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Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine Caps & Tabs and Sympazan

Determining the interaction of Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine Caps & Tabs and Sympazan and the possibility of their joint administration.

Check result:
Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine Caps & Tabs <> Sympazan
Relevance: 10.12.2022 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:

CloBAZam 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 you experience increased side effects or your condition changes. 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: Coadministration with clobazam may increase the plasma concentrations of drugs that are primarily metabolized by CYP450 2D6. The mechanism is decreased clearance due to inhibition of CYP450 2D6 activity by clobazam. In an in vivo phenotypic cocktail drug-drug interaction study consisting of 18 subjects, dextromethorphan peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 59% and 90%, respectively, when a single dose of the CYP probe substrate cocktail containing dextromethorphan (CYP450 2D6 substrate), midazolam (CYP450 3A4 substrate), caffeine (CYP450 1A2 substrate), and tolbutamide (CYP450 2C9 substrate) was administered with repeated once-daily doses of clobazam 40 mg.

MANAGEMENT: Caution is advised if clobazam must be used concomitantly with medications that undergo metabolism by CYP450 2D6, particularly those with a narrow therapeutic range. Dosage adjustments as well as clinical and laboratory monitoring may be appropriate for some drugs whenever clobazam is added to or withdrawn from therapy.

References
  • Walzer M, Bekersky I, Blum RA, Tolbert D "Pharmacokinetic drug interactions between clobazam and drugs metabolized by cytochrome P450 isoenzymes." Pharmacotherapy 32 (2012): 340-53
  • "Product Information. Onfi (clobazam)." Lundbeck Inc, Deerfield, IL.
Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine Caps & Tabs

Generic Name: acetaminophen / dextromethorphan / guaifenesin / pseudoephedrine

Brand name: Duraflu, Robitussin Cold Cough and Flu, Theraflu Max-D Severe Cold & Flu, Sudafed Cold and Cough Liquicaps, Theraflu Chest and Cough, Tylenol Cold Severe Congestion Non-Drowsy, Sudafed Sinus and Cold Liquicaps, Phlemgesic, Maxiflu DM, Flutabs, Tylenol Cold Severe Congestion

Synonyms: Acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine

Sympazan

Generic Name: clobazam

Brand name: Onfi, Sympazan

Synonyms: n.a.

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.