C-Topical Solution and Phenylephrine and promethazine
Determining the interaction of C-Topical Solution and Phenylephrine and promethazine 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:Using phenylephrine together with cocaine topical may occasionally cause irregular heart rhythm that can be life-threatening. Close monitoring by the doctor may be required 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: Concomitant use of cocaine with sympathomimetic agents such as epinephrine and phenylephrine may lead to additive cardiovascular effects. The proposed mechanism involves increased circulating catecholamines and increased activity of the sympathetic nervous system. Locally administered cocaine and epinephrine have been used in combination during septal surgery; however, concerns regarding cardiovascular side effects have been raised. Myocardial ischemia, myocardial infarction, and ventricular arrhythmias have been reported following coadministration of topical intranasal cocaine with epinephrine and phenylephrine during nasal and sinus surgery. Cases documenting the development of arrhythmias after the nasal application of cocaine and epinephrine 25%-0.18% topical paste have also been reported in 2 children and one adult receiving general anesthesia. However, the dosage of cocaine administered in these cases was above the maximum recommended dose in fit adults (1.5 mg/kg).
MANAGEMENT: Concomitant use of cocaine with sympathomimetic agents should be avoided. If coadministration is required, prolonged vital sign and ECG monitoring may be necessary.
- Thevasagyam M, Jindal M, Allsop P, Oates J "Does epinephrine infiltration in septoplasty make any difference?" Eur Arch Otorhinolaryngol 264 (2007): 1175-8
- "Product Information. Cocaine Hydrochloride (cocaine topical)." Mallinckrodt Medical Inc, St. Louis, MO.
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Kara CO, Kaftan A, Atalay H, Pinar HS, Ogmen G "Cardiovascular safety of cocaine anaesthesia in the presence of adrenaline during septal surger." J Otolaryngol 30 (2001): 145-8
- "Product Information. Adrenalin Chloride Solution (epinephrine)." Parke-Davis, Morris Plains, NJ.
- Nicholson K, Rogers J "Cocaine and adrenaline paste: a fatal combination?" Br Med J 311 (1995): 250-1
- "Product Information. Cocaine Hydrochloride Nasal (cocaine nasal)." Genus Lifesciences Inc., Allentown, PA.
Generic Name: cocaine topical
Brand name: C-Topical, Goprelto
Synonyms: C-Topical
Generic Name: phenylephrine / promethazine
Brand name: Phenergan VC, Promethazine VC Plain, Promethazine VC
Synonyms: Promethazine and Phenylephrine
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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