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Acetaminophen, dextromethorphan, guaifenesin, and phenylephrine and Methergine (Methylergonovine Injection)

Determining the interaction of Acetaminophen, dextromethorphan, guaifenesin, and phenylephrine and Methergine (Methylergonovine Injection) and the possibility of their joint administration.

Check result:
Acetaminophen, dextromethorphan, guaifenesin, and phenylephrine <> Methergine (Methylergonovine Injection)
Relevance: 04.09.2022 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 methylergonovine together with phenylephrine is generally not recommended. Methylergonovine may cause significant increases in blood pressure by constricting the blood vessels, and the risk for complications may be increased when used with other drugs that also have this effect such as decongestants, stimulants, and certain medications for headache, glaucoma, or eye redness relief. Combining these medications may also reduce blood flow to vital organs and increase the risk of rare but serious side effects such as heart attack, stroke, intestinal problems, and gangrene (death of tissues, usually in the arm or leg, that may require surgical amputation). Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. You should seek immediate medical attention if you experience severe abdominal pain, nausea, vomiting, numbness or tingling, muscle pain or weakness, blue or purple discoloration of fingers or toes, pale or cold skin, chest pain or tightness, severe or throbbing headache, irregular heartbeat, shortness of breath, blurred vision, confusion, and/or slurred speech during treatment with these 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:

GENERALLY AVOID: Additive or synergistic increases in blood pressure and/or ischemic response may occur when ergot alkaloids are combined with peripheral or central vasoconstrictors. Ergot alkaloids produce arterial vasoconstriction by stimulating alpha-adrenergic and serotonin receptors and inhibiting endothelial-derived relaxation factor release. There have been isolated case reports of gangrene in patients treated with intravenous ergonovine followed shortly by dopamine or norepinephrine.

MANAGEMENT: Ergot alkaloids should generally not be administered in combination with other vasoconstrictive agents. If concomitant use is required, patients should be monitored for excessive vasoconstriction and have vital signs measured regularly. Patients should also be advised to seek immediate medical attention if they experience potential symptoms of ischemia such as coldness, pallor, cyanosis, numbness, tingling, or pain in the extremities; muscle weakness; severe or worsening headache; visual disturbances; severe abdominal pain; chest pain; and shortness of breath.

References
  • "Product Information. Bellergal-S (ergotamine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  • Buchanan N, Cane RD, Miller M "Symmetrical gangrene of the extremities associated with the use of dopamine subsequent to ergometrine administration." Intensive Care Med 3 (1977): 55-6
  • "Product Information. D.H.E. 45 (dihydroergotamine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  • "Product Information. ProAmatine (midodrine)." Roberts Pharmaceutical Corporation, Eatontown, NJ.
  • Chuang SS "Finger ischemia secondary to the synergistic agonist effect of norepinephrine and ergonovine and in a burn patient." Burns 29 (2003): 92-4
  • Barthel W, Glusa E, Koth W "Interactions of dihydroergotamine with etilefrine in human leg veins in vitro and in situ." Int J Clin Pharmacol Ther Toxicol 25 (1987): 63-9
Acetaminophen, dextromethorphan, guaifenesin, and phenylephrine

Generic Name: acetaminophen / dextromethorphan / guaifenesin / phenylephrine

Brand name: DayQuil Severe Cold & Flu, Delsym Cough Plus Cold Day Time, Mucinex Children's Cold, Cough & Sore Throat, Mucinex Fast-Max Severe Cold, Sudafed PE Cold & Cough, Tylenol Cold & Flu Severe, Tylenol Cold Multi-Symptom Severe, Mucinex Sinus-Max, Sudafed PE Cold/Cough, Tylenol Cold Head Congestion, Tylenol Cold Multi Symptom, Tylenol Cold/Flu Severe, Vicks DayQuil Severe Cold/Flu

Synonyms: n.a.

Methergine (Methylergonovine Injection)

Generic Name: methylergonovine

Brand name: Methergine

Synonyms: Methergine (oral and injection), Methergine

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.