B-Tuss and Verapamil Injection
Determining the interaction of B-Tuss and Verapamil Injection and the possibility of their joint administration.
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:Verapamil may increase the blood levels of HYDROcodone. This may increase side effects such as drowsiness, dizziness, lightheadedness, difficulty concentrating, and impairment in thinking and judgment. In severe cases, low blood pressure, respiratory distress, fainting, coma, or even death may occur. 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 medical attention if you experience dizziness, fainting, confusion, excessive drowsiness, slow heart rate, and/or shallow or difficult breathing. Do not drink alcohol during treatment with HYDROcodone, and do not use more than the dose prescribed by your doctor. Also, avoid activities requiring mental alertness such as 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. 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 CLOSELY: Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of hydrocodone, which is substantially metabolized by the isoenzyme. Increased hydrocodone concentrations could conceivably increase or prolong adverse drug effects and may cause potentially fatal respiratory depression. Because hydrocodone is also partially metabolized by CYP450 2D6, the magnitude of interaction may be even greater with concomitant use of a CYP450 3A4 and a CYP450 2D6 inhibitor, or concomitant use of a drug that is a dual inhibitor of both isoenzymes.
MANAGEMENT: Extreme caution is advised if hydrocodone is prescribed with CYP450 3A4 inhibitors, particularly potent and moderate inhibitors (e.g., azole antifungal agents, protease inhibitors, aprepitant, ceritinib, ciprofloxacin, chloramphenicol, clarithromycin, cobicistat, conivaptan, crizotinib, delavirdine, diltiazem, dronedarone, erythromycin, fusidic acid, idelalisib, imatinib, letermovir, mibefradil, mifepristone, nefazodone, netupitant, quinupristin-dalfoprisitn, telithromycin, verapamil) or weak inhibitors that also inhibit CYP450 2D6 (e.g., abiraterone, amiodarone, cimetidine, pazopanib, ranolazine). A fatal overdose may occur following the initiation of a CYP450 3A4 inhibitor in patients already receiving hydrocodone. Patients should be closely monitored for signs and symptoms of sedation, respiratory depression, and hypotension. Following discontinuation of the CYP450 3A4 inhibitor, patients should be monitored for reduced efficacy of hydrocodone or development of withdrawal symptoms due to reduced plasma hydrocodone levels.
- Hutchinson MR, Menelaou A, Foster DJ, Coller JK, Somogyi AA "CYP2D6 and CYP3A4 involvement in the primary oxidative metabolism of hydrocodone by human liver microsomes." Br J Clin Pharmacol 57 (2004): 287-97
- "Product Information. Zohydro ER (HYDROcodone)." Zogenix, Inc, San Diego, CA.
Generic Name: chlorpheniramine / hydrocodone / phenylephrine
Brand name: B-Tuss, De-Chlor HC, DroTuss-CP, Hydron CP, Hydro-PC II, Poly-Tussin HD, Relasin-HC, Triant-HC, Z-Cof HC, Poly-Tussin, Endagen-HD, Chemdal HD, Iodal HD, Rindal-HD, Ed-TLC, Efasin-HD, Guiaphen HD, Vanex-HD, Chemdal HD Plus, Nasatuss, Atuss HD, Iotussin HC, Chlorgest HD, Ed-Tuss HC, Cyndal HD, Hyphen-HD, Tuss-PD, KG-Dal HD, Endotuss-HD, Ditussin-HC, Chemtussin HC, Exo-Tuss, Endal-HD Plus, Enplus-HD, Comtussin HC, Tuss-HC, Ventuss Syrup, Maxi-Tuss SA, Maxi-Tuss HC, Histinex HC, KG-Dal HD Plus, Highland HC, Uni Tuss HC, H-C Tussive, Histussin-HC, Cytuss HC, Tuss-DS, Efasin-HD Plus, Quindal HD Plus, Quindal HD, Hi-Tuss HC, Chlorphen HD, Duradal HD, Liquitussin HC Syrup, HYDROcodone CP, HYDROcodone HD, Tussive HC, De-Chlor HD, Atuss MS, Relacon-HC, Hydro-PC II Plus, Uni-Tricof HC, Rindal HD Plus, Echotuss-HC, Phendal-HD, Relacon-HC NR, Tusana-D, Maxi-Tuss HCX, Neo HC, Liquicough HC, Mintuss MS, Coughtuss
Synonyms: n.a.
Generic Name: verapamil
Brand name: Calan, Isoptin SR, Verelan, Isoptin, Calan SR, Isoptin IV, Covera-HS, Verelan PM
Synonyms: Verapamil
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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