Acetaminophen, dextromethorphan, and phenylephrine and Panobinostat Lactate

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.

Panobinostat may increase the blood levels and effects of dextromethorphan. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects such as difficulty breathing, dizziness, drowsiness, difficulty sleeping, or diarrhea. 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.

MONITOR: Coadministration with CYP450 2D6 inhibitors may increase the plasma concentrations of dextromethorphan in patients who are extensive metabolizers of this isoenzyme (approximately 93% of Caucasians and more than 98% of Asians and individuals of African descent). The proposed mechanism is inhibition of the CYP450 2D6-mediated O-demethylation of dextromethorphan. Increased plasma concentrations increase the risk of dextromethorphan-related adverse effects (e.g., agitation, confusion, tremor, insomnia, diarrhea, and respiratory depression) and serotonin syndrome. Coadministration of dextromethorphan (60 mg orally, once) with the CYP450 2D6 inhibitor panobinostat (20 mg orally once a day on days 3, 5, and 8) in 14 patients with advanced cancer had a highly variable effect on dextromethorphan levels, increasing the peak plasma concentration (Cmax) of dextromethorphan by 20% to 200%, and total systemic exposure (AUC 0 to infinity) by 20% to 130%, compared to dextromethorphan given alone. In addition, multiple doses of the potent CYP450 2D6 inhibitor cinacalcet (50 mg daily), increased the AUC of a single 30 mg dextromethorphan dose by 11-fold in extensive metabolizers of this isoenzyme. The moderate CYP450 2D6 inhibitor asunaprevir, given at 200 mg twice daily, also increased Cmax and AUC of a single 30 mg dose of dextromethorphan by 2.7- and 3.9-fold, respectively, in 17 study subjects.

MANAGEMENT: Caution should be exercised if these drugs must be used together. Patients should be monitored for signs of dextromethorphan adverse effects (e.g., agitation, confusion, tremor, insomnia, diarrhea, and respiratory depression) and serotonin syndrome, and advised to notify their health care professional if these adverse effects develop or worsen. Dose reduction of dextromethorphan may also be required.

Acetaminophen, dextromethorphan, and phenylephrine

Generic Name: acetaminophen / dextromethorphan / phenylephrine

Brand name: Comtrex Cold & Cough, DayQuil Cold & Flu, Daytime, Flu & Severe Cold & Cough Daytime Powder, Mapap Cold Formula, Robitussin Peak Cold Daytime Cold + Flu, Sudafed PE Pressure+Pain+Cough, Theraflu Daytime Severe Cold & Cough, Theraflu Warming Severe Cold Daytime, Tylenol Cold Multi-Symptom Daytime, Vicks Dayquil Liquicaps Cold/Flu, Contac Complete Cough, Cold & Flu Extra Strength, Tylenol Cold Daytime, Neocitran Non Drowsy Extra Strength Cold and Flu, Tylenol Cold Daytime Extra Strength, Tylenol Flu Daytime Extra Strength, Theraflu Nighttime Severe Cold & Cough, Theraflu Warming Relief Daytime Multi-Symptom Cold, Tylenol Children's Plus Cold & Cough, Theraflu Multi-Symptom Severe Cold, Day Time Cold & Flu, DayQuil Nature Fusion Cold & Flu, Theraflu ExpressMax Day Cold & Cough, Tylenol Cold Max Day, Mucinex Fast-Max Severe Cold and Sinus, Mucinex Fast-Max Congestion and Headache, Theraflu PowerPods Daytime Severe Cold, Comtrex Cold and Cough Maximum Strength, Vicks DayQuil Multi-Symptom Cold/Flu Relief

Synonyms: n.a.

What is Acetaminophen, dextromethorphan, and phenylephrine?

Panobinostat Lactate

Generic Name: panobinostat

Brand name: Farydak

Synonyms: Panobinostat

What is Panobinostat Lactate?