, Constipation, Dizziness, Vertigo, Nausea, Headache, Somnolence Vomiting, Agitation, Emotional lability, Anxiety, Hallucinations, Euphoria, Nervousness, Asthenia, Pruritus, Dyspepsia, Spasticity
1-10% (common) Diarrhea, Sweating, Dry mouth, Hypertonia, Malaise, Rash, Menopausal symptoms, Urinary frequency, Urinary retention, Visual disturbance, Vasodilation, Gastrointestinal bleeding, Perforation, and Ulcers, Dyspnea
< 1% (less common and rare) Elevation of serum alanine aminotransferase or aspartate aminotransferase, metabolic acidosis, hyperkalaemia Abnormal gait, Hepatic dysfunction, Amnesia, Depression, Difficulty in concentration,Cognitive dysfunction, Fatigue, Menstrual disorder, Motor system weakness, Dysphoria, Dysuria, Orthostatic hypotension, Tremor, Tachycardia

Special precautions and warnings during Advil and Vicodin administration:

  • Patients should not use Advil and Vicodin if they ever had any unusual or allergic reaction to them. Also they should tell their health care professional if they have any other types of allergies, such as to foods, dyes, preservatives, or animals.
  • Patient who have severe asthma or breathing problems, stomach or intestines blockage, or patients who have recently use alcohol, sedatives, tranquilizers, or narcotic medications should not use Vicodin.
  • There aren’t appropriate studies on the relationship of age to the effects of ibuprofen and hydrocodone combination in children and teenagers below 16 years of age.
  • There aren’t also appropriate studies on the relationship of geriatric-specific problems with the effects of ibuprofen and hydrocodone combination. However, elderly patients are more likely to develop kidney or stomach problems which are age-related. Vicodin is more likely to cause breathing problems in older patients who are severely ill, malnourished, or if they have other risk factors
  • Pregnant patients should never use these medicines; because their babies could become drug dependent, so life-threatening withdrawal symptoms can be caused after baby is born. Those babies may need medical treatment for several weeks. Patients should tell doctor if they are pregnant or plan to become pregnant
  • An overdose of acetaminophen (more than 4g per day) can damage liver and even cause death. Patients should called doctor if they have pain in your upper stomach, loss of appetite, nausea, dark urine, clay-colored stools, itching or yellowing of skin and eyes, because those are typical symptoms of acetaminophens hepatotoxicity. In rare cases, acetaminophen may cause a severe skin reaction. Patients should stop taking Vicodin and call their doctor if they have rash or skin redness that spreads and causes peeling and blistering
  • Vicodin should not be used together with Monoamine oxidase (MAO) inhibitor drugs such as: linezolid, isocarboxazid, selegiline, tranylcypromine, phenelzine, and rasagiline, and also with selective serotonin reuptake inhibitors (SSRIs) such as: fluoxetine, paroxetine and duloxetine, because dangerous drug interaction could occur.
  • Patients should never take Vicodin and Advil with alcohol. Drinking more than the recommended daily limit of alcohol may irritate stomach lining, and increase the risk of stomach bleeding and ulcers.

Informative articles:

http://www.drugs.com/ibuprofen.html

http://www.drugs.com/advil.html

http://www.drugs.com/vicodin.html

http://www.rxlist.com/vicodin-drug.htm

http://pubchem.ncbi.nlm.nih.gov/compound/hydrocodone#section=Drug-Warning

http://www.ncbi.nlm.nih.gov/pubmed/10381057

http://reference.medscape.com/drug/advil-motrin-ibuprofen-343289#10

http://reference.medscape.com/drug/vicodin-hydrocodone-acetaminophen-343374#10

http://www.webmd.com/drugs/2/drug-3459/vicodin-oral/details

http://www.mayoclinic.org/drugs-supplements/hydrocodone-and-ibuprofen-oral-route/description/drg-20062862

http://answers.webmd.com/answers/5006048/is-it-safe-to-take-ibuprofen-with-vicodin-or-is-tylenol-safer

Can you take Tylenol and NyQuil together

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Can you take Tylenol and NyQuil together

Jan 12 2016 Published by under Drug Interactions

Tylenol and NyQuil basic facts

Tylenol is a brand name for a drug that contains acetaminophen (also known as paracetamol) that has antypiretic and analgesic properties. It is used for reducing pain and fever and also for relieving the symptoms of common cold, cough, headache, toothache, allergies and influenza. Usual per oral doses for Tylenol are 325-650 mg. It is available in tablets, caplets and liquid dosage forms.

