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Acetaminophen, dextromethorphan, and doxylamine and Isoniazid

Determining the interaction of Acetaminophen, dextromethorphan, and doxylamine and Isoniazid and the possibility of their joint administration.

Check result:

Acetaminophen, dextromethorphan, and doxylamine <> Isoniazid

Relevance: 09.11.2022 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:

Using acetaminophen together with isoniazid may alter the effects of acetaminophen and cause serious side effects that may affect your liver. Call your doctor immediately if you experience a fever, chills, joint pain or swelling, excessive tiredness or weakness, unusual bleeding or bruising, skin rash or itching, loss of appetite, nausea, vomiting, or yellowing of the skin or the whites of your eyes. If your doctor does prescribe these medications together, you may need a dose adjustment or special tests to safely take both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

MONITOR: Some reports have suggested that isoniazid may increase the potential hepatotoxicity of acetaminophen. The mechanism may be related to induction of CYP450 2E1 metabolism of acetaminophen to toxic metabolites during concurrent administration, or transient increased metabolism of acetaminophen after discontinuation of isoniazid. Study data have been conflicting and causality is unclear due to the presence of other drugs in some cases. Both isoniazid and acetaminophen have individually been associated with hepatotoxicity.

MANAGEMENT: Until more information is available, concurrent acetaminophen use should be limited. Close attention should be paid to clinical and laboratory evidence of hepatotoxicity. Both drugs should be discontinued if evidence of hepatoxicity is observed. Aspirin or nonsteroidal inflammatory agents may be safer alternatives.

References

Murphy R, Swartz R, Watkins PB "Severe acetaminophen toxicity in a patient receiving isoniazid." Ann Intern Med 113 (1990): 799-800
Nolan CM, Sandblom RE, Thummel KE, Slattery JT, Nelson SD "Hepatotoxicity associated with acetaminophen usage in patients receiving multiple drug therapy for tuberculosis." Chest 105 (1994): 408-11
Crippin JS "Acetaminophen hepatotoxicity: potentiation by isoniazid." Am J Gastroenterol 88 (1993): 590-2
Epstein MM, Nelson SD, Slattery JT, Kalhorn TF, Wall RA, Wright JM "Inhibition of the metabolism of paracetamol by isoniazid." Br J Clin Pharmacol 31 (1991): 139-42
Moulding TS, Redeker AG, Kanel GC "Acetaminophen, isoniazid, and hepatic toxicity." Ann Intern Med 114 (1991): 431

Acetaminophen, dextromethorphan, and doxylamine

Generic Name: acetaminophen / dextromethorphan / doxylamine

Brand name: All-Nite, Contac Cold+Flu Cooling Night, Coricidin HBP Nighttime Multi-Symptom Cold, Night Time Cold/Flu, Nyquil Cold & Flu, Robitussin Peak Cold Nighttime Cold + Flu, Tylenol Cold & Cough Nighttime Cool Burst, Tylenol Warming Cough & Sore Throat Nightime, Tylenol Cough & Sore Throat Nightime, Tylenol Cough & Sore Throat Night Time, NyQuil Cold/Flu Relief Cherry, NyQuil Cold/Flu Relief, Nite Time Cold & Flu, Cough & Sore Throat Nighttime, Delsym Cough-Cold Nighttime, Sunmark Nite Time Cold and Flu, Delsym Nighttime Cough & Cold, Multi-Symptom Nighttime Cold & Flu Relief, Nyquil Cold & Flu Nighttime, NyQuil Nature Fusion Cold & Flu Nighttime, Clear Cough PM Multi-Symptom, Tylenol Cough/Sore Throat

Synonyms: n.a.

What is Acetaminophen, dextromethorphan, and doxylamine?

Isoniazid

Generic Name: isoniazid

Brand name: Nydrazid

Synonyms: n.a.

What is Isoniazid?

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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.

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