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Theraflu Warming Relief Nighttime Severe Cold and Thioridazine

Determining the interaction of Theraflu Warming Relief Nighttime Severe Cold and Thioridazine and the possibility of their joint administration.

Check result:
Theraflu Warming Relief Nighttime Severe Cold <> Thioridazine
Relevance: 27.07.2022 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 thioridazine together with diphenhydrAMINE is not recommended. Combining these medications may increase the blood levels of thioridazine to dangerous levels and cause an irregular heart rhythm that may be serious and potentially life-threatening. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with thioridazine. 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:

CONTRAINDICATED: Coadministration with inhibitors of CYP450 2D6 may increase the plasma concentrations of thioridazine and its two active metabolites, mesoridazine and sulforidazine, all of which are substrates of the isoenzyme. Significant increases (up to severalfold) have been observed during coadministration with fluvoxamine, propranolol, and pindolol in pharmacokinetic studies. The use of thioridazine has been associated with dose-related prolongation of the QT interval, thus elevated plasma levels of the drug may potentiate the risk of ventricular arrhythmias such as ventricular tachycardia and torsade de pointes as well as cardiac arrest and sudden death. Several cases of torsade de pointes have been reported.

MANAGEMENT: The use of thioridazine with drugs that inhibit CYP450 2D6 is considered contraindicated. Depending on the elimination half-life of these drugs, a considerable waiting period may be appropriate following their discontinuation before thioridazine is initiated. For example, the manufacturer of fluoxetine recommends that thioridazine not be administered within 5 weeks after discontinuing fluoxetine because of the drug's long half-life.

References
  • Greendyke RM, Gulya A "Effect of pindolol administration on serum levels of thioridazine, haloperidol, phenytoin, and phenobarbital." J Clin Psychiatry 49 (1988): 105-7
  • Carrillo JA, Ramos SI, Herraiz AG, Llerena A, Agundez JAG, Berecz R, Duran M, Benitez J "Pharmacokinetic interaction of fluvoxamine and thioridazine in schizophrenic patients." J Clin Psychopharmacol 19 (1999): 494-9
  • Glassman AH, Bigger JT Jr "Antipsychotic drugs: prolonged QTc interval, torsade de pointes, and sudden death." Am J Psychiatry 158 (2001): 1774-82
  • Abernethy DR, Greenblatt DJ, Steel K, Shader RI "Impairment of hepatic drug oxidation by propoxyphene." Ann Intern Med 97 (1982): 223-4
  • Fletcher GF, Kazamias TM "Cardiotoxic effects of Mellaril: conduction disturbances and supraventricular arrhythmias." Am Heart J 78 (1969): 135-8
  • "Product Information. Prozac (fluoxetine)." Dista Products Company, Indianapolis, IN.
  • Markowitz JS, Wells BG, Carson WH "Interactions between antipsychotic and antihypertensive drugs." Ann Pharmacother 29 (1995): 603-9
  • "Product Information. Mellaril (thioridazine)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
  • Silver JM, Yudofsky SC, Kogan M, Katz BL "Elevation of thioridazine plasma levels by propranolol." Am J Psychiatry 143 (1986): 1290-2
  • Hartigan-Go K, Bateman DN, Nyberg G, Martensson E, Thomas SHL "Concentration-related pharmacodynamic effects of thioridazine and its metabolites in humans." Clin Pharmacol Ther 60 (1996): 543-53
  • Greendyke RM, Kanter DR "Plasma propranolol levels and their effect on plasma thioridazine and haloperidol concentrations." J Clin Psychopharmacol 7 (1987): 178-82
  • Thomas M, Maconochie JG, Fletcher E "The dilemma of the prolonged QT interval in early drug studies." Br J Clin Pharmacol 41 (1996): 77-81
Theraflu Warming Relief Nighttime Severe Cold

Generic Name: acetaminophen / diphenhydramine / phenylephrine

Brand name: Theraflu Warming Relief Nighttime Severe Cold, Benadryl Allergy & Sinus Headache, Delsym Cough Plus Cold Night Time, Mucinex Fast-Max Night Time Cold and Flu, Robitussin Nighttime Multi-Symptom Cold, Sudafed PE Severe Cold, Theraflu Severe Cold & Cough Nighttime, Theraflu Warming Flu & Sore Throat, Theraflu Warming Sinus & Cold, Theraflu Warming Severe Cold Nighttime, Benadryl Allergy & Cold, Sudafed PE Nighttime Cold, Tylenol Allergy Multi-Symptom Nighttime, Theraflu Nighttime Severe Cough & Cold, Children's Delsym Cough Plus Cold Night Time, Children's Mucinex Night Multi-Symp Cold, Children's Dimetapp Multi-Symptom Cold & Flu, Theraflu ExpressMax Nighttime Severe C&C, Theraflu PowerPods Nighttime Severe Cold, Benadryl Allergy/Cold, Tylenol Allergy Multi-Symptom

Synonyms: n.a.

Thioridazine

Generic Name: thioridazine

Brand name: Mellaril, Mellaril-S

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.