Tylenol products on the market are: Tylenol Extra Strength Caplets, Tylenol Regular Strength Tablets, Tylenol 8 HR Extended-Release Caplets, Tylenol 8 HR Arthritis Pain, Tylenol Sinus Congestion & Pain Caplets, Tylenol Cold Multi-Symptom Caplets and Liquid, Tylenol Cold Head Congestion Severe Caplets, Tylenol PM Caplets and Tylenol Cold Sore Throat Liquid. [1][2]

NyQuil is a brand name for OTC medication which is used for relieving symptoms of common cold. Product is a combination of 3 active substances: acetaminophen (usually in doses from 325mg to 600mg) used as a pain reliever and fever reducer, dextromethorphan (usually in doses of 15mg/pill or 30mg/30ml) used as a cough suppressant, it also has sedative properties and doxylamine succinate (usually in doses of 6.25mg/pill or 12.5mg/30ml) which is antihistamine with hypnotic effects that is used in combination with other drugs for relieving symptoms of cold and night-time allergy. Some Nyquil’s preparations can contain other active substances such as: NyQuil D that contains nasal decongestive pseudoephedrine (30 mg/15 mL), NyQuil Sinus contains phenylephrine as nasal decongestant, Children’s NyQuil contains chlorpheniramine as antihistamine and has no alcohol.

NyQuil products on the market are: NyQuil Cold/Flu Multisymptom Relief, NyQuil D, Children’s NyQuil, NyQuil Cough, NyQuil Sinus and ZzzQuil. Nyquil is available in syrup and and LiquiCap dosage forms. NyQuil contains sedating antihistamines, hypnotics, or alcohol, and that’s why it should be taken before sleep. [3][4][5]

Mechanisms of action – How Tylenol and NyQuil work in the body

Acetaminophen is highly selective COX-2 inhibitor that inhibits prostaglandin synthesis. It can inhibit COX-2 in CNS. Acetaminophen also acts on the hypothalamic heat regulating centers to produce antipyresis. Acetaminophen’s reactive metabolite N-acetyl-p-benzoquinone imine (NAPQI) can cause a potentially fatal, hepatic necrosis through the process of lipid peroxidation if acetaminophen is overdosed (more than 4g daily). [6][7]

Dextromethorphan acts on cough center in medulla by decreasing sensitivity of cough receptors and by interrupting impulse transmission. [8]

Doxylamine succinate is competitor for H1-receptor sites on target cells and also has anticholinergic effects, lowering labyrinthine function, blocking chemoreceptor trigger zone, and diminishing vestibular stimulation. [9]

Pseudoephedrine and phenylephrine are sympathomimetics with direct action on the adrenergic receptor system. The vasoconstriction is produced after α-adrenergic receptors activation. [10]

Chlorpheniramine is antagonist of histamine H1 receptor (HRH1). It has been also shown that this drug is also a serotonin-norepinephrine reuptake inhibitor. [11]

Can patients mix Tylenol and NyQuil together

Patients should never take Tylenol and Nyquil together! Both products contain acetaminophen as an active ingredient, so if they mix them, they may exceed the allowable daily dose (more than 4g), causing potentially fatal condition called Acetaminophen’s induced hepatic necrosis.

Typical symptoms of acetaminophen induced hepatotoxity are: anorexia, nausea, vomiting and malaise (usually 0.5-24h after ingestion), abdominal pain, anorexia, nausea, vomiting, tachycardia and hypotension (usually 18-72h after ingestion), continued nausea and vomiting, abdominal pain, and a tender hepatic edge, coagulopathy, hypoglycemia and hepatic encephalopathy (usually 72-96h after ingestion). In some critically ill patients, acute renal failure can develop. Multiorgan failure may lead to death. [12] [13]

So, if patients need to get better analgesic or antipyretic effect and if patient already uses NyQuil for the treatment of cough and cold symptoms, it is always better to take one dose of ibuprofen (Advil, Motrin), naproxen (Aleve, Anaprox) or aspirin together with Nyquil than Tylenol, or any other product containing acetaminophen. However, patients should always talk with their doctors first before taking any drug on their own.

