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Guanadrel and Mardrops-EX

Determining the interaction of Guanadrel and Mardrops-EX and the possibility of their joint administration.

Check result:

Guanadrel <> Mardrops-EX

Relevance: 01.08.2022 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 guanadrel together with pseudoephedrine may alter the effects of both medications. Specifically, pseudoephedrine can reduce the effects of guanadrel in treating high blood pressure, while its own effects may be increased or decreased. 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. 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: Sympathomimetic amines may decrease the hypotensive effect of postganglionic adrenergic blocking agents, while the latter may potentiate the pharmacologic effects of direct-acting sympathomimetic amines (e.g., dobutamine, epinephrine, methoxamine, norepinephrine) but inhibit those that are primarily indirect-acting (e.g., mephentermine). Postganglionic adrenergic blocking agents such as guanadrel, guanethidine, and rauwolfia alkaloids work by depleting catecholamine stores from adrenergic nerve endings. Therefore, they may sensitize adrenergic receptors to direct-acting sympathomimetics, but blunt the effects of indirect-acting agents whose activity is mediated through the release of catecholamines. Guanethidine and reserpine have been reported to attenuate the pharmacologic effects (mydriasis, pressor response) induced by ephedrine and dopamine, both of which exhibit direct and indirect sympathomimetic activities (i.e., mixed-acting). However, guanethidine intensified the mydriasis produced by phenylephrine, which is also thought to be mixed-acting. Conversely, ephedrine has been shown to partially reverse the hypotensive effect of guanethidine.

MANAGEMENT: Due to their pressor effect, sympathomimetic amines should be used cautiously in patients with hypertension. Alternatives to postganglionic adrenergic blocking agents should be considered if patients are treated with sympathomimetic amines, since effects of the latter may be intensified or diminished depending on whether they are direct- or indirect-acting. Most agents with indirect sympathomimetic activity are mixed-acting, thus it may be difficult to predict how they will be affected by postganglionic adrenergic blocking agents. If the combination is used, blood pressure and heart rate should be monitored.

References

Gulati OD, Dave BT, Gokhale SD, Shah KM "Antagonism of adrenergic neuron blockade in hypertensive subjects." Clin Pharmacol Ther 7 (1966): 510-4
Muelheims GH, Entrup RW, Paiewonsky D, Mierzwiak DS "Increased sensitivity of the heart to catecholamine-induced arrhythmias following guanethidine." Clin Pharmacol Ther 6 (1965): 757-62
Sherman GP, Walton CA "Adrenergic transmission and drug interaction." J Am Pharm Assoc 15 (1975): 86-90
Sneddon JM, Turner P "Ephedrine mydriasis in hypertension and the response to treatment." Clin Pharmacol Ther 10 (1969): 64-71
Ziegler CH, Lovette JB "Operative complications after therapy with reserpine and reserpine compounds." JAMA 176 (1961): 114-7
Spiers AS, Calne DB "Action of dopamine on the human iris." Br Med J 4 (1969): 333-5
Burn JH, Rand MJ "The action of sympathomimetic amines in animals treated with reserpine." J Physiol (Lond) 144 (1958): 314-36
Hardman JG, Gilman AG, Limbird LE eds. "Goodman and Gilman's the Pharmacological Basis of Therapeutics. 9th ed." New York, NY: McGraw-Hill (1995):

Guanadrel

Generic Name: guanadrel

Brand name:

Synonyms: Guanadrel (Oral)

What is Guanadrel?

Mardrops-EX

Generic Name: guaifenesin / pseudoephedrine

Brand name: Mardrops-EX, Triaminic Chest/Nasal, Ambifed-G, Despec-SR, Entex T, Maxifed, Mucinex D, Mucinex D Max Strength, Poly-Vent IR, Respaire-30, Robitussin Severe Congestion, Sinutab Non Drying, Triaminic Softchews Chest Congestion, Tusnel Pediatric Drops, Entex PSE, Zephrex LA, Guaimax-D, Anatuss LA, Touro LA, Medent, Fenex-PSE, Nalex, Syn-Rx, Rymed, Respaire-60 SR, Nasabid, G-Phed, Respaire-120 SR, Guaibid D, Guaifed, Nalex Jr, G-Phed- PD, Sinufed Timecelles, Versacaps, Guaivent PD, Guaibid D Pediatric, Guaifed-PD, Pseudocot-G, Zephrex, Nasatab LA, Eudal SR, Medent LD, Sudal 60/500, Maxifed-G, Tuss-LA, Stamoist E, V-Dec-M, Deconsal LA, D-Feda II, Guaifenex PSE 60, Demibid II, Guiadrine II, Iosal II, Guiatex II, Guiadrine II SR, Defen-LA, Respa-1st, Decongest II, Desal II, Deco-D, GP 500, Guaifed-PSE, Pan-Mist LA, Abletex-PSE, Guiadrine PSE 120, Duratuss, Guai-Vent/PSE, Guaifenex PSE 120, Hi Tex PSE, Guiatex PSE, Guai Sudo, Guaipax PSE, Iotex PSE, Ami-Tex PSE, Pseudo-G/PSI, Zaptec PSE, Ru Tuss DE, Robitussin PE, Guaifenex RX, Guaitab, Biotuss PE, Guiatuss PE, Mastussin PE, Mytussin PE, Q-Tussin PE, Robichem PE, T-Tussin PE, Tusscidin PE, Tussin PE, Sinufed, Venbid TR, Degen II, Pseudoephedrine-GuaiFENesin, Robafen PE, Guaivent, Altarussin PE, S-Pack, Sudafed Non Drying Sinus, Congestac, Uni Tussin PE, Humibid GC, Med-RX, Nasabid SR, Panmist LA, Panmist JR, H 9600 SR, Pseudovent, Pseudovent Ped, Duratuss GP, Aquatab D, Guaifenex GP, Dynex, Profen II, Profen Forte, Durasal II, Miraphen PSE, Guiadrine PSE, Guiatex II SR, We Mist LA, Triaminic Chest Congestion, Coldmist, Aquatab D Dose Pack, Drituss GP, We Mist II LA, Panmist-S, Pseudo GG, Coldmist LA, Coldmist Jr, Sudal SR, Pseudo Max, Pseudovent 400, Levall G, Guaifenex PSE 80, Pseudatex, Touro LA-LD, Guaifenex PSE 85, Poly-Vent, Jr, Nomuc-PE, Ambi 60/580, Ambi 80/780, Ambi 60/1000, Pseudo GG TR, Ru-Tuss Jr, ExeFen, SudaTex-G, Medent-LDI, Ambifed, Tenar PSE, ExeFen-IR, Mucus Relief D

Synonyms: n.a.

What is Mardrops-EX?

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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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