Lorcaserin and Mucinex DM Maximum Strength

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.

Talk to your doctor before using lorcaserin together with dextromethorphan. Combining these medications can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should contact your doctor immediately if you experience these symptoms while taking the 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.

MONITOR CLOSELY: Concomitant use of lorcaserin with agents that possess or enhance serotonergic activity such as selective serotonin reuptake inhibitors (SSRIs), selective serotonin-norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs), 5-HT1 receptor agonists (triptans), ergot alkaloids, phenylpiperidine opioids, bupropion, dextromethorphan, linezolid, lithium, St. John's wort, tramadol, and tryptophan may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Although lorcaserin is primarily a serotonin 2C receptor agonist, the safety of concomitant use with other serotonergic agents has not been established. In lorcaserin clinical trials, patients receiving SSRIs, SNRIs, MAOIs, TCAs and bupropion were excluded, but use of triptans and dextromethorphan was permitted. According to the manufacturer, exposure to triptans and dextromethorphan occurred in 2% and 15%, respectively, of patients without diabetes and 1% and 12%, respectively, of patients with type 2 diabetes. Two patients treated with lorcaserin experienced a constellation of signs and symptoms consistent with serotonergic excess, including one patient on concomitant dextromethorphan who reported an event of serotonin syndrome. Some symptoms of possible serotonergic etiology that are included in the criteria for serotonin syndrome were reported by patients treated with lorcaserin and placebo during clinical trials of at least one year duration. In both groups, chills were the most frequent of these events (1.0% vs. 0.2), followed by tremor (0.3% vs 0.2%), confusional state (0.2% vs. less than 0.1%), disorientation (0.1% vs. 0.1%), and hyperhidrosis (0.1% vs. 0.2%). Because serotonin syndrome has a very low incidence, an association with lorcaserin cannot be ruled out.

MONITOR CLOSELY: Coadministration with lorcaserin may increase the plasma concentrations of drugs that are primarily metabolized by CYP450 2D6, including many antidepressants (e.g., SSRIs, TCAs, trazodone), dextromethorphan, and tramadol. The mechanism is decreased clearance due to inhibition of CYP450 2D6 activity by lorcaserin. In a study consisting of 21 CYP450 2D6 extensive metabolizers, administration of the probe substrate dextromethorphan in combination with lorcaserin 10 mg twice daily for 4 days increased dextromethorphan peak concentrations (Cmax) by approximately 76% and systemic exposure (AUC) by approximately 2-fold. A dosage adjustment may be necessary for CYP450 2D6 substrates following the initiation or discontinuation of lorcaserin.

MANAGEMENT: Caution is advised if lorcaserin must be used in combination with other agents that affect the serotonergic neurotransmitter system. Patients should be closely monitored for symptoms of the serotonin syndrome, which may include mental status changes such as irritability, altered consciousness, confusion, hallucinations, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea. Particular caution is advised when initiating or increasing the dosages of these agents. The potential risk for serotonin syndrome should be considered even when administering serotonergic agents sequentially, as some agents may demonstrate a prolonged elimination half-life. For example, a 5-week washout period is typically recommended following use of fluoxetine and 2 weeks following use of MAOIs before administering another serotonergic agent. If serotonin syndrome develops or is suspected during the course of therapy, all serotonergic agents should be discontinued immediately and supportive care rendered as necessary. Moderately ill patients may also benefit from the administration of a serotonin antagonist (e.g., cyproheptadine, chlorpromazine). Severe cases should be managed under consultation with a toxicologist and may require sedation, neuromuscular paralysis, intubation, and mechanical ventilation in addition to the other measures.

Lorcaserin

Generic Name: lorcaserin

Brand name: Belviq, Belviq XR

Synonyms: n.a.

What is Lorcaserin?

Mucinex DM Maximum Strength

Generic Name: dextromethorphan / guaifenesin

Brand name: Aquatab DM, Broncotron, Coricidin HBP Chest Congestion & Cough, DayQuil Mucus Control DM, Delsym Cough Plus Chest Congestion DM, Fenesin DM IR, G-Zyncof, Mucinex DM, Phlemex, Robitussin Cough + Chest Congestion DM, Safetussin DM, Siltussin DM, TabTussin DM, Tussin DM, Zyncof, Bidex-A, Guaifenex DM, Biospec DMX, Robitussin DM, Mucinex Cough Mini-Melts, Tussi-Organidin DM-S NR, Tussi-Organidin DM NR, Gani-Tuss-DM NR, Guaibid DM, Muco-Fen DM, Guiadrine DM, Fenex-DM, Iobid DM, Q-Bid DM, Aquabid DM, Touro DM, Respa-DM, Mucobid DM, Fenesin DM, Humibid DM Pediatric, Iofen-DM NF, Phanatuss, Naldecon Senior DX, Guiatussin-DM, Halotussin DM, Guiatuss DM, Halotussin DM Sugar Free, Rhinosyn-DMX, Tuss-DM, Kolephrin GG/DM, Cheracol D Cough, Genatuss DM, Glycotuss-DM, Mytussin DM, Tolu-Sed DM, Benylin Expectorant, Vicks 44E Pediatric, Guiacough DM, Lotussin DM, Anti-Tuss DM, Biotuss DM, Cheracol-D, GG/DM, Mastussin DM, Recofen D, Recofen Plus, Ri-Tussin DM, Robafen DM, Robichem DM, T-Tussin DM, Tusscidin DM, Bidex-DM, Diabetic Suppressant, Duraganidin, G Bid DM, GG-DM SR, Humigen DM, Tussidin DM, Altarussin DM, Amibid DM, Guiat Clear DM, Cough Formula-DM, Double-Tussin DM, Guaiasorb Cough Medicine, Kita La Tos, Q-Tussin DM, Scot-Tussin DM, Nalspan Senior DX, Diabetic Tuss DM, Vicks 44E, Scot-Tussin Senior, Naldecon DX Liquigel, Safetussin 30 DM, Duratuss DM, Guiatuss Clear, Iophen DM NR, Allfen-DM, S-Pack DM, HT Tuss DM, Monafed DM, Hydro-Tuss DM, Drituss DM, Liquibid-D LA, Guaifen DM, Maxi-Tuss DM, Robitussin-SF, Su-Tuss DM, Muco-Fen 800 DM, Guai-Dex, GuaiFENesin DM, GuaiFENesin DM SR, Tussi-Bid, Sudal DM, Iophen DM, Ru-Tuss 800 DM, Mintab DM, Mindal DM, Atuss-12 DX, Z-Cof LA, Extuss LA, DuraDEX, Humibid CS, Diabetic Tuss DM Maximum Strength, Siltussin DM DAS Cough Formula, Simuc-DM, Cofex-DM, Mucus Relief DM, G-Bid DM, Relacon LAX, Ambi 1000/55, Z-Cof LAX, Robafen DM Clear, DuraDEX Forte, Robitussin DM Infant Drops, Zotex DMX, Mucinex Children's Cough, Duratuss DM 12, Robitussin Cough Sugar-Free DM, Dex-Tuss DM, Mucinex DM Maximum Strength, GuaiFENesin DM NR, Children's Mucus Relief Cough, Siltussin-DM DAS-NA, Siltussin-DM DAS-NA Maximum Strength, ExeFen-DM, Bidex-DMI, Mucinex Children's Cough Mini-Melts, Robitussin Cough & Cong, Coricidin HBP Congestion/Cough

Synonyms: n.a.

What is Mucinex DM Maximum Strength?