The table below shows side effects after NyQuil and Robitussin administration in recommendable doses. This Incidence can be significantly increased if these drugs are overdosed or taken together. [14] [15]

Incidence

Side effects

Frequency Not Defined Nausea, Vomiting, Abdominal Pain, Malaise, Anorexia, Headache,

Hypertension, Tachycardia, Hypotension, Reflex tachycardia, Severe peripheral and visceral vasoconstriction, Tremor, Dizziness, Excitability, Sedation, Sleepiness, Restlessness, Dermatologic rash, Increased appetite, Xerostomia, Anemia blood dyscrasias (neutropenia, pancytopenia, leukopenia), Bilirubin and alkaline phosphatase may increase, Urinary retention

Special precautions and warnings during Tylenol and NyQuil administration:

  • Patients shouldn’t take NyQuil if they have used MAO inhibitors drugs such as furazolidone (Furoxone), phenelzine (Nardil), isocarboxazid (Marplan), selegiline (Eldepryl, Emsam, Zelapar), rasagiline (Azilect), or tranylcypromine (Parnate) in the last 14 days. Drug interactions can occur, leading to serious side effects.
  • Pregnant patients shouldn’t use NyQuil without medical advice; it is not known whether chlorpheniramine, pseudoephedrine or dextromethorphan will harm an unborn baby. Chlorpheniramine, dextromethorphan, and pseudoephedrine may pass into breast milk and may harm a nursing baby. NyQuil and Tylenol should not be used if mother is breast-feeding a baby.
  • Patients with phenylketonuria should avoid these medicines.
  • Children younger than 4 years should also avoid NyQuil. This medicine shouldn’t be taken for longer than 7 days in a row.
  • Nyquil may impair your thinking or reactions and cause blurred vision. Patients should be careful if they drive or do anything that requires being alert and able to see clearly.
  • Patients should avoid alcohol while using these medications. Drinking alcohol can increase certain side effects of these medications. Alcohol may increase the risk of liver damage while taking Tylenol.
  • Tylenol can cause unusual results with certain laboratory tests for glucose in the urine.
  • Patients should avoid becoming dehydrated or overheated during exercises. Chlorpheniramine can decrease sweating and patients could become more prone to heat stroke
  • Patients should avoid these medications if they also take caffeine pills, diet pills, or other stimulants. Taking decongestants (pseudoefedrine, phenylephrine) together with stimulants can increase the risk of unpleasant side effects.
  • Medicines such as sedatives, sleeping pills, narcotic pain medicines, medicine for seizures, anxiety or depression, and muscle relaxers can add sedation and sleepiness that can be also caused by dextromethorphan, chlorpheniramine, promethazine, doxylamine and pseudoefedrine. [3] [4] [16] [17]

Informations retrieved from:

  • https://www.tylenol.com/products
  • http://www.webmd.com/drugs/2/drug-7076/tylenol-oral/details
  • http://www.drugs.com/cdi/nyquil-liquid.html
  • http://www.webmd.com/drugs/2/drug-6104/nyquil-oral/details
  • http://vicks.com/en-us/browse-products/nyquil
  • http://reference.medscape.com/drug/vicks-nyquil-d-acetaminophen-doxylamine-dextromethorphan-pseudoephedrine-999380#10
  • http://dmd.aspetjournals.org/content/31/12/1499.full
  • http://reference.medscape.com/drug/balminil-dm-benylin-dm-dextromethorphan-343401#10
  • http://reference.medscape.com/drug/doxylamine-342933#10
  • http://reference.medscape.com/drug/sudafed-nexafed-pseudoephedrine-343412#10
  • http://reference.medscape.com/drug/chlortrimeton-chlorpheniramine-343386#107
  • http://www.ncbi.nlm.nih.gov/pubmed/14625346
  • http://emedicine.medscape.com/article/820200-overview
  • http://reference.medscape.com/drug/vicks-nyquil-d-acetaminophen-doxylamine-dextromethorphan-pseudoephedrine-999380#4
  • http://reference.medscape.com/drug/tylenol-acetaminophen-343346#4
  • http://www.drugs.com/tylenol.html
  • http://www.emedicinehealth.com/drug-chlorpheniramine_dextromethorphan_and_pseudoephedrine/page3_em.htm#avoid

