Although no data are available, pseudoephedrine should be used cautiously in patients using significant quantities of other sympathomimetics. Cough, Cold and Flu Medicine | Walgreens Monitor for loss of glycemic control when sympathomimetics are administered to patients taking incretin mimetics. (Moderate) Monitor for excessive sedation and somnolence during coadministration of selegiline and brompheniramine. Sympathomimetics, through stimulation of alpha- and beta- receptors, increase hepatic glucose production and glycogenolysis and inhibit insulin secretion. Metoprolol; Hydrochlorothiazide, HCTZ: (Moderate) Monitor hemodynamic parameters and for loss of efficacy during concomitant sympathomimetic agent and beta-blocker use; dosage adjustments may be necessary. The manufacturers of selegiline products recommend caution and monitoring of blood pressure during concurrent use with sympathomimetics. Amlodipine; Atorvastatin: (Moderate) Phenylephrine's cardiovascular effects may reduce the antihypertensive effects of calcium-channel blockers. Clinicians should thoroughly assess each patient's use of similar products, both prescription and nonprescription, to avoid duplication of therapy and the potential for inadvertent overdose.Safe use of chlorpheniramine; dextromethorphan in pregnancy has not been established. Well-controlled hypertensive patients receiving decongestant sympathomimetics at recommended doses do not appear to be at high risk for significant elevations in blood pressure; however, increased blood pressure (especially systolic hypertension) has been reported in some patients. Concomitant use with paroxetine increased dextromethorphan overall exposure by 2.69-fold. Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate: (Major) Because of the potential risk and severity of serotonin syndrome, coadministration of dextromethorphan and IV methylene blue should be avoided if possible. Escitalopram: (Moderate) Because of the potential risk and severity of serotonin syndrome, caution should be observed when administering dextromethorphan with escitalopram. Other possible CNS mediated effects include ataxia, lethargy, and muscular weakness. Therefore, it is possible that metabolism of one or both of these medications may be reduced in those with significant hepatic disease. Patients receiving these medications may require larger amounts of hyaluronidase for equivalent dispersing effect. Fort Worth, TX 76177, Address: This applies to sympathomimetics including stimulants for ADHD, narcolepsy or weight loss, nasal, oral, and ophthalmic decongestants and cold products, and respiratory sympathomimetics (e.g., beta agonist drugs). (Moderate) Use of dextromethorphan with cobicistat may result in increased dextromethorphan exposure. Ste. Limit the use of opioid pain medication with brompheniramine to only patients for whom alternative treatment options are inadequate. Tedizolid: (Minor) Because of the potential risk and severity of serotonin syndrome, caution should be observed when administering dextromethorphan with tedizolid. (Moderate) The cardiovascular effects of sympathomimetics may reduce the antihypertensive effects produced by diuretics. Amobarbital: (Moderate) Additive CNS depression may occur if barbiturates are co-used with sedating antihistamines, such as brompheniramine. Monitor for loss of glycemic control when sympathomimetics are administered to patients taking SGLT2 inhibitors. Well-controlled hypertensive patients receiving decongestant sympathomimetics at recommended doses do not appear at high risk for significant elevations in blood pressure, however, increased blood pressure has been reported in some patients. Also, adrenergic medications may decrease glucose uptake by muscle cells. Well-controlled hypertensive patients receiving decongestant sympathomimetics at recommended doses do not appear to be at high risk for significant elevations in blood pressure; however, increased blood pressure (especially systolic hypertension) has been reported in some patients. Additive drowsiness or other CNS effects may occur. (Moderate) An enhanced CNS depressant effect may occur when diphenoxylate/difenoxin is combined with other CNS depressants. Limit the use of opioid pain medication with brompheniramine to only patients for whom alternative treatment options are inadequate. Concomitant use may result in additive CNS depression or anticholinergic adverse effects. Additionally, the vasopressor dose may need to be increased over time due to tachyphylaxis. St. John's wort should be used cautiously with any sympathomimetic agent. Patients should be advised to avoid amphetamine drugs, decongestants (including nasal decongestants) and sympathomimetic anorexiants for weight loss, including dietary supplements. Loop diuretics: (Moderate) The cardiovascular effects of