Acetaminophen, diphenhydramine, and phenylephrine and Rexulti

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.

DiphenhydrAMINE may increase the blood levels of brexpiprazole. This can increase side effects such as drowsiness, seizure, Parkinson-like symptoms, abnormal muscle movements, and low blood pressure. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if you experience agitation, aggression, confusion, convulsions, muscle spasm, or movements that you can't stop or control such as lip smacking, chewing, puckering, frowning or scowling, tongue thrusting, teeth clenching, jaw twitching, blinking, eye rolling, shaking or jerking of arms and legs, tremor, jitteriness, restlessness, pacing, and foot tapping. Also be alert to symptoms of low blood pressure such as dizziness, lightheadedness, fainting, and/or increased pulse or heart rate. Avoid driving or operating hazardous machinery until you know how these medications affect you, and use caution when getting up from a sitting or lying position, especially at the beginning of treatment or after an increase in dose of brexpiprazole. 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.

ADJUST DOSE: Coadministration with inhibitors of CYP450 3A4 and/or 2D6 may significantly increase the plasma concentrations of brexpiprazole, which is metabolized by these isoenzymes. According to product labeling, administration of brexpiprazole with a potent 3A4 inhibitor (ketoconazole) or a potent 2D6 inhibitor (quinidine) resulted in an approximately 2-fold increase in AUC.
The combination of brexpiprazole plus potent CYP450 3A4 inhibitors in poor 2D6 metabolizers is expected to result in a 4.8-fold increase in AUC. The combination of brexpiprazole plus potent CYP450 3A4 inhibitors plus potent CYP450 2D6 inhibitors in extensive 2D6 metabolizers is expected to result in a 5.1 increase in AUC.

MANAGEMENT: The manufacturer recommends that the brexpiprazole dosage be reduced as follows during concomitant administration of CYP450 inhibitors. The brexpiprazole dosage should be increased to the original level if these agents are discontinued. It is advisable to monitor patients for clinical response.

- Potent 3A4 inhibitor: One-half of the usual dose.
- Potent or moderate 3A4 inhibitor in known poor 2D6 metabolizers: One-fourth of the usual dose.
- Potent 2D6 inhibitor: One-half of the usual dose. No dosage adjustments are required for patients with major depressive disorder.
- Potent or moderate 3A4 inhibitor plus potent or moderate 2D6 inhibitor: One-fourth of the usual dose.

Potent CYP450 3A4 inhibitors: antiviral boosters, boceprevir, ceritinib, clarithromycin, conivaptan, delavirdine, idelalisib, indinavir, itraconazole, ketoconazole, nefazodone, nelfinavir, posaconazole, saquinavir, telaprevir, telithromycin, voriconazole.

Moderate CYP450 3A4 inhibitors: aprepitant, atazanavir, ciprofloxacin, clotrimazole, crizotinib, dalfopristin, darunavir, diltiazem, dronedarone, erythromycin, fluconazole, fosamprenavir, fosaprepitant, imatinib, isavuconazonium, mifepristone, netupitant, nilotinib, ranolazine, stiripentol, verapamil.

Potent CYP450 2D6 inhibitors: bupropion, cinacalcet, fluoxetine, methotrimeprazine, paroxetine, quinidine, ritonavir.

Moderate CYP450 2D6 inhibitors: abiraterone, celecoxib, cimetidine, clobazam, darifenacin, diphenhydramine, duloxetine, eliglustat, lorcaserin, mirabegron, panobinostat, ranolazine, sertraline, stiripentol.

Acetaminophen, diphenhydramine, and phenylephrine

Generic Name: acetaminophen / diphenhydramine / phenylephrine

Brand name: Benadryl Allergy & Sinus Headache, Delsym Cough Plus Cold Night Time, Mucinex Fast-Max Night Time Cold and Flu, Robitussin Nighttime Multi-Symptom Cold, Sudafed PE Severe Cold, Theraflu Severe Cold & Cough Nighttime, Theraflu Warming Flu & Sore Throat, Theraflu Warming Sinus & Cold, Theraflu Warming Severe Cold Nighttime, Benadryl Allergy & Cold, Sudafed PE Nighttime Cold, Tylenol Allergy Multi-Symptom Nighttime, Theraflu Nighttime Severe Cough & Cold, Children's Delsym Cough Plus Cold Night Time, Children's Mucinex Night Multi-Symp Cold, Children's Dimetapp Multi-Symptom Cold & Flu, Theraflu ExpressMax Nighttime Severe C&C, Theraflu PowerPods Nighttime Severe Cold, Benadryl Allergy/Cold, Tylenol Allergy Multi-Symptom, Theraflu Warming Relief Nighttime Severe Cold

Synonyms: n.a.

What is Acetaminophen, diphenhydramine, and phenylephrine?

Rexulti

Generic Name: brexpiprazole

Brand name: Rexulti

Synonyms: n.a.

What is Rexulti?