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Silphen Cough and Zyprexa

Determining the interaction of Silphen Cough and Zyprexa and the possibility of their joint administration.

Check result:
Silphen Cough <> Zyprexa
Relevance: 19.05.2022 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:

Before using OLANZapine, tell your doctor if you are also on diphenhydrAMINE. You may need dose adjustments or special tests in order to safely use both medications together. You should notify your doctor if you have signs of bladder problems, dry mouth, stomach pain, fever, blurred vision, confusion, dizziness, or reduced heart rate. You should avoid driving until you know how these medications will affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using your medications without first talking to your doctor first.

Professional:

MONITOR: Centrally-acting anticholinergic agents may antagonize the therapeutic effects of neuroleptic agents. Although these drugs have been used together clinically, the possibility of increased risk of adverse effects such as central nervous system depression and tardive dyskinesia should also be considered. In addition, excessive anticholinergic effects may occur in combination use, which can result in paralytic ileus, hyperthermia, heat stroke, and the anticholinergic intoxication syndrome. Peripheral symptoms of anticholinergic intoxication commonly include mydriasis, blurred vision, flushed face, fever, dry skin and mucous membranes, tachycardia, urinary retention, and constipation. Central symptoms may include memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures. In hot weather, the risk of hyperthermia and heat stroke should be considered, as neuroleptic agents can interfere with temperature regulation in the hypothalamus while anticholinergic agents tend to inhibit peripheral sweating mechanisms.

MANAGEMENT: Caution is advised if anticholinergic agents are used with neuroleptic agents, particularly in the elderly and those with underlying organic brain disease, who tend to be more sensitive to the central anticholinergic effects of these drugs and in whom toxicity symptoms may be easily overlooked. Prophylactic administration of anticholinergic agents is sometimes given clinically during neuroleptic therapy for drug-induced parkinsonism or extrapyramidal symptoms but may not always be appropriate. Patients prescribed this combination should be advised to notify their physician promptly if they experience potential symptoms of anticholinergic intoxication such as abdominal pain, fever, heat intolerance, blurred vision, confusion, and hallucinations. Ambulatory patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them. A dosage reduction in one or both drugs may be necessary if excessive adverse effects develop. During hot weather, patients should avoid prolonged sun exposure and intense physical exertion and maintain adequate fluid intake.

References
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  • Rockland L, Cooper T, Schwartz F, Weber D, Sullivan T "Effects of trihexyphenidyl on plasma chlorpromazine in young schizophrenics." Can J Psychiatry 35 (1990): 604-7
  • Zelman S, Guillan R "Heat stroke in phenothiazine-treated patients: a report of three fatalities." Am J Psychiatry 126 (1970): 1787-90
  • Kulik AV, Wilbur R "Delirium and stereotypy from anticholinergic antiparkinson drugs." Prog Neuropsychopharmacol Biol Psychiatry 6 (1982): 75-82
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  • "Product Information. Cogentin (benztropine)." Merck & Co, Inc, West Point, PA.
  • Kwok JS, Chan TY "Recurrent heat-related illnesses during antipsychotic treatment." Ann Pharmacother 39 (2005): 1940-2
  • Hansen LB, Elley J, Christensen TR, Larsen NE, Naestoft J, Hvidberg EF "Plasma levels of perphenazine and its major metabolites during simultaneous treatment with anticholinergic drugs." Br J Clin Pharmacol 7 (1979): 75-80
  • Sarnquist F, Larson CP Jr "Drug-induced heat stroke." Anesthesiology 39 (1973): 348-50
  • Forester D "Fatal drug-induced heat stroke." JACEP 7 (1978): 243-4
  • "Product Information. Artane (trihexyphenidyl)." Lederle Laboratories, Wayne, NJ.
  • Singh MM, Kay SR "Therapeutic antagonism between anticholinergic antiparkinsonism agents and neuroleptics in schizophrenia: implications for a neuropharmacological model." Neuropsychobiology 5 (1979): 74-86
  • Stadnyk AN, Glezos JD "Drug-induced heat stroke." Can Med Assoc J 128 (1983): 957-9
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  • Rivera-Calimlim L, Nasrallah H, Strauss J, Lasagna L "Clinical response and plasma levels: effect of dose, dosage schedules, and drug interactions on plasma chlorpromazine levels." Am J Psychiatry 133 (1976): 646-52
  • Warnes H, Lehmann HE, Ban TA "Adynamic ileus during psychoactive medication: a report of three fatal and five severe cases." Can Med Assoc J 96 (1967): 1112-3
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  • Lee BS "Possibility of hyperpyrexia with antipsychotic and anticholinergic drugs." J Clin Psychiatry 47 (1986): 571
Silphen Cough

Generic Name: diphenhydramine

Brand name: Allergy Relief, Allermax, Banophen, Benadryl, Compoz Nighttime Sleep Aid, Diphedryl, Diphenhist, Dytuss, Nytol QuickCaps, PediaCare Children's Allergy, Q-Dryl, QlearQuil Nightitme Allergy Relief, Quenalin, Scot-Tussin Allergy Relief Formula, Siladryl Allergy, Silphen Cough, Simply Sleep, Sleepinal, Sominex, Tranquil, Twilite, Unisom Sleepgels Maximum Strength, Valu-Dryl, Vanamine PD, Z-Sleep, ZzzQuil, plus many others, Benadryl Allergy, Complete Allergy, Nytol, Unisom SleepMelts

Synonyms: n.a.

Zyprexa

Generic Name: olanzapine

Brand name: Zyprexa, Zyprexa Zydis, Zyprexa Intramuscular, Zyprexa Relprevv

Synonyms: n.a.

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.

Interaction with food and lifestyle
Disease interaction