sympathomimetics may reduce the antihypertensive effects produced by diuretics. Manufacturer Coupons and Offers Available. United States, 6623 West Cross Creek Bend Lane Drugs that can cause CNS depression, if used concomitantly with vigabatrin, may increase both the frequency and the intensity of adverse effects such as drowsiness, sedation, and dizziness. Methocarbamol: (Moderate) Methocarbamol may cause additive CNS depression if used concomitantly with other CNS depressants such as sedating H1-blockers. Limit the use of opioid pain medication with brompheniramine to only patients for whom alternative treatment options are inadequate. It is my privilege to join with you and to offer you new insights and ways to work through pain and problems. Increasing the dose of iobenguane I 123 will not overcome any potential uptake limiting effect of this medication. Also, adrenergic medications may decrease glucose uptake by muscle cells. (Moderate) Concomitant use of opioid agonists with chlorpheniramine may cause excessive sedation and somnolence. Chlorpheniramine is a substrate and moderate inhibitor of CYP2D6; eliglustat is also a substrate and inhibitor of CYP2D6 as well as a CYP3A substrate. Hydrocodone: (Moderate) Concomitant use of opioid agonists with brompheniramine may cause excessive sedation and somnolence. Azelastine; Fluticasone: (Major) Avoid concomitant use of azelastine and sedating H1-blockers due to risk for additive CNS depression. I work to identify risk factors contributing to the development of difficulties and to uncover specific protective factors to promote resilience. Empagliflozin: (Moderate) Sympathomimetic agents tend to increase blood glucose concentrations when administered systemically. Weekends: 9:00 AM 5:00 PM, Address: For treatment of cold symptoms, nasal decongestants may be preferable for short term, limited use (1 to 3 days) as an alternative to systemic decongestants in patients taking medications for diabetes. Sympathomimetics counteract the medications used to stabilize pulmonary hypertension, including treprostinil. Many of these effects are due in part to the anticholinergic properties of chlorpheniramine and include constipation, dryness of mucous membranes (e.g., nasal dryness), urinary retention, and xerostomia. United States, 12620 Woodforest Blvd., Suite 150 Beta-blockers: (Moderate) Monitor hemodynamic parameters and for loss of efficacy during concomitant sympathomimetic agent and beta-blocker use; dosage adjustments may be necessary. United States, 21715 Kingsland Blvd., Suite 103 Monitor patients for decreased pressor effect if these agents are administered concomitantly. Dutasteride; Tamsulosin: (Moderate) Use caution when administering tamsulosin with a moderate CYP2D6 inhibitor such as chlorpheniramine. Discontinue all serotonergic agents and initiate symptomatic treatment if serotonin syndrome occurs. Thiazide diuretics: (Moderate) The cardiovascular effects of sympathomimetics may reduce the antihypertensive effects produced by diuretics. Dextromethorphan is a sensitive CYP2D6 substrate. We all face challenges throughout our lives. (Moderate) Use of dextromethorphan with cobicistat may result in increased dextromethorphan exposure. Celecoxib is a CYP2D6 inhibitor, and chlorpheniramine is a CYP2D6 substrate. If concomitant use cannot be avoided, closely monitor for dextromethorphan-related side effects, such as drowsiness, nausea or vomiting, sweating, restlessness, or tremor. If concurrent use is necessary, use the lowest effective doses and minimum treatment durations needed to achieve the desired clinical effect. Excretion is primarily by renal elimination of metabolites; some drug is excreted unchanged.-Route-Specific PharmacokineticsOral Route-Chlorpheniramine: Chlorpheniramine is well absorbed from the GI tract. (Moderate) Concomitant use of opioid agonists with brompheniramine may cause excessive sedation and somnolence. Houston, TX 77055 Excessive caffeine ingestion (via medicines, supplements or beverages including coffee, green tea, other teas, guarana, colas) may contribute to side effects like nervousness, irritability, insomnia, or tremor. Epinephrine and other sympathomimetics, through stimulation of alpha- and beta- receptors, increase hepatic glucose production and glycogenolysis and inhibit insulin secretion. Round Rock, TX 78664, Address: Well-controlled hypertensive patients receiving decongestant sympathomimetics at recommended doses do not appear at high risk for significant elevations in blood pressure, however, increased blood pressure has been reported in some patients. Limit the use of opioid pain medication with chlorpheniramine to only patients for whom alternative treatment options are inadequate. Nalbuphine: (Moderate) Concomitant use of nalbuphine with other CNS depressants, such as sedating