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Acetaminophen and pyrilamine and Urocit-K 15

Determining the interaction of Acetaminophen and pyrilamine and Urocit-K 15 and the possibility of their joint administration.

Check result:
Acetaminophen and pyrilamine <> Urocit-K 15
Relevance: 17.08.2023 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

The following interaction applies only if you are taking potassium in a solid formulation (i.E., tablet or capsule swallowed whole): Talk to your doctor before using potassium oral tablets or capsules together with pyrilamine. Depending on the dose of pyrilamine and your overall physical health, combining these medications may increase the irritant effects of potassium on your stomach and upper intestine. This can rarely result in ulcers, bleeding, and other gastrointestinal injury. Contact your doctor immediately if you develop severe abdominal pain, bloating, sudden dizziness or lightheadedness, nausea, vomiting (especially with blood), loss of appetite, and/or black, tarry stools during treatment with these medications. Alternatively, a liquid formulation of potassium may be considered when used in combination with pyrilamine. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

CONTRAINDICATED: Concomitant use of agents with anticholinergic properties (e.g., antihistamines, antispasmodics, neuroleptics, phenothiazines, skeletal muscle relaxants, tricyclic antidepressants, the class IA antiarrhythmic disopyramide) may potentiate the risk of upper gastrointestinal injury associated with oral solid formulations of potassium citrate. The proposed mechanism involves increased gastrointestinal transit time due to reduction of stomach and intestinal motility by anticholinergic agents, thereby creating a high localized concentration of potassium ions in the region of a dissolving tablet or capsule and increasing the contact time with GI mucosa. Solid formulations of potassium chloride have been associated with upper GI bleeding and small bowel ulceration, stenosis, perforation, and obstruction. Deaths have been reported rarely. In clinical studies, short-term coadministration of wax-matrix or microencapsulated formulations of potassium chloride and potassium citrate at high dosages in combination with an anticholinergic agent such as glycopyrrolate resulted in more frequent and more serious endoscopic lesions than potassium therapy alone. However, the lesions were not accompanied by bleeding or epigastric symptoms. Some investigators have suggested a higher risk of upper GI lesions with wax-matrix than microencapsulated formulations, although existing data are limited and conflicting.

MANAGEMENT: The use of oral solid formulations of potassium citrate is considered contraindicated in patients receiving agents with anticholinergic properties at sufficient doses to exert anticholinergic effects. A liquid formulation of potassium citrate should be considered. Patients prescribed a solid oral formulation should be advised to discontinue potassium therapy and contact their physician if they experience potential symptoms of upper GI injury such as severe vomiting, abdominal pain, distention, and gastrointestinal bleeding.

References
  • Leijonmarck CE, Raf L "Gastrointestinal lesions and potassium chloride supplements." Lancet 1 (1985): 56-7
  • McMahon FG, Ryan JR, Akdamar K, Ertan A "Upper gastrointestinal lesions after potassium chloride supplements: a controlled clinical trial." Lancet 2 (1982): 1059-61
  • Wynn V "Potassium chloride and bowel ulceration." Br Med J 5477 (1965): 1546
  • "Product Information. K-Dur (potassium chloride)." Schering Laboratories, Kenilworth, NJ.
  • Farquharson-Roberts MA, Giddings AE, Nunn AJ "Perforation of small bowel due to slow release potassium chloride (slow-K)." Br Med J 3 (1975): 206
  • Weiss SM, Rutenberg HL, Paskin DL, Zaren HA "Gut lesions due to slow-release KCI tablets." N Engl J Med 296 (1977): 111-2
  • Leijonmarck CE, Raf L "Ulceration of the small intestine due to slow-release potassium chloride tablets." Acta Chir Scand 151 (1985): 273-8
  • Lofgren RP, Rothe PR, Carlson GJ "Jejunal perforation associated with slow-release potassium chloride therapy." South Med J 75 (1982): 1154-5
  • "Product Information. Urocit (potassium citrate)." Mission Pharmacal Company, San Antonio, TX.
  • McMahon FG, Ryan JR, Akdamar K, Ertan A "Effect of potassium chloride supplements on upper gastrointestinal mucosa." Clin Pharmacol Ther 35 (1984): 852-5
  • Heffernan SJ, Murphy JJ "Ulceration of small intestine and slow-release potassium tablets." Br Med J 2 (1975): 746
  • Lambert JR, Newman A "Ulceration and stricture of the esophagus due to oral potassium chloride (slow release tablet) therapy." Am J Gastroenterol 73 (1980): 508-11
Acetaminophen and pyrilamine

Generic Name: acetaminophen / pyrilamine

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Synonyms: n.a.

Urocit-K 15

Generic Name: potassium citrate

Brand name: Urocit-K

Synonyms: Potassium, Potassium Citrate

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

Interaction with food and lifestyle