Can you take NyQuil and Robitussin together

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Can you take NyQuil and Robitussin together

Jan 11 2016 Published by under Drug Interactions

NyQuil and Robitussin basic facts

NyQuil is a brand name for OTC medication which is used for relieving symptoms of common cold.

Product is a combination of 3 active substances: acetaminophen (usually in doses from 325mg to 600mg) used as a pain reliever and fever reducer, dextromethorphan (usually in doses of 15mg/pill or 30mg/30ml) used as a cough suppressant, it also has sedative properties and doxylamine succinate (usually in doses of 6.25mg/pill or 12.5mg/30ml) which is antihistamine with hypnotic effects that is used in combination with other drugs for relieving symptoms of cold and night-time allergy.

Some Nyquil’s preparations can contain other active substances such as: NyQuil D that contains nasal decongestive pseudoephedrine (30 mg/15 mL), NyQuil Sinus contains phenylephrine as nasal decongestant, Children’s NyQuil contains chlorpheniramine as antihistamine and has no alcohol.

NyQuil products on the market are: NyQuil Cold/Flu Multisymptom Relief, NyQuil D, Children’s NyQuil, NyQuil Cough, NyQuil Sinus and ZzzQuil.

Nyquil is available in syrup and and LiquiCap dosage forms. NyQuil contains sedating antihistamines, hypnotics, or alcohol, and that’s why it should be taken before sleep.

Robitussin is a brand name for OTC and prescription medications which are used for relieving cough and cold symptoms.

This Brand name is used for several cough syrup formulations that can contain different active ingredients: acetaminophen (pain reliever and fever reducer found in Robitussin CF), chlorpheniramine (antihistamine found in Robitussin children’s cough and cold syrups), phenylephrine (decongestant found in Robitussin CF and Daytime Cold + Flu), codeine (narcotic antitussive found in Robitussin DAC and Robitussin AC), dextromethorphan (non-narcotic antitussive found in most Robitussin products), diphenhydramine (antihistamine), doxylamine (sleep aid), guaifenesin (expectorant found in most Robitussin products), promethazine (antihistamine), pseudoephedrine (decongestant) and menthol (oral anesthetic in Robitussin DM lozenges).

Robitussin

 

Mechanisms of action – How NyQuil and Robitussin work in the body

Acetaminophen is highly selective COX-2 inhibitor that inhibits prostaglandin synthesis. It can inhibit COX-2 in CNS. Acetaminophen also acts on the hypothalamic heat regulating centers to produce antipyresis.

Dextromethorphan acts on cough center in medulla by decreasing sensitivity of cough receptors and by interrupting impulse transmission.

Doxylamine succinate is competitor for H1-receptor sites on target cells and also has anticholinergic effects, lowering labyrinthine function, blocking chemoreceptor trigger zone, and diminishing vestibular stimulation.

Pseudoephedrine and Phenylephrine are sympathomimetics with direct action on the adrenergic receptor system. The vasoconstriction is produced after α-adrenergic receptors activation.

Chlorpheniramine is antagonist of histamine H1 receptor (HRH1). It has been also shown that this drug is also a serotonin-norepinephrine reuptake inhibitor.

Guaifenesin acts by reducing the viscosity and increasing the volume of secretions in the trachea and bronchi. Studies have also shown that guaifenesin has muscle relaxant and anticonvulsant properties due to antagonism effects on NMDA receptors.

Can patients take NyQuil and Robitussin together

There should be no need to take those medications together at the same time as they act on the same way, so their effects will become additive and there is a high risk of serious side effects to happen.

NyQuil and Robitussin, both contain acetaminophen as an active ingredient, and these products are usually taken 3-4 times a day, so if these preparations are used at the same time, even in recommended daily doses, there is a high risk for acetaminophen to be overdosed (more than 4g daily), and this can cause potentially fatal, hepatic necrosis.