H1-blockers, can potentiate the effects of nalbuphine on respiratory depression, CNS depression, and sedation. Acetaminophen; Caffeine; Pyrilamine: (Moderate) CNS-stimulating actions of caffeine can be additive with other CNS stimulants or psychostimulants like phenylephrine; caffeine should be avoided or used cautiously. Limit the use of opioid pain medication with chlorpheniramine to only patients for whom alternative treatment options are inadequate. In general, medicines containing sympathomimetic agents should not be used concurrently with MAOIs or within 14 days before or after their use. Selegiline is a selective monoamine oxidase inhibitor type B; however, the selectivity of the drug decreases with increasing doses. Caffeine; Sodium Benzoate: (Moderate) CNS-stimulating actions of caffeine can be additive with other CNS stimulants or psychostimulants like phenylephrine; caffeine should be avoided or used cautiously. Mirtazapine: (Moderate) Because of the potential risk and severity of serotonin syndrome, caution should be observed when administering dextromethorphan with mirtazapine. Sympathomimetics, through stimulation of alpha- and beta- receptors, increase hepatic glucose production and glycogenolysis and inhibit insulin secretion. If concurrent use is necessary, use the lowest effective doses and minimum treatment durations needed to achieve the desired clinical effect. Dextromethorphan is largely metabolized by CYP2D6, so this particular interaction with grapefruit juice may be more relevant in patients who are poor CYP2D6 metabolizers. Monitor for additive CNS and respiratory effects, and warn about the potential effects to driving and other activities. Phenylephrine should generally not be used concurrently with MAOIs or within 14 days before or after their use. Dicyclomine: (Moderate) Monitor for signs or symptoms of anticholinergic toxicity during concomitant sedating H1-blocker and dicyclomine use. Codeine; Promethazine: (Moderate) Additive anticholinergic and sedative effects may be seen when promethazine is used with first generation antihistamines, such as brompheniramine. Candesartan; Hydrochlorothiazide, HCTZ: (Moderate) The cardiovascular effects of sympathomimetics may reduce the antihypertensive effects produced by diuretics. Ciclesonide: (Moderate) The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Some local anesthetics also contain a sympathomimetic (e.g., epinephrine). Patients should read nonprescription product labels carefully. Although no data are available, pseudoephedrine should be used cautiously in patients using significant quantities of other sympathomimetics. Sympathomimetics, through stimulation of alpha- and beta- receptors, increase hepatic glucose production and glycogenolysis and inhibit insulin secretion. The concomitant administration of dronedarone and CYP2D6 substrates may result in increased exposure of the substrate and should, therefore, be undertaken with caution. (Moderate) Because of the potential risk and severity of serotonin syndrome, caution should be observed when administering dextromethorphan with sibutramine. Cenobamate: (Moderate) Monitor for excessive sedation and somnolence during coadministration of cenobamate and sedating H1-blockers. Texas Children's Pediatrics Fannin. Concomitant use may result in additive CNS depression or anticholinergic adverse effects. Limit the use of opioid pain medication with chlorpheniramine to only patients for whom alternative treatment options are inadequate. 6091 W University Dr Suite 108-B Limit the use of opioid pain medication with brompheniramine to only patients for whom alternative treatment options are inadequate. Discounts are available exclusively through participating pharmacies. This program is administered by Medical Security Card Company, LLC, Tucson, AZ. Use caution with this combination. If concurrent use is necessary, use the lowest effective doses and minimum treatment durations needed to achieve the desired clinical effect. This effect may be clinically important if a patient is receiving an antihistamine agent for treatment of insomnia. Concomitant use may antagonize the cardiovascular effects of either drug. Atropine; Edrophonium: (Major) Atropine blocks the vagal reflex bradycardia caused by sympathomimetic agents, such as phenylephrine, and increases its pressor effect. (Moderate) Monitor for signs or symptoms of anticholinergic toxicity during concomitant sedating H1-blocker and hyoscyamine use. I understand I can opt out at any time, by clicking the 'unsubscribe' button found in the price drop alert emails I receive. United States, 20035 W. Lake Houston Pkwy., Ste. During one in vivo study, co-administration of dextromethorphan and clobazam resulted in increased AUC and Cmax of dextromethorphan by 90% and 59%, respectively. Chlorpheniramine is metabolized by the hepatic isoenzyme CYP2D6; ritonavir is an inhibitor of this enzyme. Monitor patients for decreased pressor effect if these agents are administered concomitantly. (Moderate) Concomitant use of opioid agonists with chlorpheniramine may cause excessive sedation and somnolence. Also, adrenergic medications may decrease glucose uptake by muscle cells. Adverse effects may be seen not only on GI smooth muscle, but also on bladder function, the CNS, the eye, and temperature regulation. (Moderate) Additive CNS depression may occur if barbiturates are co-used with sedating antihistamines, such as brompheniramine. 