Some NyQuil and Robitussin products can contain pseudoephedrine and phenylephrine as active ingredients, and their potential interaction can amplify sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Patients with cardiovascular diseases and patients with a history of heart attacks shouldn’t use these medicines.

NyQuil and Robitussins preparations usually contain antihistamines with hypnotic effects such as: doxylamine, diphenhydramine, promethazine or chlorpheniramine, so their combination may increase sedation and drowsiness.

A significant interaction that can cause cardiac arrhythmias or sudden death may occur after mixing NyQuil D that contains nasal decongestive pseudoephedrine and Robitussin formulations with antihistamine promethazine. However, this interaction is more likely to happen only in certain predisposed patients.

The table below shows the incidence of side effects after NyQuil and Robitussin administration in recommendable doses. This Incidence can be significantly increased if these drugs are taken together.

Incidence

Side effects

Frequency Not Defined Hypertension, Tachycardia, Hypotension, Reflex tachycardia, Severe peripheral and visceral vasoconstriction, Tremor, Dizziness, Excitability, Headache, Sedation, Sleepiness, Restlessness, Dermatologic rash, Increased appetite, Xerostomia, Anemia blood dyscrasias (neutropenia, pancytopenia, leukopenia), Bilirubin and alkaline phosphatase may increase, Urinary retention

Special precautions and warnings during NyQuil and Robitussin administration:

  • Patients shouldn’t use these medicines if they have used MAO inhibitors drugs such as furazolidone (Furoxone), phenelzine (Nardil), isocarboxazid (Marplan), selegiline (Eldepryl, Emsam, Zelapar), rasagiline (Azilect), or tranylcypromine (Parnate) in the last 14 days. Drug interactions can occur leading to serious side effects.
  • Pregnant patients shouldn’t use these medications without medical advice; it is not known whether chlorpheniramine, pseudoephedrine or dextromethorphan will harm an unborn baby. Chlorpheniramine, dextromethorphan, and pseudoephedrine may pass into breast milk and may harm a nursing baby. These medicines should not be used if mother is breast-feeding a baby.
  • Patients with phenylketonuria should avoid these medicines.
  • Children younger than 4 years should also avoid these medicines. These medicines shouldn’t be taken for longer than 7 days in a row.
  • These medications may impair your thinking or reactions and cause blurred vision. Patients should be careful if they drive or do anything that requires being alert and able to see clearly.
  • Patients should avoid alcohol while using these medications. Drinking alcohol can increase certain side effects of these medications.
  • Patients should avoid becoming dehydrated or overheated during exercises. Chlorpheniramine can decrease sweating and patients could become more prone to heat stroke
  • Patients should avoid these medications if they also take caffeine pills, diet pills, or other stimulants. Taking decongestants (pseudoefedrine, phenylephrine) together with stimulants can increase the risk of unpleasant side effects.
  • Medicines such as sedatives, sleeping pills, narcotic pain medicines, medicine for seizures, anxiety or depression, and muscle relaxers can add sedation and sleepiness that can be also caused by dextromethorphan, chlorpheniramine, promethazine, doxylamine and pseudoefedrine.

Informations retrieved from:

http://www.drugs.com/cdi/nyquil-liquid.html

http://www.webmd.com/drugs/2/drug-6104/nyquil-oral/details

http://vicks.com/en-us/browse-products/nyquil

http://www.drugs.com/cdi/robitussin-dm-elixir.html

http://www.webmd.com/drugs/2/drug-151968/robitussin-oral/details

http://www.robitussin.com/robitussin-product-line

http://reference.medscape.com/drug/childrens-robitussin-cough-cold-long-acting-chlorpheniramine-dextromethorphan-999616

http://reference.medscape.com/drug/vicks-nyquil-d-acetaminophen-doxylamine-dextromethorphan-pseudoephedrine-999380#10

http://www.emedicinehealth.com/drug-chlorpheniramine_dextromethorphan_and_pseudoephedrine/page2_em.htm

http://www.drugs.com/mtm/nyquil-cough.html

Can you mix Tramadol and Vicodin

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