100 Inform patients taking this combination of the possible increased risk and monitor for the emergence of serotonin syndrome, particularly during treatment initiation and dose adjustment. Use this coupon to get this price at any WALGREENS Pharmacy location. Also, adrenergic medications may decrease glucose uptake by muscle cells. Nafarelin: (Moderate) If use of a topical nasal decongestants (e.g., oxymetazoline, tetrahydrozoline, phenylephrine nasal) is necessary during therapy with intranasal nafarelin, the decongestant should not be used for at least 2 hours after nafarelin is administered. Do not exceed 6 doses (15 mL) per 24 hours.Oral dosage (oral solution containing chlorpheniramine 2 mg and dextromethorphan 15 mg per 5 mL; e.g., Scot-Tussin DM Maximum strength Cough Suppressant and Cold Relief):Adults, Adolescents, and Children 12 years and older: 10 mL PO every 6 hours as needed. For treatment of cold symptoms, nasal decongestants may be preferable for short term, limited use (1 to 3 days) as an alternative to systemic decongestants in patients taking medications for diabetes. Dextromethorphan is a CYP2D6 substrate and fluoxetine is a strong CYP2D6 inhibitor. Discontinue all serotonergic agents and initiate symptomatic treatment if serotonin syndrome occurs. (Moderate) Monitor for excessive sedation and somnolence during coadministration of lumateperone and chlorpheniramine. As with MAOIs, the use of a sympathomimetic drug with procarbazine may precipitate hypertensive crisis or other serious side effects. Additionally, this combination product should not be used in patients with persistent or chronic cough such as occurs with asthma, emphysema, chronic bronchitis, or tobacco smoking, or any other condition where cough is associated with excessive secretions, unless under the supervision of a health care professional.Products containing chlorpheniramine should be used with caution in patients with cardiac arrhythmias, arteriosclerosis, bradycardia, partial heart block (AV block, bundle-branch block), controlled or mild hypertension, heart failure, cardiomyopathy, ischemic heart disease, or other cardiac disease due to the anticholinergic effects of chlorpheniramine. Timolol: (Moderate) Monitor hemodynamic parameters and for loss of efficacy during concomitant sympathomimetic agent and beta-blocker use; dosage adjustments may be necessary. Dapagliflozin: (Moderate) Sympathomimetic agents tend to increase blood glucose concentrations when administered systemically. Discontinue all serotonergic agents and initiate symptomatic treatment if serotonin syndrome occurs. Peginterferon Alfa-2b: (Moderate) Monitor for adverse effects associated with increased exposure to chlorpheniramine if peginterferon alfa-2b is coadministered. The Program, as well as the prices and the list of covered drugs, can be modified at any time without notice. You will be redirected to your program in 5 seconds. Houston, TX 77081 Butabarbital: (Moderate) Additive CNS depression may occur if barbiturates are co-used with sedating antihistamines, such as brompheniramine. In an in vivo drug-drug interaction trial, the Cmax and AUC of the CYP2D6 substrate dextromethorphan were increased 2.8- and 2.9-fold, respectively when dextromethorphan 30 mg was given with abiraterone acetate 1,000 mg daily along with prednisone 5 mg twice daily. However, the potential for interaction has been studied. Quinine: (Moderate) Although clinical drug interaction studies have not been performed, antimalarial doses of quinine (greater than or equal to 600 mg/day in adults) may inhibit the metabolism of CYP2D6 substrates such as dextromethorphan and may result in increased dextromethorphan exposure. Additive drowsiness or other CNS effects may occur. Enalapril; Hydrochlorothiazide, HCTZ: (Moderate) The cardiovascular effects of sympathomimetics may reduce the antihypertensive effects produced by diuretics. Looking for a, Licensed Professional Counselor, MA, LPC, Texas, Mediato, What are you looking for in a counselor? United States, 103 S. 12th St. Manufacturer Coupons and Offers Available. This applies to sympathomimetics including stimulants for ADHD, narcolepsy or weight loss, nasal, oral, and ophthalmic decongestants and cold products, and respiratory sympathomimetics (e.g., beta agonist drugs). Memantine: (Moderate) Dextromethorphan is a NMDA antagonist and may lead to additive adverse effects if combined with memantine, also an NMDA antagonist. Excessive caffeine ingestion (via medicines, supplements or beverages including coffee, green tea, other teas, guarana, colas) may contribute to side effects like nervousness, irritability, insomnia, or tremor. 170, Texas Children's Pediatrics Humble Atascocita, Texas Children's Pediatrics Humble Kingwood, Texas Children's Pediatrics Medical Plaza, Texas Children's Pediatrics Sterling Ridge, Texas Children's Pediatrics Barker Cypress, Texas Children's Pediatrics Cohan & Masharani, Texas Children's Pediatrics Corinthian Pointe, Texas Children's Pediatrics Grand Parkway, Texas Children's Pediatrics Missouri City, Texas Children's Pediatrics Shadow Creek Ranch, Texas Children's Pediatrics Spring Branch, Texas Children's Pediatrics Thaller and Associates, Texas Children's Pediatrics Town and Country at West Campus, Texas Children's Pediatrics Pediatric Medical Group, Texas Children's Pediatrics Houston Pediatric Associates, Texas Childrens Pediatrics University Pediatric Association, Texas Children's Pediatrics Longhorn Pediatrics, Texas Children's Pediatrics Pediatric Partners of Austin, Texas Children's Pediatrics Austin Pediatrics, Texas Children's Pediatrics Lone Star Pediatrics, Texas Children's Pediatrics Dawson & Ramirez Pediatrics, Texas Children's Pediatrics JoAnne Wise Edoka, MD, Texas Children's Pediatrics Round Rock Pediatrics, Texas Children's Pediatrics Capital Pediatric Group - Central, Texas Children's Pediatrics Capital Pediatric Group - North, Texas Children's Pediatrics Elsa G. Brieno, MD, Texas Children's Pediatrics Westbank Pediatrics, Texas Children's Pediatrics Pflugerville Pediatrics, Texas Children's Pediatrics Beansprout Bee Cave, Texas Children's Pediatrics Beansprout Belterra, Texas Children's Pediatrics Beansprout Dripping Springs, Texas Children's Pediatrics Beansprout Spicewood, Texas Children's Pediatrics Hill Country Pediatrics. Formoterol; Mometasone: (Moderate) Caution and close observation should be used when formoterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Antiemetics block the histamine or acetylcholine response that causes nausea due to vestibular emetic stimuli such as motion. United States, 740 Gulfgate Mall Limit the use of opioid pain medication with brompheniramine to only patients for whom alternative treatment options are inadequate. Diazepam: (Moderate) The therapeutic effect of phenylephrine may be decreased in patients receiving benzodiazepines. Blood pressure should be monitored closely to confirm that the desired antihypertensive effect is achieved. United States, 1100 West 39 Street Quetiapine: (Moderate) Somnolence is a commonly reported adverse effect of quetiapine. (Moderate) Monitor for signs or symptoms of anticholinergic toxicity during concomitant sedating H1-blocker and glycopyrrolate use. Monitor for adverse effects if these drugs are administered together. CNS depressants can potentiate the effects of stiripentol. Monitor patients for increased pressor effect if these agents are administered concomitantly. Terbinafine: (Moderate) Monitor for dextromethorphan-related side effects, such as dizziness or drowsiness, if concomitant use of terbinafine is necessary. The incidence of such an interaction may be decreased if vasopressors are not administered prior to oxytocin. Concomitant use may increase dextromethorphan exposure and side effects. Cedar Park, TX 78613, Hours: Members are required to pay for all prescription purchases. Additive CNS depression causing sedation and/or dizziness is also possible. If concurrent use is necessary, use the lowest effective doses and minimum treatment durations needed to achieve the desired clinical effect. A 5% decrease in dextromethorphan exposure and a 29% decrease in its metabolite, dextrorphan was noted 1 week after a single tocilizumab infusion. Limit the use of opioid pain medication with brompheniramine to only patients for whom alternative treatment options are inadequate. Do not exceed 4 doses per 24 hours.Children 6 to 11 years: 10 mL every 6 hours as needed. My goal is to guide clients to explore ways to make changes in their lives so they can look forward to the future with hope. Buy & Sell Kids' Clothing, Shoes, Toys, Furniture - Kids' Resale Stores (Moderate) Concomitant use of opioid agonists with chlorpheniramine may cause excessive sedation and somnolence. (Moderate) Concomitant use of opioid agonists with chlorpheniramine may cause excessive sedation and somnolence. Patients may not perceive warning signs, such as excessive drowsiness, or they may report feeling alert immediately prior to the event.